It is important to understand where the blockage is occurring. If it is only the median lobe causing the issue then TURP might be a superior alternative to HoLep or Aquablation. HoLep takes much more prostate material than a limited TURP of the median lobe, unless you find a surgeon who does HoLep of just the median lobe. But even then, HoLep could be overkill as compared to a relatively simple TURP procedure. The TURP of the median lobe only requires a catheter for a day and has a very fast recovery. In addition, because you are left with much more prostate material, the eventual treatment for prostate cancer may not have the complications that you might have if you had done HoLep. If the person has Gleason 6 they have a 50/50 chance of eventually needing treatment for the cancer. In that scenario, doing as little as possible to the prostate can make sense, so that future treatment complications can be minimized. So TURP is still a very effective procedure, as Dr Schultz points out in his videos. Finally, to do HoLep correctly requires significant surgeon skill. There is a limited supply of these doctors.