I hope the poster sees this comment. I have/had BPH and Gleason 6 (3+3) prostate cancer. My treatments have been handled by Mayo Clinic Rochester and my local urologist working together. I struggled with the decision of treating the BPH first, given that I might have to treat the prostate cancer later (50/50 chance). The Mayo Clinic made the decision crystal clear. They told me that they treat the BPH before the prostate surgery anyway as part of their best practices. So, I needed to get the BPH treated first.

I just finished TURP with my local urologist. Why TURP? In my case, a cystoscopy revealed that the median lobe of the prostate was causing the blockage, not the general narrowing of the prostate area. So, the urologist felt that a median lobe TURP would be the least invasive procedure. Given what he's seen with patients on complications from various prostate treatments, he felt pursuing the least invasive option was very important to preserve all future prostate cancer treatment options. Mayo felt this was a reasonable approach. Mayo felt Holep would still be okay as a treatment instead of TURP, but felt TURP was fine too.

HoLep takes more prostate material than TURP. My urologist felt taking that much material was overkill for my issue. He also performs aquablation, but didn't want to do aquablation because he said the water jets leave a rough surface and he would have to smooth it out with the same tool that is used in TURP. So, he felt TURP was the best option. I'm about 8 weeks from surgery and so far I'm fine. I researched the heck out of every BPH treatment. If I had to treat the whole prostate instead of just the median lobe, I probably would have done aquablation or HoLep. But for my situation, TURP seemed to be a very good choice. The urologist I chose had done thousands of TURP procedures as well. So, I felt that would reduce the odds of complications. The day I had my surgery done, he had 6 TURP procedures scheduled. I was the first.