You might look into aquablation.

I am a 76 year old male. I've had 3 PAES. One in 2014 another one in 2017 and another one in 2023. That is how long they lasted. My prostate I went from 160 to 138 On the last PAE. It was done by Dr Bagula in northern Virginia. He is the one that's done the most in the country. The last one didn't Reduce it enough . And I still have problems urinating. He said he would do it again but there was about a 20% chance it may work. He suggested an aquablation,
I had them done then because there was nothing else At that time to have but a turp which I didn't want. So it gave me 10 years to the next best thing came out being the aqua. So I can talk as a person who's been through the trenches From three paees to the aquabilation. The after effects for the PAE were just burning urination for three days and that was it. I had my aqua ablation 10 weeks ago. I'm able to urinate with no problem but I have frequency urgency and burning every time I pee.
Up 4 and five times a night. Two weeks after my Paes I was getting up between one and 2x a night I've had For weak ejaculations Out of 25 orgasms.
My dr keeps telling me it can take up to 6 months for this to go away hopefully it will. I was on Flomax and proscar for two months before the aqua surgery because of difficulty in urination.
That gave me reverse ejaculations. The orgasms were just as strong. I felt like I was ejaculating but I didn't. The drugs had horrible side effects and I was taken off them immediately after the aqua surgery. So I'm glad I did the PAES I wish the last one didn't fail. I hope the aqua problems will cure themselves in the next few months as my doctor said. But the PAE was only a week at the most of burning. So I would take a pae any day Before an aqua. So anyone who has any questions about Paes just let me know