@albiet as someone who had a large median lobe and both the PAE and the Aquablation i would recommend skip right to the aquablation or do both in quick succession like I did. That large median lobe is damaging your bladder and the longer you wait the more permanent the damage and more likely the post procedure urgency and frequency. My results were good but they might have even been better had I acted a few years earlier. If you're concerned about the recovery I thought the PAE was worse than the Aquablation other than i had to have a catheter for 24 hours, but both were relatively painless. I think with the large median lobe you're eventually going to have a more invasive procedure. The PAE might work for a little while depending on your prostate size. I had a lousy Urologist who never even did cystoscopy and just put me on meds, the best thing that happened to me was when he retired and my new Uro did the required test, showed me I had a large median lobe and told me other less invasive methods wouldn't work. Lots of people have better or worse experiences, but delaying was a mistake for me. I also allowed myself to delay because I was scared of pain, retrograde ejaculation or loss of sexual function- all groundless fears.