I looked back at other comments and would also like to comment on picking the "right" BPH procedure. There are many choices and they can be quite overwhelming. The menu of appropriate BPH options differs for each man based on prostate size, degree of symptoms, bladder strength/weakness and risk tolerance for sexual sides effects or urinary leakage. The earlier a man chooses to treat his BPH, the more likely he will qualify for all options. The most effective and durable BPH option involves enucleation of the prostate. If one imagines a prostate as an orange, enucleation removes everything except the rind creating a verly large channel to urinate through (surgical treatment for prostate cancer on the other hand removes everything including the rind which causes more side effects affecting stuff stuck to the rind). A patient with a very weak bladder (which can be assessed with tests) or a very large prostate (typically > 100-130 grams) should undergo enucleation. Enucleation can be done through an incision or an operating urethral scope. Because enucleation is so effective at removing tissue - most men will experience some sexual side effects. Thus, men who opt for rezum or other approaches opt to sacrifice potential efficacy and durability of the procedure for decreased risk of unwanted side effects.

Best

Dr Kohler