Hi @amgracing1. Glad to see you're on the move -- so much better than "hanging tough," going nowhere, and relying on hope. My main response now: Delay making any down-the-road decisions until after a good talk with your new urologist. Put a half-dozen strategic questions to him and see what develops from his answers. After that, you could think about things for a few days and -- if you are concerned about a firm plan for next steps -- ask him about helping you get a second opinion from a urologist that isn't on staff in his joint practice. Isn't that likely, given that Ohio State University's medical expertise is also located in Columbus? You could ask him about satisfied customers, but medical privacy laws and rules get in the way on that -- he may not have permission from former patients to reveal their medical information to you. It seems to me that you're more likely to get patient input from Mayo Connect where members control whether they "undress" their private information. One way to do that is to post a new, challenging appeal for input from Connect members on the issues that concern you most. As to doing it "again every few years," I understand your concern, but I am dealing with that as follows: My TURP and TURB ten years ago were readily tolerated, and I'm not very concerned about undergoing it again. That may be necessary in the days ahead. Like you, I'll be investigating whether HoLEP is a good alternative to a TURP. Incidentally, I dropped off of Tamsulosin (Flomax) several years ago because of its minimal impact and its potential for harm after several years of uninterrupted use.