Decision guide
Am I a Candidate for BPH Surgery?
A patient-friendly walkthrough of the indications, contraindications, and pre-surgical workup for BPH procedures.
You may be a candidate if you have
- Bothersome LUTS (IPSS ≥ 8) despite adequately trialed medications
- One or more episodes of acute urinary retention
- Recurrent urinary tract infections caused by incomplete emptying
- Bladder stones
- Persistent or gross hematuria attributed to BPH (after cancer ruled out)
- Renal insufficiency from obstruction
- Medication intolerance — side effects you cannot live with
Relative contraindications
- Active urinary tract infection (treat first)
- Untreated bleeding disorder
- Severe cardiopulmonary disease limiting anesthesia options (consider PAE)
- Suspected prostate cancer not yet evaluated
Pre-surgical workup
- Urinalysis and urine culture
- Updated PSA
- Uroflow and post-void residual
- Prostate volume by TRUS
- Cystoscopy if hematuria, prior urethral trauma, or stricture history
- Anesthesia consult for high-risk patients
- Medication review — anticoagulants, alpha-blockers, GLP-1s
What to expect at consultation
A qualified urologist should discuss at least 2–3 procedure alternatives, your specific anatomy, expected sexual side effects, expected recovery, and their personal complication rates.
Educational content only. Not medical advice. Verify all credentials, licensing, accreditation, and procedure information directly with providers. Sources: Mayo Clinic, Urology Care Foundation, AUA, Cleveland Clinic, NIDDK, AAFP.