Procedures
BPH Treatment Procedures — Educational Overview
A neutral, side-by-side overview of the procedures most commonly used to treat moderate-to-severe BPH today.
Procedure selection depends on prostate size and shape (especially the presence of a median lobe), symptom severity, response to medication, sexual-function priorities, anticoagulation status, anesthesia tolerance, and patient preference. There is no single "best" procedure — only the best procedure for an individual patient. Always discuss in consultation with a urologist.
Minimally invasive office-based therapies
Rezum (Water Vapor Thermal Therapy)
Sterile water vapor is injected into prostate tissue, causing targeted necrosis that the body reabsorbs over 3 months. Best for prostates ≤80 g. Outpatient. Preserves ejaculation in most patients. Catheter typically 3–7 days.
UroLift (Prostatic Urethral Lift)
Permanent implants pull lateral prostate lobes away from the urethra. No tissue removed. No thermal injury. Best for prostates ≤80 g without a significant median lobe. Rapid recovery, preserves sexual function in nearly all patients.
Prostate Artery Embolization (PAE)
Performed by interventional radiology. Small particles block prostatic arteries, causing tissue shrinkage. Option for patients on anticoagulation or with very large prostates who cannot tolerate surgical anesthesia.
Endoscopic surgical procedures
TURP (Transurethral Resection of the Prostate)
Long-standing gold standard. Prostate tissue is resected through a scope passed via the urethra. Excellent durable symptom relief. Higher rate of retrograde ejaculation than minimally invasive options. Typical for moderate-sized prostates (30–80 g).
HoLEP (Holmium Laser Enucleation of the Prostate)
Size-independent laser enucleation that removes the entire transition zone. Excellent durability. Steep learning curve for surgeons. Considered by AUA as a preferred option for very large prostates.
PVP / GreenLight Laser Vaporization
Photoselective vaporization of the prostate. Good hemostasis, useful for anticoagulated patients. Often selected for smaller-to-moderate prostates.
Open / robotic surgery
Robotic-assisted Simple Prostatectomy
Minimally invasive removal of the inner prostate for very large glands (>100 g). Reserved for cases where endoscopic enucleation is not feasible.
How to compare
See our comparison guides: TURP vs Rezum, UroLift vs Rezum, and the full BPH Treatment Options Guide.