Procedures for BPH

[CTguy]

I’ve been dealing with BPH for several years now, have been taking tamsulosin for several years, however, my symptoms are getting worse and I am considering various procedures for treating BPH.  Who out there has had any of the treatments done like TURP, laser, aquablation, Optilume or any of the other treatments that are out there? What has been your experience both good and bad?

[+ SirBillybob]

56 minutes ago, CTguy said:

I’ve been dealing with BPH for several years now, have been taking tamsulosin for several years, however, my symptoms are getting worse and I am considering various procedures for treating BPH.  Who out there has had any of the treatments done like TURP, laser, aquablation, Optilume or any of the other treatments that are out there? What has been your experience both good and bad?

I have well controlled BPH with prostate / bladder MRI q2years, obviously for surveillance not intervention.

No intervention. But I follow BPH Canada as Zorn and team are very oriented to comprehensive consumer info. Plenty of reels. Instagram bphcanada. 

If you happen to have all or most of your PSA lab values historically, I can probably compute its upswing velocity over time, produce a graph; it does have some meaning as a component of assessment, but I do hope you have considered MRI to get a PI-RADS score if your practitioner is on board with it.

Maybe you’ve gone the further step of biopsy. IDK.

I also think you will get a lot more info on other men’s experiences with intervention as described in the associated literature. Personally, I don’t place much value on chatroom anecdote, empathic though it may be. YMMV. 

Edited August 25 by SirBillybob

[CTguy]

1 hour ago, SirBillybob said:

I have well controlled BPH with prostate / bladder MRI q2years, obviously for surveillance not intervention.

No intervention. But I follow BPH Canada as Zorn and team are very oriented to comprehensive consumer info. Plenty of reels. Instagram bphcanada. 

If you happen to have all or most of your PSA lab values historically, I can probably compute its upswing velocity over time, produce a graph; it does have some meaning as a component of assessment, but I do hope you have considered MRI to get a PI-RADS score if your practitioner is on board with it.

Maybe you’ve gone the further step of biopsy. IDK.

I also think you will get a lot more info on other men’s experiences with intervention as described in the associated literature. Personally, I don’t place much value on chatroom anecdote, empathic though it may be. YMMV. 

I have never had an MRI.  My PSA values have always been < 1 , around .6  My Provider has never mentioned getting an MRI. I’ve seen a lot of literature/videos about different BPH procedures, both Pro and Con.  I would like to hear what experiences people had with their BPH procedure.
 

 

[+ SirBillybob]

44 minutes ago, CTguy said:

I have never had an MRI.  My PSA values have always been < 1 , around .6  My Provider has never mentioned getting an MRI. I’ve seen a lot of literature/videos about different BPH procedures, both Pro and Con.  I would like to hear what experiences people had with their BPH procedure.

That’s good, except for the worsening symptoms. A separate track than the clinical thinking that directs my specialist’s surveillance playbook.  

BPH does not necessarily correlate with other prostate problems but you understandably want additional input, to calibrate the pros-and-cons of various BPH intervention measures against others’ lived experience.

With so many options, decision synthesis gets more and more complex. Good on you for being thorough. Carry on. 

Edited August 25 by SirBillybob

[Rockey]

I had greenlight (laser) surgery. I was on silodosin before but didn't like it. So I went for the surgery after declining urolift (recommended by the urologist.) It was an outpatient procedure. I was sent home with a cath that I took out the next night. Recovery was manageable but lengthy (around 3 months.) I pee like a 17 year old now, but did end up with a dry orgasm (80% chance of that side effect.) Don't mind it though. No ed problems and no mess. Win win.

[CTguy]

27 minutes ago, Rockey said:

I had greenlight (laser) surgery. I was on silodosin before but didn't like it. So I went for the surgery after declining urolift (recommended by the urologist.) It was an outpatient procedure. I was sent home with a cath that I took out the next night. Recovery was manageable but lengthy (around 3 months.) I pee like a 17 year old now, but did end up with a dry orgasm (80% chance of that side effect.) Don't mind it though. No ed problems and no mess. Win win.

What does the catheter feel like?

[Rockey]

It feels like a narrow tube shoved down the piss hole all the way into the bladder. Not painful. It’s a lot longer than you’d think. 

[+ SirBillybob]

46 minutes ago, Rockey said:

It feels like a narrow tube shoved down the piss hole all the way into the bladder. Not painful. It’s a lot longer than you’d think. 

Show off.😏

[TJnDB]

I had Urolift and it was marginally successful and symptoms returned in a year.  Then I had PAE Prostate Artery Embolization and that worked for about two years.  I had Aquablation about two years ago and is was a simple procedure for me. Spent the night in the hospital while they continually flushed my bladder and prostate, catheter came out the next day.  Out of the three, Aquablation was best for me. Talk to your Urologist, everyone is different. 

[AndyDandy]

On 8/26/2026 at 5:00 PM, Rockey said:

I had greenlight (laser) surgery. I was on silodosin before but didn't like it. So I went for the surgery after declining urolift (recommended by the urologist.) It was an outpatient procedure. I was sent home with a cath that I took out the next night. Recovery was manageable but lengthy (around 3 months.) I pee like a 17 year old now, but did end up with a dry orgasm (80% chance of that side effect.) Don't mind it though. No ed problems and no mess. Win win.

Curious, why did you decline the Urolift?

[Rockey]

9 hours ago, AndyDandy said:

Curious, why did you decline the Urolift?

I didn't like the idea of having clips installed inside me. I thought, what if they move or dislodge? Probably an irrational scenario, but it influenced my decision. Greenlight (a type of TURP) surgery felt like more of a permanent solution.  It's a tough decision for anyone with BPH. Urologists recommend different treatments. I'm hoping that I made  the right decision for myself. One and done. No meds.