I’m at a crossroads with BPH. Alpha blockers make me cough incessantly and are losing effectiveness. Do any members have experience with either procedure ?

Aquablation for the win. I do anesthesia on these cases regularly. Less pain. Faster recovery

Wow!This is the most definitive answer I have received even from my urologist.
I talked with a HoLEP specialists and ,of course , he promotes that procedure because it removes more tissues etc. he’s a great guy with a 1000 operations under his belt .
My regular urologist is an aquablation man and he thinks awuablstion. More controlled removal near the bladder and sphincter . Less sexual damage ( I’m 75 but still kicking ) more bleeding however.
My main concerns : strictures, blood clots causing urinary retention, and incontinence.
Can you shed any light on your observations of these things?
I really appreciate this reply. I’ve read about 100 articles and studies and never can get a grip on which is better.

Gonna watch this fully. I recently diagnosed with low risk prostate cancer. Level 1 of 1-5. Doc says tamsulsin and monitoring. Doc described the roto rooter thing but said lets get another exam later. I turn 76 this month

A good friend just had a robotic prostate removal due to similar cancer diagnosis . Once out they discovered it was a more aggressive cancer . He has had no problems whatsoever.. No sexual side effects other than RE. I wanted mine removed like he did but doctor will not do a removal without cancer diagnosis. So I have to have a minimally invasive procedure. I believe this is what he had.
https://www.google.com/search?...=en-us&client=safari

I had a HoLEP.

I recovered quickly, and everything works normally.

No strictures, No urinary retention, and No incontinence.

Retrograde ejaculation is a common side effect. If you get it, you will not have any more kids.

I did a lot of research, and a lot depends on the size of your prostate.

Every surgeon had his favorite procedure.

When I had mine, HoLEP was not as common as it is now.

4 surgeons, 4 different opinions.

Each procedure has different risks and likely outcomes.

New technologies are coming out all the time.

Do your research, talk to several surgeons.

There may be something better than either of those procedures, depending on the size of your prostate.

Great responses. Thank you. I have about a 60 . I had the PAE but it didn’t help . I have a large median lobe protruding into bladder a little.
The HoLEP was really great for you. I may just have to close my eyes and pick one out of a hat. The more I read, the harder the choice.

My coworker had aquablation, and it changed his life overnight. He can't say enough good things about it.

https://www.tgh.org/about-tgh/tgh-in-the-palm-beaches

go here and watch the video on prostate to the right, that is my coworker in the video.

Thank you very much. This is great .