BPH Treatment Comparison
This side-by-side guide compares available therapies based on effectiveness, invasiveness, recovery time, and impact on daily life, to help you make an informed decision.
|
TREATMENT/ |
MEDICATION (ALPHA-BLOCKERS) |
TURP |
HOLEP |
REZUM |
ITIND |
OPTILUME |
|---|---|---|---|---|---|---|
|
METHOD/TECHNOLOGY |
Oral medications that relax prostate muscles or shrink prostate tissue |
Surgical resection of prostate tissue |
Laser procedure that removes obstructing prostate tissue |
Steam ablation therapy that reduces prostate tissue over time |
Temporary nitinol implant that reshapes the urethra |
Drug-coated balloon dilation to widen the prostatic urethra |
|
HOSPITAL STAY |
Outpatient |
1-2 days |
1 day |
Outpatient |
Outpatient |
Outpatient |
|
ANESTHESIA |
None required |
General or spinal |
General or spinal |
Local or mild sedation |
Local or mild sedation |
Local or mild sedation |
|
DURATION |
Continuous treatment |
1-2 hours |
1.5-2.5 hours |
5-10 minutes |
5-7 minutes |
10-15 minutes |
|
COVERED BY OHIP |
Yes |
Yes |
Yes |
No |
No |
No |
|
RECOVERY TIME |
2-6 weeks for symptom relief |
2-6 weeks |
2-3 weeks |
2-6 weeks |
1-2 weeks |
1-3 weeks |
|
NEED FOR CATHETER |
No |
Yes, 3-7 days |
Yes, 1-2 days |
Yes, 2-7 days |
No |
Yes, 2 days |
|
PRESERVES SEXUAL FUNCTION |
Often lost¹ |
~70-86%² |
~85-95%⁴ |
~98-100%; no de novo ED⁶ |
~98-100%; no de novo ED⁹ |
~98-100%; no de novo ED¹¹ |
|
PRESERVES EJACULATION |
Often lost¹ |
~27-35%³ |
~10-40%⁴ |
~97%⁷ |
Yes¹⁰ |
~98-100%¹¹ |
|
SYMPTOM RELIEF DURATION |
Varies with use¹ |
10-15 years³ |
4-10 years⁵ |
95% free of retreatment at 5 years⁸ |
5+ years, 11% retreatment |
3-5 years¹² |
¹ D. Singh et al., 2025. Benign Prostatic Hyperplasia and Sexual Dysfunction.
² Taher A. Erectile dysfunction after transurethral resection of the prostate: incidence and risk factors. World J Urol. 2004;22(6):457-460. doi:10.1007/s00345-004-0449-1.
³ Rassweiler J, Teber D, Kuntz R, Hofmann R. Complications of transurethral resection of the prostate (TURP)—incidence, management, and prevention. Eur Urol. 2006;50(5):969-979.
⁴ Li P, Wang C, Tang M, Han P, Meng X. Holmium laser enucleation of prostate by using en-bloc and bladder neck preservation technique: technical consideration and influence on functional outcomes. Transl Androl Urol. 2021;10(1):134-142. doi:10.21037/tau-20-852.
⁵ Fallara G, Capogrosso P, Schifano N, et al. Ten-year follow-up results after Holmium laser enucleation of the prostate: durable relief of urinary symptoms in almost 75% of patients. Eur Urol Focus. 2021;7(3):612-617. doi:10.1016/j.euf.2020.05.012 PubMed
⁶ McVary KT, Rogers T, Roehrborn CG. Rezūm water vapor thermal therapy for lower urinary tract symptoms secondary to benign prostatic hyperplasia: 5-year results from randomized controlled study. J Urol. 2021;206(3):715-724. doi:10.1097/JU.0000000000001778.
⁷ Connor MJ, Sturch P, Barber NJ. Preservation of sexual function following convective water vapor energy ablation of the prostate: real-world outcomes. J Urol. 2021;206(Suppl 3):e9-e10. doi:10.1097/JU.0000000000002062.
⁸ McVary KT, Roehrborn CG. Three- and 5-year outcomes of water vapor thermal therapy for benign prostatic hyperplasia. J Urol. 2018;200(2):405-413. Updated 5-year data in: J Urol. 2021;206(3):715-724. doi:10.1097/JU.0000000000001778.
⁹ De Nunzio C, Cantiello F, Fiori C, et al. Urinary and sexual function after treatment with temporary implantable nitinol device (iTind) in men with LUTS: 6-month interim results of the MT-06-study. World J Urol. 2021;39(6):2037-2042. doi:10.1007/s00345-020-03418-2.
¹⁰ Chughtai B, Elterman D, Shore N, et al. The iTind temporarily implanted nitinol device for the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia: a multicenter, randomized, controlled trial. Urology. 2020;S0090-4295(20)31520-X. doi:10.1016/j.urology.2020.12.022.
¹¹ Kaplan SA, Moss J, Freedman S, et al. The PINNACLE study: a double-blind, randomized, sham-controlled study evaluating the Optilume BPH catheter system for the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia. J Urol. 2023;210(1):109-119. doi:10.1097/JU.0000000000003568.
¹² Kaplan SA, Pichardo M, Rijo E, Espino G, Rodriguez Lay R, Estrella R. Long-term outcomes after treatment with Optilume BPH: four-year results from the EVEREST study. Can Urol Assoc J. 2024;18(11):E319-E325. doi:10.5489/cuaj.8737.