A large number of treatments have been proposed for BPH. Each comes with its own advantages and disadvantages. Over time as more data accrues, some procedures gain further acceptance and some fall into lower utilization.
Regardless of the method of treatment, the clinical objectives of treatment are the same; to provide significant reduction in urinary symptoms that last a lifetime, while minimizing side-effects, reducing the recovery period and controlling the risks of major complications. Other criteria used by doctors include; ease of use and speed of delivery, safety and cost-effectiveness.
The risk of major complications occurring from BPH therapy is relatively minimal. However it is important to understand what can go wrong so that you can make an informed decision in selecting your therapy. Probably the most serious complication would result from damage to the sphincter muscle that controls urine retention. If the external sphincter is damaged, incontinence (the inability to more or less control urine flow) is possible. Damage to the internal sphincter (or bladderneck sphincter) can make urine control somewhat more difficult but will also result in retrograde ejaculation. This means that the semen, or ejaculate goes into the bladder instead of out the penis. The importance of this side-effect varies widely from patient to patient depending on their lifestyle and other factors. This side effect can be particularly important to men wishing to later father children.
Lesser side-effects which can occur include; discomfort during and after the procedure, urinary tract infection (often related to the creation of necrotic tissue), urethral stricture (generally caused by trauma caused to the urethra from larger-gauge transurethral instruments), long post-operative catheterization period (generally accompanying those procedures which rely on ablation rather than resection or tissue vaporization thereby removing it immediately. Bleeding, sloughing of necrosed tissue and burning sensation during urination are other side-effects that can accompany BPH treatment.