What is the primary treatment for severe symptomatic benign prostatic hyperplasia?

The primary treatment for severe symptomatic benign prostatic hyperplasia (BPH) is indeed transurethral resection of the prostate (TURP). This surgical procedure involves the removal of a portion of the prostate gland that is causing obstruction of the urethra. TURP is often recommended for patients who experience significant symptoms that affect their quality of life and are not responding adequately to medical management.

This intervention effectively relieves urinary obstruction, improves urinary flow, and alleviates symptoms associated with BPH, such as frequent urination, urgency, and nocturia. The procedure is typically performed under anesthesia, and patients can often expect significant improvements in their symptoms following recovery.

In contrast, watchful waiting may be suitable for patients with mild symptoms who are not experiencing significant bothersome effects from BPH. Medications can also be helpful, particularly in managing symptoms, but they may not provide sufficient relief for individuals with severe symptoms. External beam radiation therapy is generally not a standard treatment for BPH and is more commonly associated with prostate cancer management.