When a patient does not respond to medications, or in cases where drug treatment is not appropriate, there are several outpatient procedures available to treat benign prostatic hyperplasia, or BPH. These treatments include:

Transurethral Needle Ablation
This procedure delivers low-level radio frequency energy to destroy excess prostate tissue. A device called a cystoscope is inserted through the urethra to the prostate. Small needles are passed through the end of the cystoscope into the prostate. The needles send radio frequency energy that heats and destroys portions of prostate tissue. Shields protect the urethra from heat damage.

Transurethral Microwave Thermotherapy
In transurethral microwave thermotherapy, a catheter is inserted through the urethra to the prostate, and an instrument called an antenna sends microwaves through the catheter. The microwaves heat the portions of the prostate in order to destroy some of the excess tissue. Cooling fluid is circulated around the microwave antenna to prevent heat from damaging the rest of the urinary tract.

High-intensity Focused Ultrasound
During this procedure, a special ultrasound probe is inserted into the rectum, near the prostate. Ultrasound waves from the probe heat and destroy enlarged prostate tissue.

Water-induced Thermotherapy
This treatment uses a special catheter to treat urinary symptoms of BPH. The catheter uses hot water circulated through an inflated treatment balloon to heat the inside of the prostate, destroying adjacent tissue.

Transurethral Electrovaporization
This procedure uses an electric current to vaporize excess prostate tissue. A tubelike instrument called a resectoscope is inserted through the urethra to the prostate. An electrode attached to the resectoscope moves across the surface of the prostate and transmits an electric current that vaporizes prostate tissue. The vaporizing effect penetrates below the surface area being treated and seals blood vessels, which reduces the risk of bleeding.

Prostatic Stent Insertion
During this procedure, a small device called a prostatic stent is inserted through the urethra to the area narrowed by the enlarged prostate. The stent expands like a spring and pushes back the prostate tissue, which widens the urethra. Stents may be temporary or permanent. They are generally used in men who may not tolerate or be suitable for other procedures.

*Two procedures called prostate lift (prostatic urethral lift) and convective radiofrequency water vapor thermal therapy are emerging techniques in treating BPH.