Many thanks for the replies, and thanks to Firepole for the information on Prostatic Artery Embolization. I will ask my Urologist about this. I have done a reasonable amount of research- I use Google Scholar so that I can access research articles- sometimes using a University Library for access to databases like ProQuest.
Incidentally, like Teelack suggests, it is not always possible to have these new surgeries in Australia / New Zealand, and the cost can be high. A newspaper article in 2016 suggested the cost of PAE was around $6,000. This compares to $0 for a TURP under public health.
Duodart (a combination drug of dutasteride and tamsulosin hydrochloride is commonly used in Australia to treat BPH, as the Dustasteride works to shrink the prostate, and Duodart is available here on PBS, costing just over $5. I have not taken Duodart, because besides its cheapness and ability to reduce the symptoms of BPH, Dustasteride has some nasty side effects, particularly related to loss of sexual function and depression.
There are numerous articles on Dustasteride, including Adverse Effects and The Dark Side.
TURP is still regarded as the “golden standard” in treatment, but once surgery is done, there is no going back.
One of my colleagues, suffering from BPH, suddenly found he had complete blockage, and required a urinary catheter for some time until the TURP operation was completed. In my reading on PAE, it seems to be more suited to men who currently are prescribed with a catheter.
There are a number of negative side effects to TURP, including the need for a Blood transfusion, presumably due to excessive bleeding. This was given as high as 20% in early studies, but more recent ones suggest it is around 1%, which tallies with what my Urologist said.
It is the effect on sexual function that I am most concerned about.
Poulakis (2006) concluded ”The incidence of postoperative, newly reported ED after TURP was 12 %. Risk factors for its occurrence were diabetes mellitus and intraoperative capsular perforation.” (article PDF)
However, Jaidane in 2010 “We concluded that TURP improved erectile function in HBP patients with severe urinary symptoms. This improvement of erectile function was observed even in case of capsular perforation.” (Jaindane)
There is of course PVP (or GreenLight Laser Surgery). This surgery is quicker, requires less hospital time (1 ½ days vs 3-4 days), quicker recovery time, nil chance of bleeding. Most of the readings on PVP have been positive- except that it is more likely to require repeat surgery in time.
But, nothing is free.
Brookes (2001) in a study that compared TURP with laser surgery, concluded “Compared with laser therapy standard surgery for lower urinary tract symptoms has a beneficial effect on aspects of sexual function—particularly in improving erectile function and reducing reported pain or discomfort on ejaculation. Older men who need treatment and want to retain or improve sexual function may thus want to consider standard surgery rather than non-contact laser therapy.”
I do not have any medical training, and initially found that reading Medical Research Articles was difficult, but by constantly looking up the meaning of the different terms and acronyms that they used, it became easier, and I believe I am now in a much better position to have an informed discussion with my Urologist.
As a result of my readings, I will “most likely” opt for the TURP operation.