There are absolute and relative indications for proceeding on to enlarged prostate treatments of a surgical nature. The absolute indications are where there have been complications from the disease. These include acute urinary retention, the formation of bladder stones, development of a bladder diverticulum (this is an acquired pocket that develops in the bladder lining as a result of long standing obstruction), recurrent urinary tract infections, and persistent prostatic bleeding that has been shown to originate purely from the prostate.
There are other newer state of the art modalities which achieve the same goal, but use a different energy sources to remove the overgrown prostatic tissue, and thereby creating a larger channel and reduce the obstruction caused by an overgrown prostate. These newer modalities include GreenLight Laser prostatectomy.