Told you need TURP?
Read this first.
TURP earned seventy years as the standard prostate surgery, and it still works. But "you need a TURP" in 2026 deserves one follow-up question: compared to what? Four modern alternatives treat the same blockage, most with less disruption, and Dr. Sawkar offers every one of them, so the comparison below has no agenda except your anatomy.
Medically reviewed by Hari Sawkar, MD, board-certified urologist · Updated August 2026
Why men look for an alternative
TURP means a hospital stay, a catheter, weeks of recovery, and, for roughly two out of three men, permanent retrograde ejaculation. It also carries the bleeding and heat-injury risks of a heated-loop resection. None of that makes it wrong, but every part of it is now optional for most candidates, which is why the question deserves more than a scheduling call.
The four modern alternatives
Ordered roughly from least invasive to most definitive. Every one is typically covered by Medicare and most PPO plans, same as TURP.
PAE: skip the operating room
Prostate artery embolization shrinks the gland through its blood supply. No urethral instruments, no general anesthesia, usually no catheter, any prostate size. The gentlest exit from the TURP conversation.
UroLift: the office quick fix
Implants hold the channel open in an office visit, with the cleanest sexual-function record of any option. Best for small to moderate glands without a big median lobe.
Rezūm: steam, then shrink
Water vapor shrinks the excess tissue over a few months, nothing left behind, in one short office visit. Retreatment at five years is roughly one in twenty.
Aquablation: TURP-grade, function-sparing
The robotic waterjet matched TURP's relief in a randomized trial while preserving ejaculation for most men. Dr. Sawkar has performed more than 250, the most in Orange County.
When TURP, HoLEP, or open surgery is genuinely the right call for your anatomy, you will hear that here too. An honest menu includes them.
Common questions about avoiding TURP
Do I really have to have TURP
Rarely. TURP is a good operation, but in 2026 it is one option among five, not the default. Most men referred for TURP qualify for at least two gentler alternatives, which is exactly what a second-opinion visit with a prostate measurement establishes.
What is the closest alternative to TURP
Aquablation. It removes tissue like TURP does and matched TURP's relief in a randomized trial, while preserving ejaculation for most men. If you want TURP-grade results without TURP's signature side effect, that is the direct swap.
What if I want to avoid surgery entirely
Prostate artery embolization treats the same blockage through a pinhole in the wrist or groin: no general anesthesia, usually no catheter, home the same day. It is the only option here that never touches the urethra.
Will insurance cover these instead of TURP
Typically yes. PAE, UroLift, Rezūm, and Aquablation are all generally covered by Medicare and most PPO and commercial plans when BPH symptoms are documented, the same basis on which TURP is covered. The office verifies your plan before anything is scheduled.
One visit before you book an OR
Bring your records or start fresh; a measured prostate and thirty minutes turn "you need a TURP" into an actual decision. Same-day and next-day appointments, telehealth available, Medicare and most PPO plans accepted.
Chief of Urology, Providence St. Joseph Hospital · UroLift Center of Excellence · 250+ Aquablation procedures