BPH Treatments Compared — UroLift vs Rezum vs TURP vs HoLEP vs Aquablation

Five BPH procedures are available in Busan. The key decision factor for most foreign patients is ejaculation preservation. UroLift and Aquablation lead on this metric. TURP remains the benchmark for symptom relief and retreatment durability in large prostates.

Factor	Aquablation	UroLift	Rezum	TURP	HoLEP
Ejaculation preserved	~90%	100%	~92%	~36%	~50%
Anaesthesia	General	Local/sedation	Local/sedation	Spinal/general	Spinal/general
Prostate size range	30–150mL	≤80mL	30–80mL	Any	Any
Hospital stay	1 night	Day surgery	Day surgery	1–2 nights	1–2 nights
Catheter duration	~1 day	0–1 day	2–3 days	5–7 days	1–2 days
Min. Busan stay	7–10 days	4–5 days	4–5 days	8–10 days	8–10 days
Busan USD (all-in)	$4,800–$6,200	$4,200–$5,400	$3,900–$5,000	$3,200–$4,200	$4,000–$5,200
10yr retreatment risk	~5–8%	~13–20% at 5 years	10–15%	5–7%	2–4%
Available in Busan	Seomyeon L only	All 5 clinics	All 5 clinics	All 5 clinics	All 5 clinics

Aquablation WATER RCT data: Gilling et al., European Urology 2019. UroLift LIFT trial data. Retreatment rates from published 5-year follow-up studies. Busan pricing from clinic-published tariffs mid-2025.

Questions

Which BPH procedure is best for preserving ejaculation?

UroLift is the only procedure that preserves ejaculation in 100% of patients, but is limited to prostate ≤80mL without significant median lobe. Aquablation preserves ejaculation in ~90% and handles more complex anatomy. If ejaculation is a priority and prostate is ≤80mL without median lobe: UroLift first. Larger or complex anatomy: Aquablation.

Which BPH procedure has the best long-term durability?

HoLEP has the lowest retreatment rate at 10 years (2–4%). TURP is comparable at 5–7%. UroLift has the highest retreatment risk (~13–20% at 5 years at 5 years). HoLEP or TURP for patients who want the most durable single procedure. Aquablation long-term data: ~5–8% at 5 years (still accumulating).

Is Aquablation available at all Busan urology clinics?

No. Aquablation requires PROCEPT BioRobotics certification. As of 2025, only Seomyeon L Urology (14F Busan Lotte Hotel) is certified in Busan.

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How to Choose Between BPH Procedures — A Decision Framework

The BPH procedure comparison table above covers 5 major procedures. Most foreign patients are choosing between 2–3 options based on their prostate size, ejaculation priority, and acceptable Busan stay duration. The following framework covers the most common decision scenarios.

Scenario 1: Sexually Active, Prostate ≤80mL, No Median Lobe

Primary recommendation: UroLift. Ejaculation preserved in 100% of patients. Day surgery. Minimum 4–5 days in Busan. USD $4,200–$5,400. If retreatment risk concerns you (~13–20% at 5 years at 5 years): consider Aquablation (90–90% ejaculation preserved, lower retreatment risk, but requires 7–10 days in Busan and is only available at Seomyeon L Urology).

Scenario 2: Sexually Active, Prostate 80–150mL or Median Lobe Present

Primary recommendation: Aquablation (if staying 7–10 days in Busan is acceptable). 90–90% ejaculation preserved, handles complex anatomy including median lobe. Only available at Seomyeon L Urology. If Aquablation is not accessible: Rezum for 30–80mL with median lobe. TURP or HoLEP for larger prostates.

Scenario 3: Ejaculation Not a Concern, Maximum Durability Desired

Primary recommendation: HoLEP. Lowest retreatment rate at 10 years (2–4%). Handles any prostate size. Requires 8–10 days in Busan. USD $4,000–$5,200. TURP is comparable in durability at 5–7% 10-year retreatment and costs slightly less ($3,200–$4,200) — appropriate for very large prostates.

Scenario 4: Minimum Busan Stay Required

UroLift or Rezum: 4–5 days minimum. Both are day procedures with fast catheter removal (0–3 days) and early flight clearance. For the shortest Busan stay combined with ejaculation preservation, UroLift is the optimal choice.