My urologist in Australia has the qualifications FRCS, FRACS. That's as high up the medical tree as one can get. He's also one of the nicest people I have ever met, Malaysian Chinese.
Every time he performs a cystoscopy on me, "obstructive prostate" appears on the post-op report.
I have been on finasteride or dutasteride for about 8 years, for BPH. I pee about 2-3 times a night.
I asked him if having a TURP would be a preferred option. He said in his experience, 90% of TURP patients develop one or more complications. It did not matter what ablation procedure was used.
His advice was to stick with the medication for as long as possible, and regard surgery as a last resort. This is a surgeon who makes over a quarter of a million dollars a year from surgery.
My only annoying side effect of finasteride/dutasteride is a significant reduction in libido.