It is the question I am asked most often in clinic when I suggest an operation, and it is a reasonable one. Most men who reach this point have been taking tablets for years, have got used to getting up two or three times every night and have put it down to getting older.
The short answer: an operation is considered when the problem is no longer just a nuisance and has started to have consequences, or when medication no longer gives you what you need.
The long answer is this article.
After a HoLEP, most of the questions I get are about the days that follow rather than the operation itself: how long will the catheter stay in, why am I still seeing blood, when can I get back to normal, and what is normal and what is not.
This guide answers those questions. It does not replace the specific instructions you are given when you leave hospital (every patient and every prostate is different), but it will help you know what to expect and when something needs checking.