Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA Guideline (2026) Part III: Procedural/Surgical Management

PURPOSE: Procedural therapies for lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH) are expansive and are associated with distinct risks and benefits. This Guideline covers the treatment of LUTS/BPH. The summary presented herein represents Part III of the three-part series addressing procedural/surgical management of LUTS/BPH. Please refer to Parts I and II for additional information on this topic. MATERIALS AND METHODS: The systematic review that informs this Guideline was based on searches in Ovid MEDLINE, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews through January 2025. Update searches were conducted on December 15, 2025. Literature searches were limited to studies of medical therapies published since 2009 and surgical studies published since 2014. The searches were supplemented by reviewing electronic database reference lists of relevant articles. Criteria for inclusion and exclusion of studies were based on the Key Questions and the populations, interventions, comparators, outcomes, timing, types of studies and settings (PICOTS) of interest developed by the Panel. RESULTS: Guideline statements herein address general procedural principles and management of LUTS/BPH. Evidence- and consensus-based statements were developed to assist clinicians considering procedural interventions based on individual patient characteristics. Additional sections addressing sexual function, retreatment rates, and postoperative follow-up were included to support patient counseling and procedural selection. CONCLUSIONS: Procedural management of LUTS/BPH involves a complex balance between efficacy, durability, and procedure-specific adverse effects. Shared decision-making is essential to tailor therapy to the individual patient.