I am 68 and enjoy playing golf. On the golf course I may urinate 12 times, but on most trips only drips or drops come out. Flomax did not help. I also tried a very uncomfortable heat-based prostate treatment and saw palmetto without success.
I now feel surgery may be my only option, but I am worried about losing my sex life, which I still enjoy with my wife. Before surgery, is there anything else I should try, and how long does it take to get back to normal afterward?
Quick Answer
Your symptoms are severe enough that I would recommend a fresh urological evaluation before simply trying more home remedies. Urinating very frequently but producing only drips or drops may indicate significant bladder-outlet obstruction, a high post-void residual, overactive bladder, or even overflow from incomplete bladder emptying.
If medication and a previous minimally invasive treatment have failed, surgery or another procedure may indeed be reasonable—but the best procedure depends on prostate size, anatomy, residual urine, bladder function and how strongly you want to preserve ejaculation.
BPH surgery does not automatically mean losing erections or sexual pleasure. The major sexual trade-off with TURP and HoLEP is usually ejaculation: semen commonly goes backward into the bladder or little/no semen comes out at orgasm. Procedures such as UroLift, Rezūm and, for selected prostates, Aquablation generally have a better chance of preserving antegrade ejaculation.
Recovery varies substantially by procedure. After TURP, ordinary activities often resume over about 2–4 weeks and full healing may take up to 6 weeks. HoLEP patients often feel ready for many normal activities earlier, but golf and other strenuous activity are still usually restricted for a period. Office-based treatments can have shorter activity recovery, although urinary irritation may persist for weeks.
Hello Charles,
The first issue I would address is not your golf schedule or even the surgery itself. It is the description that you may try to urinate a dozen times but mostly produce drips and drops.
That pattern can occur with severe BPH obstruction, but it can also occur when the bladder is not emptying adequately or when an overactive bladder is contracting against obstruction.
Before Surgery, Make Sure You Know What Is Actually Causing the Symptoms
At this stage, I would expect your urologist to consider:
- an International Prostate Symptom Score (IPSS);
- urinalysis;
- post-void residual urine measurement;
- uroflowmetry;
- prostate size and anatomy;
- PSA when appropriate;
- cystoscopy if anatomy or urethral narrowing needs clarification; and
- urodynamic testing when it is unclear whether the main problem is prostate obstruction or weak bladder contraction.
This matters because removing prostate tissue may improve obstruction dramatically, but it will not completely solve symptoms if the bladder itself has become significantly overactive or weak.
Why Flomax May Have Failed
Flomax is the brand name for tamsulosin, an alpha blocker. It relaxes smooth muscle around the prostate and bladder neck but does not remove tissue or substantially shrink the prostate.
If there is marked mechanical obstruction, a very large prostate, a prominent median lobe, urethral narrowing, poor bladder contractility, or severe storage symptoms, tamsulosin alone may not provide enough benefit.
Depending on prostate size and your previous treatment history, a urologist may also consider a 5-alpha-reductase inhibitor or other BPH medication. But with the degree of bother you describe and previous treatment failure, repeatedly cycling through unproven remedies is unlikely to be the best strategy.
What Was the Heat Treatment You Had?
Your description sounds compatible with an older transurethral thermal therapy, possibly microwave thermotherapy or a related technique.
These older treatments were intended to heat obstructing prostate tissue through the urethra. Transurethral microwave thermotherapy is now considered a legacy technology rather than a leading contemporary BPH procedure.
If your previous treatment failed, that does not mean every minimally invasive BPH procedure will fail. Newer procedures work differently and have different trade-offs.
Does Saw Palmetto Deserve Another Trial?
I would not recommend it after the symptoms you describe.
High-quality reviews summarized by the National Center for Complementary and Integrative Health conclude that saw palmetto used alone provides little or no meaningful benefit for BPH symptoms.
It has also not been shown to reliably resolve significant obstruction or prevent urinary retention.
Should You Try Baking Soda or Urinary “Alkalinizers”?
No—not as treatment for BPH or routine urinary symptoms.
The original page recommended drinking sodium bicarbonate mixed with water. I would remove that advice.
Baking soda does not treat prostate obstruction or cure a urinary infection. Repeated ingestion can also deliver a substantial sodium load and may cause electrolyte or acid-base problems, especially in people with hypertension, heart disease, kidney disease or certain medications.
If infection is suspected, obtain appropriate urine testing and use antibiotics only when clinically indicated.
What About Uva Ursi or Rose-Hip Tea?
I would not use these as treatment for severe lower urinary tract symptoms.
They do not remove prostate obstruction and should not delay proper investigation when a patient is passing only small amounts of urine repeatedly.
Does Prostate Massage Shrink BPH?
No.
There is no good evidence that prostate massage or “milking” shrinks benign prostate tissue or reverses bladder-outlet obstruction.
I would remove prostate massage from the BPH-treatment advice on this page.
Is Surgery Really Your Only Option?
Not necessarily, but a procedure may now be reasonable.
Modern BPH treatment provides a spectrum from office-based minimally invasive procedures to more definitive tissue-removing surgery.
| Procedure | Symptom/flow effect | Sexual-function considerations | General recovery trade-off |
|---|---|---|---|
| UroLift / prostatic urethral lift | Improves symptoms and flow, but generally less than TURP. | Very low incidence of new ejaculatory dysfunction; often considered when preserving ejaculation is a major priority. | Usually rapid recovery; higher retreatment likelihood than TURP. |
| Rezūm / water-vapor therapy | Meaningful symptom improvement; objective improvement generally less than TURP. | Erectile and ejaculatory function are usually preserved. | Office/outpatient option; symptoms can temporarily worsen and meaningful improvement may take several weeks to months. |
| Aquablation | Strong symptom and flow improvement, comparable to TURP in selected prostate sizes. | Lower anejaculation risk than TURP in trials; EAU specifically highlights it when ejaculatory preservation is important. | Operating-room procedure rather than a simple office treatment; catheter/hospital recovery is typically short. |
| TURP | Established, strong improvement in obstruction and urinary flow. | Erections are often preserved, but retrograde/dry ejaculation is common. | More recovery time and bleeding/anesthesia burden than office MISTs. |
| HoLEP | Very effective and durable, including for larger prostates. | Erectile function is generally preserved, but dry/retrograde ejaculation is very common. | Endoscopic surgery with relatively rapid functional recovery but still requires healing before strenuous activity. |
If Sex Is Important, Be Very Specific About What You Want to Preserve
Patients often say, “I don’t want surgery to ruin my sex life,” but there are several different functions to consider:
- ability to get and maintain an erection;
- sexual desire;
- ability to reach orgasm;
- ability to ejaculate semen forward; and
- fertility.
These are not the same outcome.
If preserving visible ejaculation is very important to you, tell your urologist explicitly before choosing the procedure.
UroLift: Strongest Focus on Ejaculatory Preservation
The 2026 EAU guideline recommends prostatic urethral lift for appropriately selected men who are particularly interested in preserving ejaculatory function.
The trade-off is durability: symptom and flow improvement are generally less than TURP, and retreatment is more frequent.
Prostate size and anatomy matter. EAU currently recommends PUL particularly for prostates below about 70 mL without an obstructing middle lobe.
Rezūm: Another Lower-Burden Sexual-Preservation Option
Water-vapor therapy can be performed in an office-based setting. Steam is delivered into selected prostate tissue, which gradually shrinks over the following weeks and months.
EAU data show preservation of erectile and ejaculatory function, with antegrade ejaculation preserved in the great majority of men in comparative studies.
The drawback is that you may initially experience more urgency, frequency, burning or catheter use, and the improvement is not immediate.
Aquablation: Worth Discussing if You Want Strong Relief With Better Ejaculation Preservation
Aquablation uses a robotically controlled high-velocity water jet to remove obstructing prostate tissue.
Current EAU evidence shows symptom outcomes similar to TURP for appropriately selected prostates while producing lower rates of anejaculation. Five-year studies have also shown durable results.
This makes Aquablation particularly worth discussing when a man wants stronger obstruction relief than some office-based procedures but considers ejaculatory preservation important.
What About TURP?
TURP remains a highly effective established treatment for prostate obstruction.
It usually improves flow quickly, but postoperative urgency and frequency may take weeks or sometimes a few months to settle because the bladder has adapted to obstruction over time.
The major sexual consideration is retrograde ejaculation. Many men still have erections and orgasms, but semen may no longer come out normally.
What About HoLEP?
HoLEP removes the obstructing adenoma using a laser-enucleation technique and is highly effective across a wide range of prostate sizes.
It is particularly durable. However, if preserving forward ejaculation is one of your highest priorities, standard HoLEP may not be the most attractive choice because dry/retrograde ejaculation is very common.
How Long After BPH Surgery Until You Can Play Golf?
The answer depends heavily on which procedure you choose.
| Procedure | Typical activity recovery | Golf / strenuous exercise | Sexual activity |
|---|---|---|---|
| Rezūm | Many men are doing light normal activity quickly, but urinary irritation may persist for weeks. | Running, heavy lifting, cycling and other strenuous activity are commonly avoided for a few weeks; follow the treating urologist’s instructions. | Often avoided for several days initially, then resumed according to comfort and the surgeon’s instructions. |
| UroLift | Generally one of the quicker recoveries among BPH procedures. | Return is often faster than after tissue-removing surgery, but individual post-procedure instructions apply. | Usually relatively rapid once discomfort has settled. |
| TURP | Usual activities often resume over approximately 2–4 weeks; full healing may take up to about 6 weeks. | Heavy lifting and intense exercise are commonly restricted for several weeks. Some NHS programs specifically advise avoiding golf for about 2 weeks and gradually increasing activity afterward. | Often resumed after roughly 2–4 weeks when comfortable and according to the surgeon’s instructions. |
| HoLEP | Many patients feel ready for routine activity/work after roughly 1–2 weeks, although full recovery continues longer. | Some current NHS guidance specifically advises avoiding golf and other strenuous exercise for about 2 weeks, then gradually returning. | Often around 3–4 weeks when comfortable and urine is clear, depending on the center’s instructions. |
What Is “Normal” After TURP or HoLEP?
Do not expect the bladder to behave perfectly the day after surgery.
It can be normal temporarily to experience:
- burning during urination;
- urgency;
- frequency;
- small amounts of blood in the urine;
- temporary leakage; and
- fatigue.
The urine stream may improve rapidly, while urgency or frequency may take much longer to settle.
Cambridge University Hospitals notes that overactive-bladder symptoms can take around three months to resolve after HoLEP even though flow improves immediately. TURP recovery guidance similarly notes that urinary frequency can persist for weeks during healing.
Can BPH Surgery Cause Erectile Dysfunction?
It can occur, but it is not correct to tell men that BPH surgery inevitably destroys erections.
NIDDK lists sexual problems—including erectile dysfunction and retrograde ejaculation—among possible complications of BPH surgery, but the exact risk varies greatly by procedure.
If you already have good erectile function, that information should be documented before surgery so you and your surgeon can compare procedures using both urinary and sexual outcomes.
Do Kegel Exercises Help Before Surgery?
Pelvic-floor exercises can be useful for urinary control after some prostate procedures, but they do not remove BPH obstruction.
I would not use Kegel exercises as an alternative to investigating frequent dribbling and possible retention.
Questions I Would Ask Before Agreeing to Surgery
- What is my prostate volume?
- Do I have an obstructing median lobe?
- What is my post-void residual?
- What is my maximum urine-flow rate?
- Is my bladder still contracting normally?
- Why did Flomax and my previous thermal treatment fail?
- Am I suitable for UroLift, Rezūm or Aquablation?
- Which option gives me the best balance between strong urinary relief and preservation of ejaculation?
- What is your own retreatment rate for that procedure?
- How often do your patients experience new erectile dysfunction?
- How often do your patients lose forward ejaculation?
- When would you personally allow me to return to golf?
I would not spend more time cycling through saw palmetto, urinary alkalinizers, herbal teas or prostate massage. With twelve bathroom trips on a golf course and mostly drips or drops, you need objective testing to determine whether your bladder is significantly obstructed or retaining urine.
If obstruction is confirmed and medication has genuinely failed, a procedure is reasonable to discuss. But I would not agree to “prostate surgery” without first comparing the sexual-function trade-offs.
If preserving ejaculation is one of your highest priorities, specifically ask whether you are anatomically suitable for UroLift, Rezūm or Aquablation. If you need the strongest and most durable obstruction relief, TURP or HoLEP may be better—but you should expect a much higher likelihood of dry/retrograde ejaculation.
Your ability to enjoy sex does not automatically disappear after BPH surgery. The key is choosing the procedure with your priorities clearly stated before treatment.
Dr. Albana Greca, MD, MMedSc
Family Physician / General Practitioner
Founder & Lead Medical Author, Prostate Treatment Options
Medical References
European Association of Urology. 2026 Guidelines on the Management of Non-neurogenic Male Lower Urinary Tract Symptoms: Aquablation, water-vapor thermal therapy, prostatic urethral lift, TURP and laser enucleation.
American Urological Association. Surgical Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia and BPH Guideline Amendment.
National Institute of Diabetes and Digestive and Kidney Diseases. Enlarged Prostate (Benign Prostatic Hyperplasia): surgery, recovery and complications.
National Center for Complementary and Integrative Health. Saw Palmetto: Usefulness and Safety.
NHS. Transurethral Resection of the Prostate (TURP): recovery.
Cambridge University Hospitals / Dorset County Hospital. HoLEP recovery and postoperative activity guidance.
Cleveland Clinic. Rezūm Water Vapor Therapy: recovery and expected symptom improvement.
Last evidence update: September 2026.