BETTY: BEnign Prostatic Hyperplasia Transperineal Targeted Microwave therapY

Inclusion Criteria:

• Age over 50 years.

• Benign prostatic hyperplasia with prostate size 30-80 cc

• IPSS ≥ 14

• PSA ≤ 4 ng/mL or PSA >4 ng/mL with no evidence of suspicious lesion on mpMRI

• Maximum urine flow rate (Qmax) ≤ 15 mL/s.

• Post-Void Residual ≤ 150 mL.

• Patient suitable for IV sedation and/or spinal anaesthesia and/or generalanaesthesia and focal microwave ablation.

• Informed written consent

Exclusion Criteria:

• Significant intravesical median lobe hyperplasia.

• Suspicious lesion on mpMRI prostate

• History of prostate, bladder or urethral surgery.

• History of prostate cancer

• Presence of stones, bladder diverticulum and/or bladder tumor

• History of long-term indwelling catheter.

• Urethral stricture

• Known coagulopathy or on anticoagulant

• Presence of a pacemaker.

• Active infection

• Dysuria due to bladder dysfunction.

• Serious medical illness, including any of the following: uncontrolled congestiveheart failure, uncontrolled angina, myocardial infarction, cerebrovascular eventwithin 6 months prior to the screening visit.

• Neurological disorders that would impact bladder function (e.g., multiple sclerosis,Parkinson's disease, spinal cord injury).

• Contraindications for mpMRI exam or MR contrast

• Acute and/or chronic renal failure (GFR <50 ml/min and serum creatinine > 1.5 mg/d).

• Patient currently participating in another interventional clinical trial.