Seth K. Bechis, MD, presented “Making Sense of BPH: Which Treatment for Which Patient – Review of Guidelines for BPH” during the 43rd Annual Ralph E. Hopkins Urology Seminar on January 31, 2024, in Jackson Hole, Wyoming.

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How to cite: Bechis, Seth K. “Making Sense of BPH: Which Treatment for Which Patient – Review of Guidelines for BPH .” January 31, 2024. Accessed Jul 2024.

Making Sense of BPH: Which Treatment for Which Patient – Review of Guidelines for BPH – Summary

Seth K. Bechis, MD, reviews the 2023 American Urological Association (AUA) guidelines for benign prostatic hyperplasia (BPH) treatment. Dr. Bechis begins by enumerating the currently available procedures for BPH treatment, with less invasive approaches favoring ease of use, minimal morbidity, and minimal ejaculatory problems versus the more invasive approaches favoring definitive efficacy and durability of results. 

Dr. Bechis shares the 2023 AUA guidelines on surgical management of BPH and explains considerations for treatment choice include prostate size, presence of a median lobe, and preferences regarding sexual function. He covers guidelines for: 

  • Prostatic Urethral Lifts
  • Water Vapor Thermal Therapy 
  • Temporarily Implanted Prostatic Devices
  • Greenlight Photoselective Vaporization of the Prostate (PVP)  
  • Drug-Eluting Catheters 
  • Holmium Laser Enucleation of the Prostate (HoLEP)
  • Robotic Waterjet Treatment (Aquablation)

Dr. Bechis concludes by explaining how he counsels patients by reviewing the data together and involving them in shared decision-making. He stresses the importance of anticipating recovery pathways and post-op hurdles for each treatment. 

About The 43rd Annual Ralph E. Hopkins Urology Seminar:

The Ralph E. Hopkins Urology Seminar is a multi-day meeting focused on training urologists in the latest in assessing, diagnosing, and treating urologic conditions in the clinical setting. Updates are provided on urologic cancers, stone disease, urologic reconstruction, female urology, infertility, sexual function, emerging surgical techniques, and general urology. The 43rd iteration of the meeting took place from January 31st to February 2nd, 2024, in Jackson Hole, Wyoming.

For further educational activities from this conference, visit our collection page.


Seth K. Bechis, MD is a board-certified urologist specializing in diseases of the urinary tract, including kidney stones, benign prostatic hyperplasia (BPH) or enlarged prostate, and men's health issues. Dr. Bechis completed fellowship training in laparoscopy/robotics and endourology at the University of California (UC), San Diego School of Medicine, and residency training at Harvard Medical School, Massachusetts General Hospital in Boston. He earned his medical degree from UC San Francisco School of Medicine and holds additional Master of Science training in biomedical research, also from UC San Francisco, focusing on ways to prevent and treat diseases.

As a member of the Comprehensive Kidney Stone Center at UC San Diego Health, Dr. Bechis has a special interest in advanced surgical treatment, medical prevention, and research on kidney stone disease. He has surgical expertise in percutaneous nephrolithotomy (PCNL) for complex stones, ureteroscopy, and shockwave lithotripsy. Dr. Bechis specializes in all procedures of the prostate including minimally invasive procedures such as Rezum water vapor therapy and UroLift, as well as robotic surgery and GreenLight™ Laser photoselective vaporization of the prostate (PVP).

Dr. Bechis serves as the associate program director for the UC San Diego - Kaiser Laparoscopy/Endourology Fellowship in the Department of Urology at UC San Diego School of Medicine. His current research includes improving surgical techniques and clinical outcomes in stone disease, as well as tools for stone diagnosis and opiate-sparing pathways for managing pain. His research has been featured in peer-reviewed medical journals and he has authored chapters for university handbooks.

Prior to joining UC San Diego Health, Dr. Bechis worked at Massachusetts General Hospital and Harvard Medical School, where he taught residents and medical students in the operating room and clinic.