Inclusion Criteria:

• Ability to understand and the willingness to sign an informed consent.
• Diagnosis of LUTS secondary to BPH refractory to/contraindicated for medical treatment or not patient preference.
• Severe urinary symptoms on IPSS (IPSS score ≥ 20).
• Bladder outlet obstruction (BOO) is defined by Qmax ≤ 15ml/sec, based on uroflowmetry.
• Prostate volume at minimum 50 ml measured by TRUS or MR.
• Men with prostate cancer in Active Surveillance or Watchful Waiting who have LUTS due to a large BPH component are allowed.
• Indwelling catheter or intermittent catheter is allowed. In this case baseline IPSS is 35 points.

Exclusion Criteria:

• Active bladder cancer (patients with pTa low-grade tumors are allowed).
• Previous pelvic radiation for cancer treatment.
• Bladder stones (inclusion is allowed after removal).
• Current urethral strictures or bladder neck contracture.
• Neurogenic LUTS.
• Symptomatic urinary tract infection at the time of intervention.
• Documented bacterial prostatitis in the last year.
• Severe atheromatous disease or other pathology preventing catheter-based intervention (as rated on CT angiography by an interventional radiologist).
• Allergy to iodinated contrast media.
• Renal failure defined as estimated glomerular filtration rate (eGFR) < 35ml/min.
• High bleeding risk (spontaneous international normalized ratio (INR) > 1.6).
• Contraindication to conscious sedation (if requested by the patient).
• Prostate median lobe defined by treating physician.
• Urethral colliculus to bladder neck length <35mm.