Lower urinary tract symptoms suggestive of BPH are frequently encountered in aging men. Surgery is recommended for patients who are moderately to severe bothered by their symptoms and refractory to drug treatment. Transurethral resection of the prostate remains a widely applied gold standard therapy. It provides a consistent, long lasting, high level of improvements in symptoms, quality of life and peak urine flow rate. In recent years, several new surgical procedures which use various energy sources for resection, ablation, or vaporization of the prostate have been developed. Although the short-term results demonstrate the benefits of the new surgical methods, multicentered randomized studies are needed to assess the long-term durability.