Patient description: The patient is a 55 year old man visiting his primary care physician for lower urinary tract symptoms including frequency, urgency, weak stream, incomplete emptying and intermittent flow for the past 9 months. Further evaluation revealed: IPSS score : 15 Post-void residual: 70 mL Prostate volume (TRUS): 60 mL Prostate-specific antigen (PSA) level: 3.2 ng/mL 10 mL/sec of maximum flow rate when urine volume was 130 mL He is otherwise healthy only using Vit D 1000 units daily. His recent blood chemistry (3 days ago) was normal: Hgb: 13.5 g/dl WBC: 135000 /mm3 Plt: 350000 /ml PT: 11 second PTT: 35 second INR: 0.9 Creatinine: 0.5 mg/dl BUN: 10 mg/dl U/A: Color: yellow Appearance: cloudy PH: 5.3 Specific gravity: 1.010 Glc: 100 Nitrite: negative Ketone: none Leukocyte esterase: negative RBC: negative WBC: 2 WBCs/hpf U/C: negative

Clinical trial eligibility criteria: eligible ages (years): 45.0-80.0,  Benign Prostatic Hyperplasia (BPH) Subject has diagnosis of lower urinary tract symptoms due to benign prostatic enlargement causing bladder outlet obstruction 2. Subject is willing to be randomized 3. Subject is mentally capable and willing to sign a study-specific informed consent form 4. Subject is willing and able to comply with all study requirements 5. Age from 45 through 80 years 6. Subject has medical record documentation of a prostate volume up to 60mL (inclusive) by Transrectal Ultrasound (TRUS) (If TRUS testing documentation is available from less than 90 days prior to the informed consent date and the prostate volume is up to 60mL, it may be used for the inclusion/  ) 7. Subject has an IPSS urinary symptoms score greater than or equal to 13 measured at the baseline visit 8. Subject has medical record documentation of a maximum urinary flow rate (Qmax) ≤15mL/s and ≥5mL/s (If uroflow testing documentation is available within 90 days prior to the informed consent date, and the sample is greater than or equal to 120mL, and the Qmax is ≤15mL/s and ≥5mL/s, it may be used for the inclusion/ ) 9. Subject has a serum creatinine that is within the normal range for the laboratory at the study center (or documentation of clinical insignificance in the subject's medical record by the investigator if outside the normal range) and measured ≤ 30 days prior to the date of surgery 10. History of inadequate response, contraindication, or refusal to medical therapy 11. Blood CBC and biochemistry up to two weeks before screening demonstrating: Normal values of the PT, PTT and INR tests 12. Normal Urinalysis and urine culture 13. Sexually active within 6 months before the index procedure 14. Sexual Health Inventory for Men score >6 15. Positive response to MSHQ-EjD (excluding the response ''Could not ejaculate'') 16. Incontinence Severity Index score >4 BMI ≥ 42 2. History of prostate cancer or current/suspected bladder cancer 3. Prostate cancer should be ruled out before participation to the satisfaction of the investigator if PSA is above acceptable thresholds 4. Subjects with a history of actively treated bladder cancer within the past two (2) years 5. Neurogenic bladder as confirmed by urodynamics or other neurological disorder that affects bladder function 6. Diagnosis of polyneuropathy 7. Bladder calculus or clinically significant bladder diverticulum (e.g., pouch size >20% of full bladder size) 8. Active infection, including urinary tract infection 9. Prostatitis treated with antibiotics within 1 year of enrollment 10. Diagnosis of or has received treatment for chronic prostatitis or chronic pelvic pain syndrome (e.g. nonbacterial chronic prostatitis) 11. Ever been diagnosed with a urethral stricture, meatal stenosis, or bladder neck contracture 12. Subject has damage to external urinary sphincter 13. Subject has diagnosis of stress urinary incontinence that requires treatment or daily pad or device use 14. PVR > 250 mL 15. Urinary retention at time of enrollment or subject has been catheterized in the 14 days prior to the surgical procedure 16. Subject has a history of intermittent self-catheterization 17. Previous prostate surgery or history of other lower urinary tract surgery such as e.g. urinary diversion, artificial urinary sphincter or penile prosthesis 18. Subjects on anticoagulants (if medication cannot be stopped before and after procedure) or known coagulopathy (except aspirin below 100mg/d) 19. Any severe illness that would prevent complete study participation or confound study results 20. Serious concurrent medical conditions such as heart disease (e.g., myocardial infarction within 30 days prior to the date of informed consent, congestive heart failure NYHA IV), pulmonary disease or uncontrolled diabetes 21. Has had an open heart surgery, or cardiac arrest < 180 days prior to the date of informed consent 22. Heart surgery, or cardiac arrest < 180 days prior to the date of informed consent 23. Participants using systemic immune-suppressants including corticosteroids; unable to withhold non-steroidal anti-inflammatory agents (NSAIDs, including aspirin) for 3-5 days prior to treatment except for low dose aspirin (e.g. less than or equal to 100mg) 24. Known illicit substance abuse 25. Participants using anticholinergics specifically for bladder problems. Use of medications with anticholinergic properties is allowable provided the patient does not have documented adverse urinary side effects from these medications 26. Dementia or psychiatric condition that prevents the participant from completing required follow up 27. Contraindication to general or spinal anesthesia 28. Previous pelvic radiotherapy 29. Participating in another investigational study that could affect responses to the study device 30. Subject has any other disease or condition(s) that would interfere with completion of the study and follow up assessments, would increase risks of the procedure, or in the judgment of the investigator would potentially interfere with compliance to this study or would adversely affect outcomes 31. Subject is unwilling to accept a transfusion should one be required 32. Median lobe obstruction of the prostate as assessed by TRUS 33. Known allergy to nickel 34. Unwilling to report sexual function. Intraoperative Median lobe obstruction or any abnormal findings on cystoscopy at the time of implantation that can interfere with iTind implantation or TURP procedure