Benign prostatic hyperplasia (BPH) affects nearly 50% of men over 50 and up to 80% of men over 70. Symptoms such as frequent urination, weak stream, and nocturia disrupt sleep, work, and quality of life. For decades, the standard surgical treatment was transurethral resection of the prostate (TURP) – effective but associated with risks of bleeding, retrograde ejaculation, and a hospital stay. In 2025 and 2026, a new generation of minimally invasive treatments has changed the landscape. Among them, the Urocross Expander system, approved by the FDA in March 2026, offers a temporary implant that widens the prostatic urethra and is removed after six months, with durable symptom relief and preservation of sexual function.
At Adult & Pediatric Urology, we follow these innovations closely. Many men first learn about BPH when they experience Male Urinary Symptoms – How Our Clinic Identifies and Treats the Root. Understanding the full range of modern options helps patients choose the right treatment for their anatomy and lifestyle.
Why Minimally Invasive BPH Treatments Are Gaining Popularity
Traditional TURP has been the gold standard for decades, but its side effects – especially retrograde ejaculation (up to 65-75% of men) and the need for hospitalization – have led both physicians and patients to seek alternatives. Over the past ten years, several minimally invasive therapies have emerged: Rezūm (water vapor thermal therapy), UroLift (permanent urethral lift), Aquablation (water jet ablation), and Holmium laser enucleation (HoLEP). Each has strengths and weaknesses.
The ideal BPH treatment would:
- Relieve symptoms quickly
- Preserve ejaculatory and erectile function
- Allow same-day discharge or short recovery
- Be repeatable if symptoms recur
- Work for various prostate sizes and shapes
The Urocross Expander system, approved by the FDA on March 16, 2026, addresses several of these goals with a novel approach: a temporary implant that remodels the urethra.
Urocross Expander System: A Temporary Implant for Lasting Relief
The Urocross system, developed by Prodeon Medical, consists of a non-permanent implant placed in the prostatic urethra during a short outpatient procedure. Unlike UroLift, which uses permanent metal tags, or Rezūm, which destroys prostate tissue with steam, Urocross works by gently expanding the urethra and holding it open for six months. After that period, the implant is removed. The tissue remodels around the newly shaped opening, and symptom relief persists.
How the Procedure Works
Under local or light sedation anesthesia, a urologist inserts a cystoscope into the urethra. The Urocross implant – a thin, expandable structure is positioned across the narrowed segment of the prostate. The implant gently widens the prostatic urethra, relieving obstruction. The entire procedure takes approximately 15-20 minutes. The patient goes home the same day with a temporary urinary catheter for less than 24 hours.
The implant remains in place for about six months. During this time, the prostate tissue adapts to the expanded shape. At the end of six months, the physician removes the implant in a brief office procedure. The tissue has remodelled, and the urethra stays open.
Clinical Results from the Expander-2 Study
The pivotal Expander-2 clinical trial enrolled men with moderate-to-severe BPH symptoms (IPSS ≥13). The six month results were published in early 2026 and showed:
- Mean IPSS (International Prostate Symptom Score) improved from 22.4 at baseline to 9.6 at six months – a 57% reduction.
- Peak urinary flow rate (Qmax) increased from 9.2 mL/sec to 16.7 mL/sec – a 81% improvement.
- Quality of life score (QoL) improved from 4.3 to 1.8 (scale 0-6, lower is better).
Importantly, the effect persisted after implant removal. At 12 months (six months after explant), the IPSS was 11.6, still a 48.1% improvement from baseline. The response rate – defined as at least a 3-point IPSS reduction was 74.5%.
Sexual Function Preservation
One of the most compelling findings was the absence of new cases of erectile or ejaculatory dysfunction. In the trial, no man reported de novo retrograde ejaculation. This contrasts sharply with TURP (up to 75% retrograde ejaculation) and even with some other minimally invasive therapies (UroLift has a lower rate but still about 2-4% risk of ejaculatory changes; Rezūm around 5-10%). For men who wish to preserve fertility or are concerned about sexual side effects, Urocross may be an attractive option.
Men who are already taking medications for ED may also benefit. The article Erectile Dysfunction and Benign Prostatic Hyperplasia Treatment Together discusses how many men suffer from both conditions simultaneously. For these patients, a treatment that does not worsen erectile or ejaculatory function is critical.
Comparison of Urocross with Other Minimally Invasive BPH Treatments
The table below summarizes the key differences between currently available MIST options.
| Treatment | Mechanism | Anesthesia | Preservation of Ejaculation | Recovery | Durability |
|---|---|---|---|---|---|
| Urocross | Temporary urethral expander | Local/sedation | Yes (0% de novo retrograde ejaculation in trial) | Same day, catheter <24h | ≥12 months (after explant) |
| Rezūm | Water vapor thermal ablation | Local/sedation | 90-95% preservation | Same day, catheter 3-7 days | 2-4 years |
| UroLift | Permanent urethral lift (tags) | Local | 98-99% preservation | Same day, minimal | 3-5 years |
| Aquablation | Water jet ablation (robotic) | General or spinal | 70-80% preservation | 1 day hospital | 5+ years |
| HoLEP | Laser enucleation | General or spinal | 60-70% preservation | 1-2 days hospital | >10 years (gold standard for large prostates) |
| TURP | Electrosurgical resection | Spinal/general | 25-35% preservation | 1-3 days hospital | >10 years |
For men with prostate volumes between 30 and 80 cc, Urocross, Rezum, and UroLift are all reasonable options. For larger prostates (>80 cc), Aquablation, HoLEP, or TURP are typically preferred. The Enlarged Prostate (Benign Prostatic Hyperplasia BPH) article provides more detail on how prostate size and shape guide treatment selection.
Patient Selection: Who Is a Good Candidate for Urocross?
Not every man with BPH is a candidate for Urocross. The device is best suited for:
- Men with prostate volume between 30 and 80 cubic centimeters
- Those with moderate-to-severe symptoms (IPSS ≥13)
- Men who wish to preserve ejaculatory function
- Patients who prefer a temporary implant rather than permanent tissue destruction or permanent metal implants
- Those who can return for a six month follow up removal procedure
Urocross may not be ideal for men with:
- Very large prostates (>80 cc)
- Median lobe enlargement that significantly protrudes into the bladder
- Prior prostate surgery
- Active urinary tract infection or bladder stones
Before any procedure, a thorough evaluation including digital rectal exam, uroflowmetry, and sometimes cystoscopy is performed. Men who are taking Flomax (Tamsulosin) for Benign Prostatic Hyperplasia and Erectile Dysfunction may find that medication side effects (dizziness, retrograde ejaculation) are unacceptable; they may be excellent candidates for a MIST procedure like Urocross.
Other 2025 Innovations in BPH Treatment
While Urocross is the most recent FDA clearance, other technologies continue to evolve:
- Rezum – Updated long-term data from 2025 show sustained symptom improvement at 5 years with low retreatment rates (about 10-15%). It remains the most widely available steam-based therapy.
- UroLift 2.0 – A refined delivery system with smaller implants that may reduce post-procedural discomfort.
- Optilume BPH – A drug-coated balloon that delivers paclitaxel to prevent re-narrowing after dilation. Early studies show promise but long-term data are pending.
- iTind – A temporary nitinol device that is placed for 5-7 days, similar in concept to Urocross but shorter duration. It is approved for prostates up to 75 cc and has good preservation of ejaculation.
For men who have failed medical therapy and wish to avoid more invasive surgery, the range of options has never been broader. However, the choice should be individualized. The article Benign Prostatic Hyperplasia Adenoma – Symptoms, Diagnosis, Treatment and Prevention provides a comprehensive overview of all treatment pathways.
Comparison of Urocross to Medical Therapy
Many men with BPH are initially prescribed alpha-blockers (tamsulosin, silodosin) or 5-alpha-reductase inhibitors (finasteride, dutasteride). Medications can be effective but have drawbacks:
- Alpha-blockers can cause dizziness, fatigue, and retrograde ejaculation (up to 15%).
- 5-ARIs take months to work, reduce PSA, and may cause decreased libido or erectile dysfunction.
- Many men stop medications due to side effects or inadequate relief.
Urocross offers a one time procedure with no daily pills and no ongoing medication costs. For men who are poor candidates for medical therapy or who prefer to avoid daily drugs, it is an attractive alternative.
Frequently Asked Questions
Is the Urocross procedure painful?
Most men report mild discomfort during the placement, similar to a cystoscopy. Local anesthesia or light sedation is used. After the procedure, there may be burning with urination for a few days, which resolves quickly.
How long does the symptom relief last after the implant is removed?
In the Expander-2 trial, symptom improvement persisted at 12 months (six months after removal), with a 48% reduction in IPSS. Longer-term follow-up is ongoing, but the tissue remodeling effect is expected to last for years.
Can Urocross be repeated if symptoms return?
Yes. Because no tissue is destroyed, the procedure can be repeated if symptoms recur after several years. This is an advantage over thermal or ablative therapies, which cannot be easily repeated in the same tissue.
Will my insurance cover Urocross?
As a newly FDA approved device, coverage will vary by insurer. Medicare is expected to assign a specific reimbursement code in late 2026. Many private insurers may cover it as a minimally invasive alternative to TURP. Check with your insurance provider.
How does Urocross compare to Rezūm or UroLift?
Urocross is unique because the implant is temporary and then removed. Rezum and UroLift leave permanent changes (destroyed tissue or metal implants). Urocross may have a lower risk of post-procedural irritation and preserves sexual function at 100% in trials. However, its long-term durability beyond 12 18 months is still being studied.
Medical Disclaimer
The information provided in this article is for educational purposes only and does not substitute professional medical advice. Urocross is an FDA approved device, but individual results vary. Always consult a licensed healthcare provider to determine the best BPH treatment for your specific anatomy, symptoms, and health status.
Author and Reviewer
Author – Shawn M. McGee, M.D. – Urologist at Adult & Pediatric Urology. Dr. McGee practices in Sartell, Crosby, and Aitkin, with a special interest in minimally invasive treatments for benign prostatic hyperplasia.
Reviewer – Christopher W. Boelter, M.D. – Urologist and medical reviewer at Adult & Pediatric Urology. Dr. Boelter practices in Sartell, Crosby, and Baxter, and reviews all content for clinical accuracy and safety.
Last updated: May 21, 2026