If his bladder contracts, and/or there is an obstruction, and pills are ineffective, then he may certainly need the TURP or a similar procedure to relieve the obstruction. The alternative is continued intermittent catheterization, while adding a second drug
Proscar to try to shrink the prostate and get him voiding. This is not the best alternatives because studies show that prostates respond best to there drugs like proscar if they are 40 grams or larger and it takes 6-12 months to work .