BETTY: BEnign Prostatic Hyperplasia Transperineal Targeted Microwave therapY

Inclusion Criteria: * Age over 50 years. * Benign prostatic hyperplasia with prostate size 30-80 cc * IPSS ≥ 14 * PSA ≤ 4 ng/mL or PSA \>4 ng/mL with no evidence of suspicious lesion on mpMRI * Maximum urine flow rate (Qmax) ≤ 15 mL/s. * Post-Void Residual ≤ 150 mL. * Patient suitable for IV sedation and/or spinal anaesthesia and/or general anaesthesia and focal microwave ablation. * Informed written consent Exclusion Criteria: * Significant intravesical median lobe hyperplasia. * Suspicious lesion on mpMRI prostate * History of prostate, bladder or urethral surgery. * History of prostate cancer * Presence of stones, bladder diverticulum and/or bladder tumor * History of long-term indwelling catheter. * Urethral stricture * Known coagulopathy or on anticoagulant * Presence of a pacemaker. * Active infection * Dysuria due to bladder dysfunction. * Serious medical illness, including any of the following: uncontrolled congestive heart failure, uncontrolled angina, myocardial infarction, cerebrovascular event within 6 months prior to the screening visit. * Neurological disorders that would impact bladder function (e.g., multiple sclerosis, Parkinson's disease, spinal cord injury). * Contraindications for mpMRI exam or MR contrast * Acute and/or chronic renal failure (GFR \<50 ml/min and serum creatinine \> 1.5 mg/d). * Patient currently participating in another interventional clinical trial.