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Transurethral balloon dilatation of the prostate is a safe method of treating benign prostatic hyperplasia; it has been largely free of complications, and does not produce retrograde ejaculation. However doubts remain over its efficacy. We have performed balloon dilatation on 28 patients using balloons of diameter 30 mm (90F), and one year follow-up data is now available on 20 patients. Nine patients were satisfied with the outcome of treatment and reported reductions in their symptom score by a mean of 8.8 points. In addition, eight of these patients showed a reduction in their ultrasound residual volume by a mean volume of 75 ml. However urinary flow rate was only improved in four. Of the remaining 11 patients, two showed some initial improvement but then relapsed and nine derived no benefit from the procedure. We conclude that balloon dilatation may be of value in younger patients wishing to avoid or delay TURP, but is unlikely to achieve wider application.