Willing and able to sign informed consent

Subject is able and willing to complete all procedure and follow-up visits indicated in the protocol

Absence of urinary retention

Prostate volume: ≥ 18 and ≤ 100 cc, measured by transrectal ultrasound

Serum creatinine levels \<2 ng/dl and GFR \> 45

Serum PSA levels \< 20 ng/ml

Multiparametric prostate MRI with piRADS scores 3-5

Prostate volume: ≥ 18 and ≤ 100 cc, measured by MRI

Presence of Intermediate risk prostate cancer with a volume that is less than 1/3 of the gland volume by MRI evaluation

Minimum age: 50

Post-void residual (PVR): \> 250 mL or \> 50% of voided volume

Previous prostate cancer intervention (Radiation therapy, brachytherapy, prostate cryoablation

Major neurological conditions such as Alzheimer's, Parkinson, Multiple sclerosis, ALS, spinal cord injury

Evidence of neurogenic bladder determined by urodynamics studies

Presence of Indwelling Foley catheter or on active regime of clean intermittent catheterization (CIC) in the prior 30 days

Active urinary tract infection determined by urinary cultures

SHIM score \<14

IPSS score \>23

Acute prostatitis

Macroscopic hematuria without a known contributing factor

History of colorectal carcinoma with anterior perineal resection of rectum

History of pelvic radiation therapy or radical pelvic surgery

History of bladder neck contracture and/or urethral strictures within the 5 years prior to the informed consent date

Bladder stones

Medical contraindication for undergoing TPFLA surgery (eg, infection, coagulopathy, significant cardiac or other medical risk factors for surgery)

Diagnosed or suspected bleeding or coagulopathic disorder such as hemophilia, ITP, TTP

Medical contraindication to being subjected to local anesthesia