A 68-year-old man with a three-year history of progressive lower urinary tract symptoms (weak stream, hesitancy, nocturia ×4–5) and two episodes of acute urinary retention presents for evaluation. His IPSS is 24 (severe) and post-void residual is 210 mL. Uroflowmetry shows a maximum flow rate of 7 mL/s. On transabdominal ultrasound, the structure marked **A** is measured on three orthogonal axes (transverse 5.4 cm, anteroposterior 4.8 cm, cephalocaudal 5.2 cm) and calculated to be approximately 71 cc using the prolate ellipsoid formula. According to the AUA BPH Guideline 2023, what is the most appropriate next step in management given this prostate volume and clinical presentation?
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