The first one I had was a couple ago. My PCP referred me because I was having classic signs of BPH. After the initial exam by the urologist, (a very thorough genital exam, followed by a very deep DRE) she scheduled me for a scope the next week.
I arrive at the office as scheduled. She comes in and we talk about how my symptoms were doing, and she explained the procedure. First, she sent me down the hall for a TRUS. I go down, the tech checks the order and tells me to lay down on my left side, pull my pants and underwear to my ankles, and pull my knees to my chest. He then lubes my ass up and inserts the transducer. After about 5 minutes of him moving the transducer and taking pictures, he pulls it out, hands me some tissues and tells me to get dressed and go back to the doctor.
I get back to the room, and the doctor comes in with the results and goes over them. Then she tells me to strip from the waist down, lie on my back on the table and she steps out. I do as I'm told, and the nurse, who is still in the room preparing the instruments, drapes me. Doctor comes in, grabs my penis, pulls back my foreskin, covers the head with betadine (or whatever they use now) and injects my urethra with lidocaine. (No pain, but pressure as she does the scope.) After a couple minutes, she has me put my feet flat on the table (still holding on to me) and to spread my legs. She runs the scope down my penis. (I did not watch the scope, nor did she ask me if I wanted to.) It took about a half hour and found the anterior lobe was somewhat enlarged, and the bladder neck was slightly thickened, and recommended a TURP "just to shave a little off" and also told me about the Urolift procedure. I mulled it over and decided to go with the Urolift, so she recommended me to a colleague since she was not trained in the Urolift, who I then go see, and he examines me again and scheduled the procedure. (Instead of doing it in the office, he prefers the OR under general. Good thing, too because there was more bleeding than he anticipated.)