In male patients over 50 years of age who present with lower urinary tract symptoms as the main complaint, the possibility of prostatic hyperplasia should be considered first. To make a definitive diagnosis, the following clinical evaluation is required: (a) Initial evaluation: (1) History questioning: (1) characteristics, duration and concomitant symptoms of lower urinary tract symptoms; (2) history of surgery, trauma, especially pelvic surgery or trauma; (3) past history and sexually transmitted diseases, diabetes mellitus, neurological diseases; (4) medication history to find out whether the patient or has recently taken drugs that affect bladder outlet function The I-PSS score is a subjective reflection of the severity of lower urinary tract symptoms in patients with prostate enlargement. I-PSS score patients are classified as follows: mild symptoms: 0 to 7 points; moderate symptoms: 8 ~19 points; severe symptoms: 20~35 points. (7) Quality of life score (QOL): QOL score (0 ~ 6) is to understand the patient’s subjective feelings about their current level of lower urinary tract symptoms along with their lifetime. Its main concern is the degree to which prostate enlargement patients are troubled by lower urinary tract symptoms and whether they can tolerate them, so it is also called the distress score. The main concern is the level of lower urinary tract symptoms and whether they are tolerable. Rectal examination can reveal the presence of prostate cancer. 26-34% of patients with suspected abnormalities on rectal examination are finally diagnosed with prostate cancer. The positive rate tends to increase with age. Rectal examination can reveal the shape, size, texture, nodules and pressure pain of the prostate, whether the central sulcus becomes shallow or disappears, and the tone of the anal sphincter. The rectal examination is not precise enough to determine the volume of the prostate. Currently, transabdominal ultrasound or transrectal ultrasound can describe the morphology and volume of the prostate more accurately. (2) Local neurological examination: including motor and sensory. (3) Urine routine: Urine routine can determine whether the patient has hematuria, proteinuria, pusuria and urine sugar. 4. Serum PSA: Prostate cancer, prostate enlargement, and prostatitis may all elevate serum PSA. Therefore, elevated serum PSA is not unique to prostate cancer. In addition, urinary tract infection, prostate puncture, acute urinary retention, indwelling catheterization, rectal examination and prostate massage can also affect the serum PSA value. 5. Ultrasound: It is possible to understand the prostate morphology, size, presence of abnormal echogenicity, degree of protrusion into the bladder, and residual urine volume. Transrectal ultrasound can also accurately determine the volume of the prostate (the formula is 0.52 x anterior-posterior diameter x right and left diameter x upper and lower diameter). In addition, transabdominal ultrasound can understand whether there is fluid accumulation, dilatation, stones or occupying lesions in the urinary system. 6, urine flow rate examination: there are two main indicators of urine flow rate, the maximum urine flow rate and the average urine flow rate, of which the maximum urine flow rate is more important. However, a reduced maximum urinary flow rate cannot distinguish between obstruction and reduced contractility of the detrusor muscle. It should be combined with other tests and, if necessary, urodynamic studies. The maximum urinary flow rate is highly individual and volume-dependent, so it is more accurate when the urine volume is between 150 and 200 ml. (ii) Depending on the results of the initial evaluation, some patients may require further testing: 1. Urinary diary: A urinary diary is valuable in patients with lower urinary tract symptoms, such as increased nocturia, and a 24-hour urinary diary can help identify nocturnal polyuria and excessive drinking. 2. Blood creatinine: Bladder outlet obstruction due to prostatic hyperplasia can cause renal impairment and elevated blood creatinine. 3. Intravenous urography: If patients with lower urinary tract symptoms are accompanied by recurrent urinary tract infections, microscopic or meatus hematuria, suspected hydronephrosis or ureteral dilatation reflux, urinary stones should undergo intravenous urography. 4. Urethrography: This test is recommended when urethral stricture is suspected. 5.Urodynamic examination: This examination is performed by pressure-flow rate function graph and A-G graph to analyze the function of the forced urinary muscle and to determine whether there is bladder outlet obstruction. This test is recommended when there is a question about the cause of bladder outlet obstruction or when bladder function needs to be evaluated, combined with other relevant tests to exclude the possibility of neurological pathology or neurogenic bladder due to diabetes. 6. Urethrocystoscopy: This test is recommended when prostatic hyperplasia is suspected to be combined with urethral stricture or occupying lesions in the bladder. Cystourethroscopy can clarify the following: (1) features of urethral and bladder neck obstruction due to prostate enlargement; (2) obstruction due to elevation of the posterior lip of the bladder neck; (3) formation of bladder trabeculae and diverticulae; (4) bladder stones; (5) determination of residual urine volume; (6) bladder tumors; (7) site and extent of urethral stricture.