Indications for surgery for benign prostatic hyperplasia 1. Indications for surgical treatment of benign prostatic hyperplasia: Patients with severe benign prostatic hyperplasia or those whose lower urinary tract symptoms have significantly affected their quality of life may opt for surgical treatment; patients who have had poor results with medication or refuse to accept medication may be considered for surgical treatment. Surgical treatment is recommended when BPH leads to the following complications: (1) recurrent urinary retention: inability to urinate after at least one extubation or twice; (2) recurrent hematuria: ineffective treatment with 5α-reductase inhibitors; (3) recurrent urinary tract infections; (4) bladder stones; (5) secondary upper urinary tract fluid (with or without renal impairment): BPH patients with a combination of large bladder diverticula, inguinal hernia, severe hemorrhoids or prolapse, and those who are clinically judged to have difficulty in achieving therapeutic results without relieving lower urinary tract obstruction should be considered for surgical treatment. Previously, residual urine volume was also an indication for surgery, but due to poor repeatability of residual urine volume measurements, individual differences, and inability to identify the cause (lower urinary tract obstruction or bladder contraction weakness), the upper limit of residual urine volume that can be used as an indication for surgery cannot be determined at this time. However, surgical treatment should be considered if the residual urine increases significantly and causes overflow incontinence. The gold standard of surgical treatment for BPH is still transurethral resection of the prostate. Other surgical options are open prostate removal.