Prostate enlargement, also known as prostate hyperplasia, is one of the most common benign diseases causing urinary disorders in middle-aged and older men. Prostatic hyperplasia is mainly characterized by histological enlargement of the interstitial and glandular components of the prostate, anatomical enlargement of the prostate, urodynamic obstruction of the bladder outlet and clinical symptoms dominated by lower urinary tract symptoms. Patients may present with pathologic changes before the age of 40 years, but most do not develop symptoms until after the age of 50 years. These two conditions in older men as well as functioning testes lead to prostate enlargement. The development of prostatic hyperplasia shows a time-related progression. The functioning testes continuously secrete androgens that stimulate prostate enlargement and hypertrophy. The normal range of prostate size is 2 x 4 x 3 cm (about 4 cm horizontal, 3 cm vertical, and 2 cm anterior and posterior). Generally, prostate enlargement occurs in the middle lobe, especially protruding into the bladder, which may cause patients to have difficulty urinating, frequent and urgent urination, and increased nighttime urination, as well as symptoms such as straining to urinate, thinning of the urine line, urinary retention, urinary incontinence, and hematuria. In severe cases, hydronephrosis and renal insufficiency may be present. Rectal examination is a simple and valuable method to diagnose prostatic hyperplasia and must be performed after emptying the bladder of urine. The most important thing to note is the boundaries of the prostate, its size, texture, the depth of the central groove, the presence of hard nodes and tenderness. If it cannot be detected by rectal examination, it can be diagnosed by ultrasound or urological X-ray.