Abnormal urination, including urinary frequency, urgency, pain and difficulty in urination, is a common symptom in middle-aged and elderly men, and is often easy to be ignored, however, these urinary abnormalities are usually the early symptoms of some urological diseases, which often delay the diagnosis and treatment of the disease. Abnormal urination symptoms are closely related to prostate diseases in middle-aged and elderly men. Benign prostatic hyperplasia (BPH) is a common disease in middle-aged and elderly men. Frequent urination is an early sign of prostatic hyperplasia, and an increase in the number of nocturnal urination is especially clinically significant. In general, the amount of nocturia tends to parallel the degree of prostate enlargement. The appearance of 1-2 times of nocturnal urination in the elderly who originally did not get up at night often reflects the advent of early obstruction, while the development from 2 times per night to 4-5 times per night or even more indicates the development and aggravation of the lesion.The advanced stage of BPH may present severe urinary frequency, urgency, difficulty in urination, and even urinary retention, hydronephrosis to the point of renal insufficiency, etc. The frequency of urination can be palpated through rectal examination. The enlarged prostate can be palpated through rectal palpation, color ultrasound can measure the volume of the prostate, and it can check the amount of residual urine and the condition of the upper urinary tract. For early stage patients with mild symptoms, conservative treatment can be taken, correcting lifestyle and dietary habits, drinking plenty of water, with medication can achieve good results. For patients with severe symptoms and complications such as bladder stones, hydronephrosis and recurrent urinary retention, surgery is the best way to solve the problem. Nowadays, surgical treatments for prostate enlargement tend to be diversified and minimally invasive, so that patients can relieve the symptoms of dysuria in a short period of time without incisions. With the prolongation of human life expectancy, the trend of population aging, and the improvement of clinical diagnosis and detection technology, the incidence rate of prostate cancer has been increasing year by year. Prostate cancer has become the most common malignant tumor in men. Since early prostate cancer is usually asymptomatic and the incidence of prostate cancer is similar to that of BPH in the population, many prostate cancer patients are misdiagnosed as BPH due to the presence of typical symptoms of prostate enlargement such as frequent urination, urgency, painful urination, and difficulty in urination, thus losing the best time for treatment. Therefore, it is recommended that men over 50 years of age with lower urinary tract symptoms should undergo annual routine PSA and rectal examination, and men with a family history of prostate cancer should undergo annual examination starting from the age of 45. PSA is a prostate-specific antigen, which is currently the most valuable tumor marker for prostate cancer. It has a diagnostic specificity of 90-97% for prostate cancer. PSA less than 4 is normal, and greater than 4 is abnormal and requires further examination to rule out prostate cancer. Therefore, for middle-aged and old-aged patients with abnormal urination symptoms, it is recommended that you test PSA to exclude prostate cancer and consult with a professional urology clinic to get the most standardized diagnosis and treatment.