Prostatic hyperplasia is a progressive disease and some patients will eventually require surgical treatment to relieve lower urinary tract symptoms and their impact on quality of life and complications. Patients with severe prostatic hyperplasia whose lower urinary tract symptoms have significantly affected the patient’s quality of life may opt for surgical treatment, especially if medication is not effective or if the patient refuses to undergo medication. Surgical treatment is recommended when prostatic hyperplasia 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 5-alpha reductase inhibitors; 3. recurrent urinary tract infections; 4. bladder stones; 5. secondary upper urinary tract fluid; 6. patients with prostatic hyperplasia combined with large bladder diverticula, inguinal hernia, severe hemorrhoids or prolapse, and those who are clinically judged to have difficulty in achieving therapeutic results without lifting the lower urinary tract obstruction should be considered for surgical treatment. The measurement of residual urine volume has some reference value for the degree of lower urinary tract obstruction due to prostatic hyperplasia, but because of the instability of repeated measurements, inter-individual variability, and the inability to distinguish lower urinary tract obstruction from bladder contraction weakness, it is not considered possible to determine the upper limit of residual urine volume that can be used as an indication for surgery. However, if the residual urine is significantly increased to the point of overflow incontinence prostatic hyperplasia or surgical treatment should be considered.