The early stage of prostatic hyperplasia is atypical due to compensations, and as the lower urinary tract obstruction worsens, the symptoms gradually become obvious. Clinical symptoms include symptoms during the storage phase, urinary symptoms during the voiding phase, and post-void symptoms. Due to the slow progression of the disease, it is difficult to determine the time of onset. 1.Storage phase symptoms (1)Frequent urination and increased nocturia are early symptoms, starting with an increase in the number of nocturia, but the volume of urine is not much each time. After the loss of compensation of the bladder forced urinary muscle, chronic urinary retention occurs, and the effective capacity of the bladder is thus reduced, and the interval between urination is even shorter. If there are bladder stones or infections, the frequency of urination becomes more and more obvious and is accompanied by painful urination. (2) Urinary urgency and urinary incontinence In case of lower urinary tract obstruction, 50% to 80% of patients have urinary urgency or urge incontinence. 2.Symptoms during urination Difficulty in urination: As the gland increases in size, mechanical obstruction increases and difficulty in urination increases, and the degree of lower urinary tract obstruction is not proportional to the size of the gland. Due to increased urethral resistance, patients have delayed onset of urination, prolonged urination time, short range, thin and weak urine line. The urine is bifurcated and there is a feeling of incomplete urination. If the obstruction is further aggravated, the patient must increase the abdominal pressure to help urination. Breathing makes the abdominal pressure increase or decrease, and there is interruption of urine flow and dripping. 3, post-voiding symptoms incomplete urination and increased residual urine: residual urine is the result of loss of compensation of the bladder forced urinary muscle. When the amount of residual urine is large, the bladder is overinflated and the pressure is very high, higher than the urethral resistance, urine will overflow from the urethra by itself, called overflow incontinence. Some patients usually do not have much residual urine, but acute urinary retention can occur suddenly when they get cold, drink alcohol, hold urine, take medication or have other causes of sympathetic excitation. The patient’s symptoms of urinary retention can be good and bad at times. Some patients can have acute urinary retention as the first symptom. 4, other symptoms (1) hematuria Capillary congestion and small blood vessels on the mucosa of the prostate gland are dilated and stretched by the enlarged gland or rubbed with the bladder, which can cause microscopic or visual hematuria when the bladder contracts, which is one of the common causes of hematuria in elderly men. Cystoscopy, metal catheter catheterization, and sudden bladder decompression during catheterization for acute urinary retention can easily cause severe hematuria. (2) Urinary tract infection Urinary retention often leads to urinary tract infection, which can lead to symptoms such as urinary urgency, urinary frequency and difficulty in urination, and is accompanied by painful urination. When secondary upper urinary tract infection occurs, fever, back pain and systemic toxicity symptoms will appear. Usually patients do not have symptoms of urinary tract infection, but there may be more white blood cells in the urine or bacterial growth in the urine culture, which should be treated before surgery. (3) Bladder stones Lower urinary tract obstruction, especially in the presence of residual urine, and prolonged retention of urine in the bladder, can gradually form stones. In case of bladder stones, there may be interruption of urinary line, pain at the end of urination, and urination can be done after changing position. (4) Impairment of renal function Mostly due to ureteral reflux, hydronephrosis leads to destruction of renal function, and patients’ complaints at the time of consultation are often loss of appetite, anemia, elevated blood pressure, or drowsiness and dullness of consciousness. Therefore, for elderly men with unexplained symptoms of renal insufficiency, prostatic hyperplasia should be ruled out first. (5) Long-term lower urinary tract obstruction may present as a lower abdominal mass due to bladder diverticulum filling or an upper abdominal mass due to hydronephrosis. Long-term reliance on increased abdominal pressure to help urination can cause hernias, hemorrhoids and prolapse.