In recent times I have treated three consecutive elderly male patients with severe hematuria, which was found to be prostatic hypertrophy, or benign prostatic hyperplasia, after examination. During emergency surgery, the patients were found to have significantly enlarged prostate glands, angry vascularity on the surface of the prostatic urethra, significant inflammatory congestion, and rupture and bleeding of some of the mucosa. One patient had approximately 500 ml of blood clots removed from the bladder cavity and another patient had a hematocrit of only 6.8 grams. I also performed prostate enucleation during the operation, which reduced the pain of re-operation. After the operation, the patient’s hematuria symptoms were significantly controlled, and all of them were able to urinate freely after the catheter was removed after the operation. The prostate enlargement not only affects the patient’s urinary function, but also causes urinary tract infections, bladder stones, hematuria, chronic hydronephrosis, and even renal insufficiency, of which hematuria can easily cause psychological tension in patients. Hematuria in patients with prostate enlargement has certain characteristics, namely initial and/or final hematuria. It is manifested as a segment of urine at the beginning of urination or a segment of hematuria near the end, often accompanied by painful urination and lower abdominal distension. If there are elderly patients who need to take long-term anticoagulant drugs, such as aspirin and warfarin, because of cardiovascular disease, they are also prone to hematuria. Of course, other diseases such as prostate tumors have to be ruled out when this condition of hematuria occurs. What the patient needs to do at this point is to seek immediate treatment at a urology clinic and receive help from a urologist.