When to treat surgically? Theorists say: Surgery in patients who have failed to respond to systemic medication or who have refractory complications (such as recurrent infections, urinary retention, bladder stones and hematuria). Practitioners say: do it as needed, when it is done. I agree with the latter opinion. The reason for doing it on demand is that the disease is benign, a progressive disease, and the treatment plan should be developed by both the doctor and the patient, if the patient’s prostate volume is already large (>80g) and the symptoms are severe, taking medication will only delay the best time for treatment (especially with the physical condition), so why do we have to take medication? So when it’s done, it’s done! There are also some patients who take several years of medication are not effective, side effects are still many, plus other diseases, taking medication is like eating, so early surgery is also recommended. What kind of surgery do I choose? Currently, the main surgical options are open surgery and endoscopic surgery (minimally invasive surgery). With the advancement of surgical skills and medical equipment open surgery is rarely used nowadays, endoscopic surgery is mainly transurethral resection surgery: the common ones are transurethral resection TURP, plasma resection TUERP and various laser surgeries (red laser, green laser, holmium laser, etc.). How to choose from so many surgical procedures? You see, if you look carefully, it is not difficult to find, in fact, different surgery is mainly the use of different “knife”, some are electric and ion and some are just laser, surgery mainly depends on the person using the knife (doctor), just like the swordsman in martial arts, the same knife different people make a very different effect. So do not believe in what laser ah ion ah and other propaganda, first of all, choose the right knifes (doctors) is very important! Second, in all these surgical methods, which surgery is the most thorough? So, what is a good path. The first thing you need to do is to take a look at the prostate gland, which is like an orange, with a skin and flesh. It is easy to imagine that if the flesh is removed from between the skin and the flesh, it will of course be complete and less “juice” will be lost (less bleeding!). . This is why we call this route “anatomical enucleation”, and it is becoming more and more popular. The addition of various advanced lasers is the icing on the cake. This procedure reduces the chance of true postoperative incontinence because it avoids accidental damage to the external sphincter during surgery. The story was originally told that this method was used for the elderly, without the risk of bleeding, with increased surgical efficiency and shorter operating time, so the risk of surgery for the elderly was minimized. In conclusion, elderly people with prostate enlargement, early medication for early control and surgical treatment on demand when done.