Benign prostatic hyperplasia is the most common benign disease causing urinary disturbance in middle-aged and older men, mostly occurring in men over 50 years of age. The main manifestations are histological enlargement of the interstitial and glandular components of the prostate, anatomical enlargement of the prostate, clinical symptoms dominated by lower urinary tract symptoms, and urodynamic obstruction of the bladder outlet. Old age and a functioning testis are two important conditions for the development of BPH, one without the other. The normal prostate is divided into an inner and outer layer, with the inner layer being the urethral mucosa and submucosal glands around the urethra also known as the migratory zone, and the outer layer being the peripheral zone with a fibrous membrane separating the two layers. In the case of prostate hyperplasia, multiple central fibromuscular nodules and stromal hyperplasia first appear in the submucosal glandular area of the prostate segment, followed by glandular epithelial hyperplasia. The lower urinary tract symptoms caused by BPH increase with age, the prostate volume increases with age, and the maximum urinary flow rate decreases with age. The main symptoms are bladder irritation, which includes frequency, urgency, painful urination, nocturia and urge incontinence, and obstructive symptoms, which include waiting for urination, tardiness, thinning of the urine line, weakness of the urine stream, shortening of the projectile, prolonged urination, post-urinary drip, interruption of the urine stream, urinary retention and filling incontinence. Rectal palpation and local neurological examination can provide an understanding of the prostate and rectum, evaluate anal sphincter tone and make a preliminary determination of the presence of other neurological disorders causing the patient’s lower urinary tract symptoms. Rectal examination is performed after the bladder has been emptied and can reveal the size, shape, texture, nodularity and tenderness of the prostate, whether the central sulcus has become shallow or disappeared, and the tone of the anal sphincter. Serum PSA can be used for screening of prostate cancer, and PSA ≥4ng/ml is generally used clinically as the cut-off point. In addition, serum PSA as a risk factor can predict the clinical progression of BPH and thus guide the choice of treatment. Ultrasonography, CT and MRI can all provide insight into the morphology and volume of the prostate, but CT and MRI are generally not recommended due to the high cost of the test. Ultrasound can show the shape and size of the prostate, the presence of abnormal echogenicity, the degree of protrusion into the bladder, and the amount of residual urine. In patients with benign prostatic hyperplasia, the sonogram shows an enlarged prostate with a smooth, intact envelope and no interruptions, and the interior is usually homogeneous and hypoechoic. Transrectal ultrasound (TRUS) can also accurately determine the volume of the prostate (calculated as 0.52 anterior-posterior diameter left and right diameters and upper and lower diameters). In addition, transabdominal ultrasound can be used to find out if there is fluid or dilatation in the urinary system (kidneys, ureters), stones or occupying lesions. Urodynamic examinations are important in the diagnosis of BPH and include uroflowmetry, filling cystometry, urethral manometry, simultaneous pressure/flow rate examination, voiding urethral manometry, and simultaneous pressure/external urethral sphincter electromyography. Urodynamic testing can determine the degree of bladder outlet obstruction, urethral and internal and external sphincter resistance in the prostate, and the functional status of the forced urinary muscles. Based on the measured urinary flow rate, forceps pressure, urethral pressure curve, and sphincter electromyography data, it is possible to analyze whether the lower urinary tract symptoms are due to obstruction or irritation, and to understand whether there is forceps instability, impaired forceps contraction function, and bladder compliance changes. This test is recommended when there is doubt about the cause of bladder outlet obstruction or when bladder function needs to be evaluated, along with other relevant tests to exclude the possibility of neurological pathology or neurogenic bladder due to diabetes mellitus. Differential diagnosis: Prostate cancer: Prostate cancer can present with urinary obstruction and irritation, and with bone metastases it can present with bone pain or pathological fracture; it can often be differentiated by PSA, transrectal prostate ultrasonography, prostate MRI and prostate puncture biopsy. Urethral stricture: Urethral stricture often has a history of urethral surgery, operation or trauma, and manifests as difficulty in urination, which may be accompanied by bladder irritation symptoms, and can often be clearly diagnosed by urography. Neurogenic bladder: Neurogenic bladder often has a history of neurological disease and presents with difficulty in urination, renal insufficiency, etc. It can be accompanied by symptoms of bladder irritation and can be clearly diagnosed by urodynamic examination or imaging urodynamics, and protection of upper urinary tract function is the main therapeutic goal. Common complications: bladder stones, bladder diverticulum, urinary retention, renal insufficiency, hernia, etc. Prognosis: BPH is a slowly progressive benign prostate disease with symptoms that progressively worsen as patients age, with corresponding complications, including decreased quality of life due to worsening lower urinary tract symptoms, progressive decrease in maximum urinary flow rate, acute urinary retention, recurrent hematuria, recurrent urinary tract infections, and renal impairment, etc. Patients with BPH undergo surgical procedures Treatment is the ultimate manifestation of disease progression.