In recent years, 60-year-old Chen Bo often have to get up at night to urinate once or twice, and when urinating, he has to wait for a while to urinate. He went to the hospital for a checkup, and the result was mild to moderate prostate hyperplasia. The doctor said that while he is still in good health, he should have an early operation to avoid trouble in the future. But Uncle Chen is also very contradictory, really want to operate immediately? Faction dispute, each has its own rationale: part of the urethra is wrapped by the prostate gland, when the prostate gland hyperplasia (hypertrophy), the urethra will be squeezed narrow, the emergence of urinary obstruction symptoms, such as urinary difficulties, waiting for urine, nocturia and other lower urinary tract symptoms. Surgery, such as transurethral resection of the prostate, to remove the enlarged prostate tissue, can make this narrowed area open again. But is it better to have the surgery sooner rather than later? Among doctors, there are two schools of thought: – the “urgent” school: Although taking medication may also control most prostate enlargement and relieve the related symptoms, but the patient may also face surgery in the future; and as a person grows old, some other diseases such as hypertension, coronary heart disease, diabetes, etc. occur, And as a person ages, the incidence of other diseases such as hypertension, coronary heart disease, diabetes, etc. also increases, then the tolerance of the surgery will become worse, it is better to have surgery earlier and safer. Besides, if the obstruction of the urinary tract caused by prostate enlargement exists for too long, some secondary changes may occur, such as impairing the function of the bladder’s forced urinary muscle; even if the operation is done, the bladder’s force to force urine is not enough, or even powerless, and, as a result, symptoms such as difficulty in urination may not be improved. –The “slow cut” school: any surgery, in addition to curing the disease may also cause disease; prostate surgery is the same, it may lead to the occurrence of some complications, affecting the sexual function is more common, such as retrograde ejaculation, erectile dysfunction (ED), etc., like the chances of sexual function is affected by the operation. The chance of sexual function being affected is as high as 20% to 40%, and retrograde ejaculation may be as high as 90% or more. In addition, if the main cause of lower urinary tract symptoms is not prostate enlargement, but is caused by other factors, such as weakness or dysfunction of the urethra muscle or inflammation, surgery may not be able to solve the problem completely. When to operate, it still depends on whether the patient really meets the indications for surgery. Beware of “side effects”: It is worth reminding that, as mentioned earlier, the causes of lower urinary tract symptoms such as urinary frequency, urinary urgency, increased nocturia, and urge incontinence, such as prostatitis, cystitis, and prostate cancer, can also be caused; in addition, neurological disorders, such as cerebrovascular accidents, can also cause difficulty in urination. If a doctor does not assess these conditions well and operates on a patient before he/she can fully understand whether the symptoms are mainly caused by prostate enlargement, he/she may get half the result with half the effort. However, the reality is that some doctors do not have a comprehensive or deep understanding of prostate enlargement and related urinary tract symptoms, and do not rule out the possibility of individual commercial interests, the surgery is very “active”, and even individual hospitals of small size, the total number of prostate surgery in a year than the provincial and municipal hospitals, which, it is likely that some of the This is likely to have some patients who do not need surgery for the time being. Whether or not surgery, they also want to think clearly: disease is a certain development process, we do not necessarily have to intervene early; after all, surgery has a certain trauma and risk. Moreover, every organ in the body has a role to play, only that some of its roles may not be clear to us at the moment. For example, the appendix, which used to be considered useless and was cut out when appendicitis appeared, but nowadays it is not advocated to cut out all of them. About when to operate, China has the corresponding diagnosis and treatment guidelines (see the Chinese Medical Association Urology Branch disease diagnosis and treatment guidelines), for example, for belonging to the moderate/severe prostate hyperplasia, the lower urinary tract symptoms obviously affect the patient’s quality of life; medication is ineffective, then surgery can be considered. Or, prostate enlargement has complications, such as recurrent urinary retention (inability to urinate after at least one extubation or two urinary retentions), recurrent hematuria or urinary tract infections, the presence of bladder stones, and the development of secondary upper urinary tract fluid (with or without renal impairment), at which time early surgery is also warranted. When the disease appears in different people, it is all somewhat different. Therefore, to early surgery or not, the patient himself should think three times: First, think about their own physical condition, cardiopulmonary function, whether they suffer from coronary heart disease, hypertension and other chronic diseases; second, if the medication has an effect, whether they are willing to adhere to the medication treatment; third, whether they are very concerned about sexual function. Although the incidence of postoperative sexual dysfunction is 20% to 40%, but for everyone, once it happens, it is 100%, one should be clear whether one can accept this. Personally, if the patient’s cardiopulmonary function has been a problem, and they are worried about not being able to operate in the future, and they don’t want to take medication all the time, and at the same time, they don’t care too much about their sexual function, then, at this time, they can consider surgical treatment; of course, the patient can also consult with several specialists, and then make a decision with a comprehensive opinion. Some patients have stronger sexual ability after surgery Some patients have open prostatectomy, sexual function but stronger, the reason is that the doctor to remove the prostate at the same time, the prostate venous plexus ligation, so that the return of venous blood to the penis will be a little slower, so that the erectile function in a period of time than before more durable.