Many middle-aged and older men are sad after a routine health check-up because the medical report shows prostate enlargement. What is prostate enlargement? The actual fact is that you will be able to get a lot more than just a few of the most popular and popular items. This is one of the most common problems encountered in urology clinics. The prostate gland is an accessory gland for men, the occurrence of prostate hyperplasia is closely related to the imbalance of androgens and estrogens in the body, so after the age of 50 most men will have histological prostate hyperplasia, for many years called prostate hypertrophy, but the enlarged prostate is due to cellular hyperplasia, not cellular hypertrophy, so in recent years uniformly called benign prostatic hyperplasia (BPH for short). The incidence of BPH increases with age and can even reach 80% by the age of 80. Research on the risk factors for prostate enlargement is inconclusive. Many people consider the development of BPH symptoms to be a phenomenon of physical aging, not a disease. Prostatic hyperplasia does not necessarily present with abnormal urination. Some older men may have prostatic hyperplasia on physical examination, but may never have any symptoms of urinary discomfort in their lifetime. Benign prostatic hyperplasia itself is not very harmful, but buries unique dangers due to the unique growth environment of the prostate. The symptoms of BPH appear gradually with the pathological changes in the prostate. Frequent and urgent urination, slow urination, straining to urinate, weakness in ejaculation, thin urine line, dripping urine stream, segmented urination, incomplete urination and increased nighttime urination are the most common symptoms. Patients with a long history of the disease may also have recurrent urinary tract infections, massive hematuria and other symptoms, and even in severe cases, complications such as difficulty in urination requiring catheterization (acute urinary retention), bladder stones, bladder diverticulum, hydronephrosis and renal insufficiency. The fact that it is difficult to urinate for a long time and depends on increasing abdominal pressure to urinate can cause or aggravate diseases such as hemorrhoids, prolapse and inguinal hernia. For patients with mild BPH, no urinary symptoms or very mild symptoms, with an International Prostate Symptom Scale (IPSS) score of less than 7, they need to be examined regularly and closely monitored. Once the disease has progressed, it needs to be treated aggressively. This is what we call “vigilant observation”. In recent years, with the rapid development of pharmaceutical technology, there are many drugs to reduce the size of the prostate and improve urinary tract obstruction, it is now generally accepted that drug therapy for BPH should be the first line of treatment, greatly reducing the rate of surgery. One of the principles of drug therapy is to relax the tension in the bladder neck, prostate envelope and smooth muscles within the gland to reduce or relieve the functional obstruction caused by prostate enlargement; another treatment route is to reduce the volume of the prostate to reduce or eliminate the mechanical obstruction factor; in addition, there are herbal phytogenic preparations available. Surgery is still one of the most important methods of treating BPH, so when is surgery necessary? Recurrent meatus hematuria, recurrent urinary tract infections, bladder stones, large bladder diverticula, hydronephrosis, renal insufficiency, and urinary retention (inability to urinate after at least one extubation) due to prostatic hyperplasia should all be treated with aggressive surgical procedures. The decision to operate also depends on the impact of prostate enlargement on the patient’s quality of life and the patient’s ability to tolerate the symptoms. Even if the patient does not have any of the above absolute indications for surgery, surgery may be considered because of the severe impact of the symptoms on the patient’s quality of life, or because the patient is unwilling to tolerate the slow action of medication for a long period of time. There are various methods of surgical treatment, but with the development of medical imaging, minimally invasive intracorporeal surgery of the prostate has become the most commonly used surgical method in the 20th century, and open surgery has basically been used as a backup plan. The traditional open surgery can be chosen by combining the hospital conditions, the operator’s surgical proficiency and experience, and the most commonly used are suprapubic transcatheter prostatectomy. In minimally invasive endoluminal surgery, transurethral resection of the prostate (TURP) has become the gold standard for prostate surgery, and by the end of the 20th century, transurethral electrovaporization of the prostate, plasma electrodesection of the prostate, and laser (green laser, holmium laser, thulium laser) prostatectomy have emerged, all of which can remove the enlarged prostate and provide patients with a variety of options. The KLS is an improved upgrade of the TURP procedure. In conclusion, some middle-aged and older men still have blind spots in their understanding and treatment of prostate enlargement, and delaying the timing of consultation is now common in all types of common and high-risk diseases. We recommend that men over the age of 50 should have regular checkups. Once BPH is detected, seek early medical attention and use appropriate treatment according to the condition to avoid a series of complications caused by untimely treatment or improper treatment.