患者，男，65岁。近8年来夜尿由2~3次渐增至4~5次，排尿踌躇，涩滞不畅，昨晚发生小便欲解不能，小腹急满胀痛，舌黯、脉细涩，直肠指诊前列腺增大约（55×41×33）cm。中央沟消失，质韧有弹性，光滑无结节。首先考虑的疾病是

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