Dog neutering

Hi Everyone, my son is 4.5 years old. He’s a shihtzu. He’s always had a very tough life because his mom was very sick, and as a result he also has a lot of health issues that kept on recurring. He was recently diagnosed with very mild hip dysplasia but he’s had several episodes wherein he had to be given very strong pain meds to control the pain.

Today we just went for a routine checkup and were told that he has now developed cysts in his prostrate and that his prostrate is very enlarged. We were told to neuter him. He’s already dealt with so much pain in his life, we cannot see him in more pain. And he’s just 4.

What do you all think? Is neutering the only solution.

Ps : he’s had uti many times and there was one time in which he was peeing fresh blood. Vet said that this is all because of his prostrate. But does the surgery ensure that the cysts will go away and that the size will reduced?