Final answer:
A 60-year-old male exhibiting symptoms and physical examination findings suggestive of benign prostatic hyperplasia (BPH) should be managed with medications initially, with surgery as a potential option for severe cases.
Step-by-step explanation:
The 60-year-old male with a six-month history of lower urinary tract symptoms and an enlarged, nontender prostate on rectal examination is likely experiencing symptoms of benign prostatic hyperplasia (BPH). Given that the symptoms are affecting his quality of life, the most appropriate management would be medication to alleviate urinary symptoms and reduce prostate size. Surgery is reserved for cases where symptoms are severe and have not responded to medical therapy.