Management of Benign Prostatic Hyperplasia in 2024


  • Luke Fazio, MD Humber River Hospital, Toronto, ON; TCBH Surgical Centre, Toronto, ON



Benign prostatic hyperplasia (BPH) is a condition involving the proliferation of smooth muscle and epithelial cells within the transition zone of the prostate. The process by which this takes place is not precisely known. It does require that testosterone and 5-alpha reductase convert it to dihydrotestosterone (DHT) which is the active androgen within the prostate. The growth of the prostate results from an imbalance between cell growth and cell death. Obstruction occurs via compression of the urethra by the resulting hyperplastic nodules, as well as increased smooth muscle tone and resistance within the enlarged gland. It is an almost universal process in men beginning in their 40’s; it increases to a prevalence of 60% by age 60 and 80% by age 80.1 This results in progressive bladder outlet obstruction (BOO) and lower urinary tract symptoms (LUTs). Patients can range from being asymptomatic to severely symptomatic. In the most extreme cases, it can result in complete urinary retention and renal dysfunction. The annual economic impact of BPH has been estimated at nearly $4 billion in the Unites States.

Author Biography

Luke Fazio, MD, Humber River Hospital, Toronto, ON; TCBH Surgical Centre, Toronto, ON

Dr. Luke Fazio completed completed medical school at McGill University. He did his residency in urology at Western University and completed a fellowship in endourology and minimally invasive surgery through the University of Toronto at St. Michael’s Hospital. He took an associate staff position at Queen’s University before joining the Division of Urology at Humber River Hospital. His practice focuses on endourology as well as minimally-invasive and robotic surgery. For the last 4 years he has been the Division Head for urology at Humber River Hospital and the co-chair of the robotic surgery. He is also the medical director of urologic surgery at TCBH surgical centre in Toronto. 


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How to Cite

Fazio L. Management of Benign Prostatic Hyperplasia in 2024. Can Prim Care Today [Internet]. 2024 Jun. 17 [cited 2024 Jul. 19];2(1):19—23. Available from: