Nursing 211

N211: Health Differences Across the Lifespan I

3.10 Benign Prostatic Hyperplasia Benign Prostatic Hyperplasia (BPH) is enlargement or hypertrophy of the prostate. It is the most common genitourinary system problem of the older male occurring in about 50% of men over the age of 50 years of age. The enlargement of the prostate gland places pressure on the prostatic urethra, leading to dysuria and difficulty voiding. The obstruction causes the bladder musculature to lose its elasticity, which results in urinary retention. Nursing Assessment Includes increased frequency of voiding with a decrease in the amount of each void; nocturia, hesitancy, terminal dribbling, decrease in size and force of stream, acute urinary retention and bladder distension. Diagnostics Include digital rectal examinations indicates enlarged and elastic gland. Cystoscopy shows the extent of the urethra and bladder infringement. Intravenous and retrograde pyelogram provides information about possible damage to the upper urinary tract secondary to urinary retention. Blood chemistries, BUN, and creatinine rule out kidney dysfunction from kidney damage by prolonged obstruction at the bladder neck. Prostate specific antigen (PSA) may be slightly elevated if BPH is present. Marked elevation may indicate cancer. Nursing Diagnosis • Pain related to bladder distension secondary to prostate enlargement • Risk for infection related to indwelling catheter • Fear related to potential or actual sexual dysfunction, possible diagnosis of cancer, and lack of knowledge regarding surgical procedure • Pain related to irrigation and clots, presence of catheter • Ineffective therapeutic management related to lack of knowledge of postoperative follow up care Medical Interventions Include Suprapubic prostatectomy, retropubic prostatectomy, perineal prostatectomy, transurethral prostatectomy (TURP), and laser ablation. Finasteride (Proscar), an androgen hormone inhibitor, can be given to decrease symptoms. Non-surgical procedures include intermittent catheterization or insertion of an indwelling catheter may bypass the obstruction. Stents or coils are placed in the urethra, holding it open, allowing unobstructed urinary flow. Prostatic balloon dilation uses a balloon to dilate the urethra by


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