Benign prostatic hyperplasia (BPH) - also called prostate gland enlargement and one of the

most common diseases in aging men. BPH typically occurs in men older than 40 years of age.
By the time they reach 60 years of age, 50% of men have BPH. It affects as many as 90% of men
by 85 years of age. BPH is the second most common cause of intervention in men older than 60
years of age.

An enlarged prostate gland can cause uncomfortable urinary symptoms, such as blocking the
flow of urine out of the bladder. It can also cause bladder, urinary tract or kidney problems.

Modifiable Non- Modifiable

1. Diabetes Mellitus 1. Aging <40 years
2. Heredity
2. Heart Disease
3. Lifestyle - Obese
 Disease Process
Nodules (Hyperplasia and Hypertrophy)
FORM IN THE INNER PROSTATE

URETHRA IS COMPRESSED

INCOMPLETE EMPTYING OF BLADDER

INFECTION CYSTITIS BLADDER DISTENTION

Hydronephritis

Pyelonephritis
Kidney Damage

Sign and Symptoms Diagnostic Test

Frequent or urgent need to urinate 1. Digital rectal exam

Increased frequency of urination at night 2. Urine Test

(nocturia)
3. Blood Test
Difficulty starting urination
4. PSA test
Weak urine stream or a stream that stops
5. Urinary Flow test
and starts

Dribbling at the end of urination 6. Post void residual volume test

Inability to completely empty the bladder 7. 24-hour voiding diary

8.Transrectal ultrasound
Urinary tract infection
9. Prostate biopsy
Inability to urinate

Blood in the urine 10. Cystoscopy

 Acute Pain Risk for
Urinary related to
retention
Deficient Fluid
bladder Volume
related to distention
enlarged related to
prostate overdistended
bladder

Nursing Intervention
• The treatment plan depends on the cause, severity of obstruction, and condition of the patient.
Treatment measures include the following:
• Immediate catheterization if patient cannot void (an urologist may be consulted if an ordinary catheter
cannot be inserted). A suprapubic cystostomy is sometimes necessary.
• “Watchful waiting” to monitor disease progression.

Pharmacologic Management
•Alpha-adrenergic blockers (eg, alfuzosin, terazosin), which relax the smooth muscle of the bladder
neck and prostate, and 5-alpha-reductase inhibitors.
• Hormonal manipulation with antiandrogen agents (finasteride [Proscar]) decreases the size of the
prostate and prevents the conversion of testosterone to dihydrotestosterone (DHT).
•Use of phytotherapeutic agents and other dietary supplements (Serenoa repens [saw palmetto berry]
and Pygeum africanum [African plum]) are not recommended, although they are commonly used.

Surgical Management
•Minimally invasive therapy: transurethral microwave heat treatment (TUMT; application of heat to
prostatic tissue); transurethral needle ablation (TUNA; via thin needles placed in prostate gland);
prostatic stents (but only for patients with urinary retention and in patients who are poor surgical risks)
• Surgical resection: transurethral resection of the prostate (TURP; benchmark for surgical treatment);
transurethral incision of the prostate (TUIP); transurethral electro vaporization; laser therapy; and open
prostatectomy
 Complications

 Sudden inability to urinate (urinary retention). You might need to

have a tube (catheter) inserted into your bladder to drain the urine.
Some men with an enlarged prostate need surgery to relieve urinary
retention.

 Urinary tract infections (UTIs). Inability to fully empty the bladder

can increase the risk of infection in your urinary tract. If UTIs occur
frequently, you might need surgery to remove part of the prostate.

 Bladder stones. These are generally caused by an inability to

completely empty the bladder. Bladder stones can cause infection,
bladder irritation, blood in the urine and obstruction of urine flow.

 Bladder damage. A bladder that hasn't emptied completely can

stretch and weaken over time. As a result, the muscular wall of the
bladder no longer contracts properly, making it harder to fully empty
your bladder.

 Kidney damage. Pressure in the bladder from urinary retention can

directly damage the kidneys or allow bladder infections to reach the
kidneys.