Benign Prostatic Hyperplasia (BPH)

Benign Prostatic Hyperplasia (BPH)

Prostrate is a gland about the size of a walnut and is present only in males. It lies below the urinary bladder and surrounds the urethra. The prostate secrete a fluid that helps to nourish sperm as part of the semen (ejaculatory fluid). It is a noncancerous enlargement or hypertrophy of the prostate.

Definition

A benign (not cancer) condition in which an over growth of prostane tissue pushes against the urethra and bladder, blocking the flow of urine.

Risk factors

•               Aging occurs after 50- 80 years.

•               Family history

•               Obesity

•               Diabetes

•               Heart diseases.

•               Diabetes and heart diseases and use of beta blockers

•               Obesity

•               Ethnicity Black men may get symptoms at a younger age.

Causes

•               Hormonal changes androgen/estrogen imbalance

•               Neoplastic theory is of all the elements of prostoke

•               Frequency

Signs and Symptoms

•               Hesitancy, urgency, weak stream and straining to pass urine

•               Nocturia

•               Acute retention of urine

•               Chronic retention of urine

•               Dribbling or leaking during urination after urination

Diagnosis

•               History collection

•               Physical examination -digital rectal exam to check the size and shape of the prostate.

•               Urine culture and sensitivity to rule out infection

•               Uroflowmetry: Urine flow test to measure the urine stream.

•               Measurement of post voidal residual volume

•               PSA (Prostate-Specific Antigen) blood test. High PSA levels are a sign of a large prostate.

•               Ultra Sonogram

•               Biopsy to rule out cancer.

•               Cystocopy as part of treatment.

Management

Medical

•               Alpha blockers- relax the muscles of the prostate and neck of the bladder.

•               5-Alpha Reductase Inhibitors (5-ARIs)-shrinks the prostate and prevents additional growth.

•               Phosphodiesterase 5 Inhibitors (PDE5 inhibitors) - relieves the symptoms and increases the flow rate of urine

Surgical

•               Transvesical suprapubic Prostatectomy

•               Transurethral resection of the prostate (TURP)

•               Retropubic prostatectomy.

Nursing

•               Ensure patient voids at regular intervals

•               Provide warm environment as cold worsens the symptoms

Lifestyle changes:

•               Exercise to strengthen the pelvic floor muscles

•               Reduce the intake of fluids in the night before going to bed

•               Avoid caffeine and alcohol

Complications

•               Urinary tract infection(UTI)

•               Renal stone

•               Bladder outlet obstruction

•               Renal failure.