Benign prostate hypertrophy

BPH

1. BENIGN PROSTATIC HYPERTROPHY MR. MOUNESH. BADIGER SENIOR TUTOR MEDICAL SURGICAL DEPARTMENT KAHER INSTITUTE OF NURSING SCIENCES, BELAGAVI, BPH MR. MOUNESH BADIGER, MSc (N) Senior Tutor MEDICAL SURGICAL DEPARTMENT KAHER ,ION,BELAGAVI 23/10/2020 1 MOUNESH

2. PROSTATE GLAND The main function of the prostate gland is to secrete an alkaline fluid that comprises approximately 70% of the seminal volume. The secretions produce lubrication and nutrition for the sperm. The alkaline fluid in the ejaculate results in liquefaction of the seminal plug and helps to neutralize the acidic vaginal environment. The prostate secretes fluid that nourishes and protects sperm. During ejaculation, the prostate squeezes this fluid into the urethra, and it’s expelled with sperm as semen 23/10/2020 MOUNESH 2

3. INTRODUCTION Be n ign pr o stat i c hyp e r p lasia (BPH) i s a benign enlargement of the prostate gland . This condition is known as benign prostatic hyperplasia (BPH), the enlargement, or hypertrophy of the prostate. 23/10/2020 3 MOUNESH

4. It is the most common urologic problem in male adults. 50 % of men having evidence of BPH by age of 50years . 8 5 % by age of 80 years. 23/10/2020 4 MOUNESH

5. DEFINITION Be n ign pr o stat i c hyp e r p lasia or hypertrophy (BPH) i s a condition characterized by benign enlargement of the prostate gland in men that leads to urinary obstruction. 23/10/2020 5 MOUNESH

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8. CAUSES AND RISK FACTORS Dihydrotestosterone (DHT) (14-77ng/dl) Idiopathic Smoking Oncology conditions 23/10/2020 8 MOUNESH

9. Aging. Family history. Lifestyle – Obesity Erectile dysfunction 23/10/2020 9 MOUNESH

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11. Increased frequency of urination Nocturia Post void dribbling Decrease i n v o lu m e an d fo r ce of urinary stream Sensation o f inco m pl e t e e m pt y ing of the bladder Suprapubic discomfort and distention 23/10/2020 11 MOUNESH

12. Acute urinary retention (more than 60 ml) Recurrent UTI S . Fatigue Anorexia Nausea and vomiting Ultimately azotaemia Hematuria. 23/10/2020 12 MOUNESH

13. PATHOPHYSIOLOGY 23/10/2020 13 MOUNESH

14. Due to etiological factor enlargement of prostate gland hypertrophied lobes compress the bladder of neck causing urinary retention Gradual dilation of ureter and kidneys Prolonged urinary retention and obstruction cause UTI 23/10/2020 14 MOUNESH

15. DIAGNOSTIC METHODS 23/10/2020 15 MOUNESH

16. History collection Physical examination Urinalysis t o s c re e n f o r h e m a tur i a and UTI. Prostate-specific antigen (PSA ) 4.0 ng/ml Cystoscopy Ultrasound CT scan or MRI 23/10/2020 16 MOUNESH

17. Uroflowmetry: detects poor force of urinary stream Voiding cystogram : detects anatomic defects of urethra Hematological: CBC, RFT and Coagulation profile. 23/10/2020 17 MOUNESH

18. MEDICAL MANAGEMENT 23/10/2020 18 MOUNESH

19. Indwelling catheterization A suprapubic cystostomy or suprapubic catheter 23/10/2020 19 MOUNESH

20. Alpha blockers. ( α- blockers or α- adrenoreceptor antagonists) These medications relax bladder neck muscles and muscle fibers in the prostate, making urination easier . 5-alpha reductase inhibitors . (dihydrotestosterone blockers) These medications shrink prostate by preventing hormonal changes that cause prostate growth . Hair loss treatment. 23/10/2020 20 MOUNESH

21. Tadalafil ( Cialis ): Studies suggest this medication, which is often used to treat erectile dysfunction, can also treat prostate enlargement. Pulmonary artery hypertension. Antibiotics A ntispasmodic Antiemetic Loop diuretics 23/10/2020 21 MOUNESH

22. MEDICAL MANAGEMENT 23/10/2020 22 MOUNESH

23. Transurethral resection of the prostate (TURP) It is performed by visualizing the prostate through the urethra and removing tissue by electro cautery or sharp dissection. 23/10/2020 23 MOUNESH

24. Transurethral incision of the prostate (TUIP) 23/10/2020 24 MOUNESH

25. COMPLICATIONS Acute urinary retention Involuntary bladder contraction Cystolithiasis Gross hematuria UTI 23/10/2020 25 MOUNESH

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