Benign prostate hypertrophy.pptx .

PRESENTED BY:
Ms. Yashaswini Hiremath
2nd year B.Sc. Nursing
BBC College of Nursing Gangavathi

1. BENIGN PROSTATE HYPERTROPHY PRESENTED BY : Ms. Yashaswini Hiremath 2 nd year B.Sc. Nursing BBC College of Nursing Gangavathi SUPERVISED BY: Mr. George. D. Honnalli M.Sc.[N] HOD, Dept of Medical Surgical Nursing BBC College of Nursing Gangavathi

2. INTRODUCTION Benign Prostate Hypertrophy (BPH) is a common condition that affects many men as they age, significantly impacting their quality of life. The condition often leads to a range of symptoms that can interfere with daily activities and overall well-being.

3. ANATOMY AND PHYSIOLOGY Location : below the bladder, in front of the rectum and surrounding the urethra. Size : 1.5 inch and oval in shape weight 20 gm Function: production of seminal fluid. sperm protection urine control

4. DEFINITION Benign Prostate Hypertrophy (BPH) is a non-cancerous enlargement of the prostate gland that commonly occurs in older men. This condition leads to the growth of the prostate tissue.

5. As of 2023, the global prevalence of BPH among men aged 60 years and older remains high, with estimates suggesting around  80 million cases . The age-standardized prevalence is approximately  2,500 per 100,000 people . In India, BPH continues to affect about  50% of men by the age of 60 years . INCIDENCE

6. CAUSES Exact cause is unknown RISKFACTORS Age: 40 years and above Gender: in men Hormonal change: Accumulation of dihydroxy testosterone, Genetics: Family history Lifestyle factors: Obesity Chronic conditions: Diabetes and heart disease Inflammation: Prostate inflammation or infection

7. DUE TO ETIOLOGICAL FACTOR LIKE AGING DECREASED TESTOSTERNE LEVEL TESTOSTERONE CONVERTED INTO DEHYDROXYTESOSTERONE DEHYDROXYTESTOSTERONE ACCUMULATED IN STROMAL CELL OF PROSTATE ENLARGEMENT OF P ROSTATE BENIGN PROSTATE HYPERTROPHY PATHOPHYSIOLOGY

8. CLINICAL MANIFESTATIONS Urinary Symptoms Frequency: Needing to urinate more often, especially at night (nocturia). Urgency: A sudden, strong urge to urinate. Hesitancy: Difficulty starting urination, even with the urge. Weak stream : A decrease in the force of the urine stream. Intermittent stream: Starting and stopping several times during urination. Incomplete emptying: Feeling that the bladder is not fully emptied after urination. Straining: Needing to push or strain to initiate or maintain urine flow. Dribbling: Leakage of urine, especially after finishing urination.

9. Bladder and Kidney Issues Bladder distension: Swelling of the bladder due to the inability to fully empty. Urinary retention: Inability to pass urine Infections: Increased risk of urinary tract infections (UTIs) due to retained urine. Bladder stones: Formation of stones due to stagnant urine. Kidney damage: Long-standing BPH can lead to kidney damage due to increased pressure in the bladder and urinary system.

10. General Symptoms Discomfort or pain: Discomfort in the lower abdomen or pelvis, sometimes due to bladder distension or UTIs. Hematuria: Presence of blood in the urine, though rare in uncomplicated BPH, it can occur if there is bladder damage or infection.

11. DIAGNOSTIC EVALUVATION History collection Physical examination Digital rectal exam[DRE] Prostate-specific antigen test [PSA] Urine flow test Postvoid residual volume test Ultrasound[transrectal] Cystoscopy

12. URINE FLOW TEST Postvoid residual volume test

13. Cystoscopy Ultrasound[transrectal]

14. MANAGEMENT

15. PHARMACOLOGICAL MANAGEMENT Watchful waiting – It is often chosen by men who are not bothered by the symptoms of BPH. They have no treatment but to get regular checkups and wait to see whether or not the condition get worse. Alpha 1 androgenic receptor blockers - Tamsulosin Dose - 0.4 mg Route – oral Frequency – OD[30 min after meal] 5 alpha reductive inhibitors - Finasteride Dose – 5 mg Route – oral Frequency – OD[without meal]

16. NON-PHARMACOLOGICAL MANAGEMENT LIFE STYLE MODIFICATION : Fluid management ,bladder training, avoid irritants, diet PELVIC FLOOR EXERCISE: Kegel exercise HYDROTHERAPY : warm bath BEHAVIOURAL MODIFICATION : encourage the patient to urinate for few minutes

17. SURGICAL MANAGEMENT 1. Transurethral resection of the prostate [TURP]

18. 2. Suprapubic prostectomy

19. 3.Retropubic prostectomy 4. Perineal proeostectomy Removing of prostate gland through an incision in the perinium

20. Minimal invasive therapy Transurethral needle ablation : It uses low-level radio frequencies to produce localized heat to destroy prostate tissue. Microwave thermotherapy : Microwaves are passed through a catheter inserted to the urethra opening of the penis to destroy the excess tissue Transurethral laser resection : Cystoscopy inserted into the urethra and a laser attached to the cystoscope fiber and it sends laser to burn away the prostate tissue Prostate stent : Prostate stent is a tubular device inserted to the urethra to the point of construction it allowed to expand

21. NURSING MANAGEMEMNT

22. Monitor urinary output frequency and urgency Assess for bladder distension and signs of urinary retention Educate on fluid intake [avoid excessive fluids at night] Advise on avoiding bladder irritants caffeine and alcohol Administer prescribed medications like Alpha one blocker or 5 Alpha adaptors inhibitor monitor for side effects like dizziness or hypotension Watch for signs of infection example fever and this area assess for acute urinary retention or hematuria

23. Prepare the patient for non invasive treatments like TUMT or surgical interventions TURP Provide post procedure care and monitor for complications like bleeding Advice routine checkups to monitor prostate size and urinary symptoms Help with the positioning to ease urinary discomfort Encourage pelvic floor exercises to strengthen muscles and improve control

24. NURSING DIAGNOSIS : IMPAIRED URINARY ELIMINATION REALTED TO BLADDER OUTLET OBSTRUCTION DUE TO ENLARGED PROSTATE AS EVIDENCED BY WEAK URINE STREAM. ACUTE PAIN RELATED TO BLADDER DISTENSION AS EVIDENCED BY VERBALIZATION . RISK FOR INFECTION RELATED TO URINARY STASIS DUE TO IMCOMPLETE BLADDER EMPTYING. URINARY RETENTION REALTED TO ENLARGED PROSTATE AS EVIDENCED BY INABILITY TO VOID . DISTURBED SLEEP PATTERN REALTED TO FREQUENT NOCTURIA AS EVIDENCED BY FATIGUE DURING THE DAY

25. CONCLUSION Benign Prostatic Hyperplasia (BPH) is a common condition affecting older men, characterized by the non-cancerous enlargement of the prostate gland. This enlargement can lead to significant urinary symptoms, including frequent urination, difficulty starting and stopping urination, and weak urine flow.

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