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1. Disorders of prostate gland ~presented by Dipannita Barik 4 th semester BSC Nursing student Government college of nursing Sarat Chandra chattopadhyay government medical College And Hospital

2. Prostate gland

3. Disorders of prostate gland Prostatitis benign prostatic hypertrophy ( bph ) Prostate cancer

4. Prostatitis Prostatitis is an inflammation of prostate gland . risk factors: young or middle age, infection of urinary or reproductive system, aids, urinary catheter use etc. Causative agents: most common causative agent is Escherichia coli , also klebsiella and proteus species cause prostatitis.

5. Prostatitis PATHOPHYSIOLOGY:

6. Prostatitis Categories of prostatitis Acute Bacterial prostatitis: sudden onset of fever, dysuria, perineal prostatic pain . Chronic bacterial prostatitis: typically asymptomatic. Chronic prostatitis: Genitourinary pain . Asymptomatic prostatitis: diagnosed during a workup infertility.

7. Prostatitis Diagnosis: History collection and physical examination culture of the prostate fluid or tissue urine analysis and culture WBC test MRI and transabdominal ultrasound.

8. Prostatitis Medical management: antimicrobial therapy: 10-14 days Antipyretics chronic bacterial prostatitis: antimicrobial (ciprofloxacin, norfloxacin )- 4 weeks oral antispasmodic agents Non bacterial prostatitis: antimicrobial ( doxycycline) – 2 weeks , anti cholinergic, anti inflammatory drugs .

9. Prostatitis Surgical management SUPRAPUBIC cystostomy TRANSURETHRAL resection of the prostate ( turp )

10. Prostatitis NURSING management: assess the patient’s health condition. administration of prescribed antibiotics and provision of comfort measures. Take history of previous luts / STDs Monitor recent voiding patterns. Genital examination – urethral discharge

11. Prostatitis Nursing diagnosis Ineffective thermoregulation related to infection as evidenced by high body temperature and patient ‘s VERBALISATION. Acute pain related to prostatitis as evidenced by pain management scale score ,poor facial expressions and patient VERBALISATION.

12. Benign prostatic hypertrophy definition: Bph is defined as non cncerous increase in size of prostate gland which involves hyperplasia of prostatic stromal and epithelial cell resulting in formation of large , fairly discrete nodules in transitional zone of prostate, which push on and narrow the urethra resulting in an increase resistance to flow of urine from the bladder.

13. Benign prostatic hypertrophy Etiology Aging Excessive accumulation of prostatic Androgen Family history Diet increases animal fat and fatty acids Alcohol consumption etc .

14. Benign prostatic hypertrophy PATHOPHYSIOLOGY

15. Benign prostatic hypertrophy Clinical manifestations Urinary frequency and urgeNCy Hesitancy Weak stream Of urine Dcrease in Urinry stream Dribbling or looking after urination Intermittency Pain and burning sensation

16. Benign prostatic hypertrophy DIAGNOSTIC EVALUATION HISTORY COLLECTION AND PHYSICAL EXAMINATION USG URODYNAMIC ANALYSIS MEASUREMENT OF PSA KIDNEY FUNCTION TEST NEUROLOGICAL EXAMINATION URINARY FLOW TEST POST VOID RESIDUAL DIARY 24 HOURS VOIDING DIARY TRANSRECTAL USG PROSTATE BIOPSY CYSTOSCOPY INTRAVENOUS PYELOGRAM

17. Benign prostatic hypertrophy Medical management non - pharmacological management pharmacological management: alpha -1- Blockers( prozosin , terazosin) 5- alpha reductase inhibitor ( finasteride ) , combination drug therapy.

18. Benign prostatic hypertrophy Surgical. Management : TRANSUREThral microwave thermotherapy TRANSURETHRAL NEEDLE ABLATION

19. Benign prostatic hypertrophy Laser therapy ABLATIVE PROCEDURE ENUCLEATIVE PROCEDURE

20. Benign prostatic hypertrophy Prostate lift EMBOLIZATION

21. Benign prostatic hypertrophy Open prostatectomy ROBOT ASSISTED PROSTATECTOMY

22. Benign prostatic hypertrophy TRANSURETHRAL resection of the prostate ( turp ) TRANSURETHRAL INCISION OF PROSTATE TRANSURETHRAL INCISION OF PROSTATE

23. Benign prostatic hypertrophy Nursing management: Nursing diagnosis: urinary retention related to enlarged prostate as evidenced by frequency, hesitancy, inability to empty bladder completely , bladder distension. Acute pain related to mucosal irritation as evidenced by poor facial expression,pain management scale score and pts VERBALISATION. Anxiety related to change in health status as evidenced by facial expression, sweating and pts VERBALISATION.

24. Prostate cancer Definition: prostate cancer is a malignant tumor usually grows slowly and remains confined to gland for many years.or it is the carcinoma of prostate gland.

25. Prostate cancer Risk factor Obesity Age Family history Lower level of vitamin D Prostatitis Elevated blood levels of testosterone

26. Prostate cancer PATHOPHYSIOLOGY

27. Prostate cancer Clinical manifestations Asymptomatic at early staGe Hesitancy and straining on voiding Nocturia Pain Anemia , weight loss, weakness, nausea, oligouria , hematuria Lower extremities edema

28. Prostate cancer Diagnostic evaluation history collection and physical examination Digital rectal examination needle biopsy trans rectal usg psa test

29. Prostate cancer Medical management Analgesic and narcotics Hormonal therapy

30. Prostate cancer SURGICAL MANAGEMENT RADICAL PROSTATECTOMY CRYO SURGERY RADIATION TURP SUPRAPUBIC CYSTOSTOMY

31. Prostate cancer Nursing management Assessment of pts health Adminitrating all medicines pre- operative management Post operative management

32. Prostate cancer Nursing diagnosis Impaired urinary elimination relaturethral obstruction of urethra as evidenced by intake output chaRt and patient VERBALISATION. Risk for infection to urinary incontinence, difficulty voiding as evidenced By poor facial expressions, constant question and sweating.

33. Prostate cancer Pre oprerative inTervention Post operative intervention

34. Evaluation What are the disorders of prostate gland? Say some pre and post operative management of surgical procedures in prostate gland.