Benign prostatic hyperplasia (BPH) is a common non-cancerous enlargement of the prostate gland in older men. As men age, the prostate may grow large enough to squeeze the urethra and obstruct the flow of urine. BPH generally begins producing symptoms after age 50. Risk factors include increasing age and family history. Symptoms include frequent urination, weak urine stream, and incomplete bladder emptying. Diagnosis involves a digital rectal exam and other tests to rule out prostate cancer. Treatment options include watchful waiting, medications to shrink the prostate or relax muscles, and surgery to remove part of the prostate if symptoms are severe. Nursing care focuses on managing symptoms, preventing complications, and educ

1. Mrs. Sneha Patel
Apollo institute of nursing
Gandhinagar
BENIGN PROSTATIC
HYPERTROPHY

2. • Prostate gland is
located below the
urinary bladder and
surrounds the urethra
• Two major functions of
the prostate include:
• Secreting fluids that
contribute to the
ejaculatory volume
• Secreting fluids that
have antibiotic
effects
PROSTAT GLAND:

4. WHAT IS BENIGN PROSTATIC
HYPERTROPHY?
• Benign Prostatic Hypertrophy (BPH) is a
common condition affecting the prostate
• BPH is defined as an enlargement of the
prostate gland – is not prostate cancer
• Prostate becomes enlarged because the cells of
the prostate increase in number

5. • Benign prostatic hyperplasia (BPH), also
known as benign prostatic hypertrophy is
a non-cancerous enlargement of the
prostate,
• The prostate gland enlarges, extending
upward into the bladder and obstructing
on the vesical orifice

6. • This condition is known as B.P.H , the
enlargement or hypertrophy of the prostate
gland enlargement can block the flow of urine
out of the bladder and can cause bladder, urinary
tract or kidney problems
• BPH generally begins in a man’s 30s evolves
slowly, and most commonly only causes
symptoms after 50

8. EPIDEMOILOGY:
• BPH is the most common disease of aging men
in America
• Disease prevalence is age dependent
• By 60 years of age, prevalence is > 50%
• By 80 years of age, prevalence is 90%
• Estimated that 50% of men who have an
enlarged prostate have moderate to severe
lower urinary tract symptoms (LUTS)

9. CAUSES:
• Exact cause is unknown
• Age most common risk factor
• Certain medical conditions
• Cardiovascular disease risk factors (obesity, high
blood pressure, and metabolic syndrome) are also
associated with developing BPH
• Certain medications can worsen BPH-related symptoms
• Testosterone should not be administered in patients with
BPH due it’s effects of enlarging the prostate

10. RISK FACTORS:
• Age: after 40 years of age
• Family history
• Ethnic background: most common
in white and black man
diet, effects of chronic inflammation

11. PATHOPHYSIOLOGY
• Due to etiological factor enlargement of prostate gland
• Normally thin and fibrous outer capsule of prostate become
spongy and thick as enlargement progress
• Hypertrophied lobes compress bladder neck or prostatic
urethra, causing incomplete emptying and urinary retention
• Gradual dilation of ureter and kidney
• Prolonged urinary retention/obstruction causes urinary tract
infection

12. CLINICAL MANIFESTATION:
 urgency, frequency
Changes in size and force of urinary stream
Retention
Dribbling
Nocturia
Hematuria
Urinary stasis
UTIs

13. DIAGNOSTIC INTERVENTION:
History
Physical examination – digital rectal examination
may be done
Clinical manifestation
Urianalysis and urodynamic studies
Renal function studies including serum creatinine
Haematologic investigation and clotting profile
Assement of cardio-respiratory function.

14. • Digital rectal examination of prostate
-- Prostate size, consistency, surface nodularity,
tenderness
• Bladder palpation – residual urine volume
• Cystography, Intravenous pyelography
• Transrectal sonography of prostate

15. • Medical treatment to reduce prostate size
or decrease intraprostatic resistance
• Surgical treatment to remove prostatic
obstruction or reduce urethral resistance
• Minimally invasive therapies

16. MEDICAL THERAPY FOR BPH
• The treatment plan depends on the cause of
BPH severity of obstruction and the condition of
the patient
• Watchful waiting: watchful waiting is often
chosen by men who are not bothered by
symptoms of BPH. They have no treatment but
get regular checkup and wait to see whether or
not the condition gets worse.

17. • Alpha-1 – adrenergic receptor blockers:-- this drugs that
can inhibit the contraction of the smooth muscle of the
prostate gland and bladder neck and in this way improve
the urinary flow rate. alpha blockers work quickly
• 5-alpha-reductase inhibitors:-- block the conversion of the
male hormone testosterone into its active form in the
prostate, the prostate enlargement in BPH is directly
dependent, decreased levels of dihydrotestosterone,
suppress glandular cell activity size

18. SURGICAL TREATMENT:
1. Trans Urethral resection of prostate (TURP):
It is the most common procedure and can be carried out
by means of an endoscopic instrument that has ocular
and surgical capability. The instrument is introduced
directly through the urethra to prostate, which can be
viewed directly. The gland is then removed in small chips
with an electrical cutting loop.
2. Suprapubic prostectomy:
This is one method of removing the prostate gland
through an abdominal wound. An opening is made into the
bladder, and the gland is removed from above.

19. CONTD…
3. Perineal prostatectomy:
It involves the removal of gland through an incision in the
perineum.
4. Retropubic prostatectomy:
It is another technique and is more common than the
suprapubic approach. A low technique and is more
common than the suprapubic approach. A low abdominal
incision is made, and the prostate gland is approached
between the pUbic arch and the bladder.

20. NURSING MANAGEMENT:
1. Encourage fluid intake of up to 2000 to 3000 ml.per day unless
contraindicated.
2. Prepare for bladder drainage via urinary catheterization for distention.
3. Avoid administering medication that cause urinary retention, such as
anticholinergics, anti histamines and decongestants.
4. Administer finasteride (Proscar) as prescibed to shrink the prostate gland
and improve urine flow.
5. Prepare the client for surgery and prescribed.
6. Reduce anxiety and facilitate communication
7. Bed rest must be ensured
8. Analgesics to be administered
9. Monitor voiding patterns and clinical manifestation
10. Cathererization to be done
11. Pre- operative enma to prevent post operative straining.

21. CONTD…
• Post- operative:
1. Bed rest for 1st 24 hours
2. Warm compress to pubis or sitz baths to provide symptomatic relief of
spasms.
3. Analgesics to relieve pain
4. Monitor patient's vital signs
5. Catheter irrigation and care is important
6. Prevent infection by aseptic precautions during wound dressing
7. Heat lamp may be directed to perineal area to promote healing
8. Sitz baths are encouraged to promote healing
9. Encourage walking and perineal exercises
10. Prevent constipation and encourage fluids
11. Educate and pressure that sexual activity may be resumed in 6 to 8 weeks.

22. COMPLICATIONS:
• HEAMORRHAGE
• INFECTION
• THROMBOSIS
• CATHETER OBSTRUCTION

23. THANK YOU !!!