BPH is an enlargement of the prostate gland due to increased cell growth. Risk factors include aging, family history, and lifestyle factors like smoking, alcohol, and diet high in animal fats. Symptoms include difficulty urinating and frequent urination. Treatment involves medications to relax the bladder and prostate or surgical procedures to remove prostate tissue. Nursing management focuses on restoring urinary function, preventing infections, and educating patients.

1. BENGIN PROSTATE
HYPERPLASIA (BPH)
ANILKUMAR BR
MSC. N (MSN)

2. INSIDE
 Definition
 Etiology and risk factors
 Pathophysiology
 clinical manifestations
 complications
 Diagnostic assessment
 Medical management
 Surgical management
 Nursing management

3. It is a condition progressive
enlargement of prostate gland,
resulting from an increase in the
number of size of epithelial cells
and stromal tissue.

5. Etiology
 Ageing
 Excessive accumulation of prostatic androgen
 Family history
 Diet increase animal fat and saturated faty acids
 Reduced exercise and alcohol consumption

6. Continue..
 Recent studies have identified
smoking (both current and
former smoking), heavy alcohol
consumption, hypotension, heart
disease and diabetes mellitus as
risk factors associated with BPH.

7. PATHOPHYSILOGY
 The cause of BPH is uncertain, but studies
suggest that estradiol levels may have a
relationship to prostate size among men
with testosterone levels above the median.
 Recent studies have identified smoking
both current and former, heavy alcohol
consumption, hypertension, heart disease
and diabetes as risk factors of BPH.

8. Conti
 The hypertrophied lobes of prostate may obstruct the
vesical neck or prostatic urethra, causing incomplete
emptying of the bladder and urinary retention.
 As a result. A gradual dilation of the ureters
(hyroureter) and kidneys (hydronephrosis) can occur.
Urinary tract infections may result from urinary stasis.
Urine remaining in the urinary tract serves as a
medium for infectve organisms.

9. Signs and symptoms
 Obstructive
Reduced force of urine stream
Difficulty in initiating voiding
Intermittency
Dribbling at the end of urination

10. Sings and symptoms conti…
 Irritative
Frequency
Urgency
Dysuria
Bladder pain
Nocturia (excessive urination at night)
Incontinence

11. Continue
 Inflammation and infection
 Decrease volume and force of the
urinary stream
 sensation that the bladder has not
been completely emptied

12. Generalized symptoms include
• Fatigue
• Anorexia
• Nausea and vomiting
• Epigastric discomfort

13. Complications
 Acute urinary retention
Urinary tract infections (UTI)
Renal stone (kidney stone)
Bladder damage
Hydronephrosis
Pyelonephritis

15. Assessment and diagnostic findings

16. Continue
 Complete blood studies are performed because hemorrhage
is a major complication of prostate surgery, all cloting defects
must be corrected. A high percentage of patients with BPH
have cardiac or respiratory complications, or both because of
their age therefore cardiac and respiratory function also
assessed.

17. Medical management
 The main goals of medical
management
• Restore bladder function
• Relive signs and symptoms and
prevent and treat complications.

18.  The treatment Plan depends on the
cause of BPH, the severity of the
obstruction, and the patient’s general
health conditions.
If the patient is admitted on an
emergency basis because he can not
void, he is immediately catheterized.

19. Diet
 Decrease amount of intake
caffeine and artificial swetners,
limit spicy and acidic foods
and alcohol.

20. Pharmacologic therapy
 Pharmacologic therapy include
• Alpha adrenergic blocker and 5-alpha
reductase inhibitors this type of
medications relax the smooth muscle of
the bladder neck and prostate. The
smooth muscle blockade improves
urine flow and relives BPH symptoms.

21. Surgical approaches or therapy
 several approaches or methods
can be used to remove the portion
of the enlarged prostate gland.

22. Types of surgical therapy for BPH
 Closed surgical procedure
• TURP (Transurethral resection of
the prostate)
• TUIP (Transurethral incision of
the prostate)

23. Open surgical procedure
 Suprapubic prostectomy
Perineal prostectomy
 Retropubic prostectomy

24. TURP (Transurethral resection of the
prostate)
Removal of prostate tissue using a
resectoscope inserted through the
urethra under spinal or general
anesthesia.

25. TUIP (Transurethral resection of the
prostate)
Is an out patient basis procedure of
delivery microwaves directly to the
prostate Transurethral probe

26. Suprapubic prostectomy
suprapubic prostectomy is one
method of removing the enlarged
gland through an abdominal incision .
An incision is made into the bladder
and the prostate gland is removed
from above.

27. Perineal prostectomy
Perineal prostectomy involves
removing the gland through an
incision in the perineum. (This method
is practical when other methods or
approaches are not possible.

29. Retropubic prostectomy
Retropubic prostectomy is a another
technique, is more common than
suprapubic approach. Incision made on
low abdominal between prostate gland
and pubic arch and the bladder without
entering the bladder.

30. Nursing management
The goals of nursing management
• Restoration of urinary drainage
• Treatment of urinary tract infections
• understanding the procedure

31. Pre operative interventions
 Avoid alcohol and caffeine
 Advise to urinate every 2-3 hours
 Normal fluid intake should be maintain and
avoid over fluid intake and volume over
land.
 Antibiotics before any Invasive procedure

32. Post operative care
 Assess the patient’s conditions.
 Main complications is hemorrhage, bladder spasm,
urinary Incontinence and infections.
 Bladder irrigation
 cathter care
 Avoid activities that increase abdominal pressure.

33. Continue
 To Relive bladder spasms use Anti spasmodics
 After removing catheter, patient should urinate
within 6 hours.
 Patient should practice pelvic floor exercise ( kegel
exercise)
 Encourage to practice straining and stoping the
stream during urination.

34. Continue
 Dietary advice or management
including fiber and easily digestibale
food
 Adminster stool softners, avoid heavy
alcohol intake, weighting, and sexual
intercourse.