Lesson Plan on Beningn Prostatic Hyperplasia

1. LESSON PLAN ON MANAGEMENT OF
BENIGN PROSTATIC HYPERPLASIA
Submitted to:
Submitted by: Ms. Sancty Thomson
Submitted on:

2. LESSON PLAN ON MANAGEMENT OF BENIGN
PROSTATIC HYPERPLASIA
I) Introduction:
 Good afternoon, all. How are you? Hope you all had a good lunch. I would like
to share a recent experience with you. I have an uncle who is ex-serviceman.
He is a family man and gets along with all easily and consumes alcohol almost
frequently. Recently he complained of urine retention, increased urinary
frequency and nocturia. He consulted a Urologist and after investigations was
diagnosed as Benign Prostatic hyperplasia (BPH). What treatment can be
provided to him?

3. LESSON PLAN ON MANAGEMENT OF BENIGN
PROSTATIC HYPERPLASIA
II) Announcement of the Topic:
 Benign Prostatic hyperplasia (BPH)
III) Review:
 Where is the Prostatic gland located?

4. LESSON PLAN ON MANAGEMENT OF BENIGN
PROSTATIC HYPERPLASIA
IV) Definition:
 Benign Prostatic hyperplasia (BPH) is a benign enlargement of the prostate
gland.

5. LESSON PLAN ON MANAGEMENT OF BENIGN
PROSTATIC HYPERPLASIA

6. LESSON PLAN ON MANAGEMENT OF BENIGN
PROSTATIC HYPERPLASIA
V) Management:
The goals are to:
 restore bladder drainage
 relieve the patient's symptom
 prevent or treat the complications of BPH.

7. LESSON PLAN ON MANAGEMENT OF BENIGN
PROSTATIC HYPERPLASIA
Medical Management:
Non-Pharmacological Management:
The approaches include:
 Life-style modification
 Catheterization
 Double void

8. LESSON PLAN ON MANAGEMENT OF BENIGN
PROSTATIC HYPERPLASIA
Life-style modification:
Life-style alterations to address the symptoms of BPH include:
 Physical activity
 Decreasing fluid intake before bedtime.
 Moderating the consumption of alcohol and caffeine containing products
 Following a timed voiding schedule.

9. LESSON PLAN ON MANAGEMENT OF BENIGN
PROSTATIC HYPERPLASIA
Catheterization:
 The treatment plan depends on the cause of BPH, the severity of the
obstruction and the patient's condition
Double void:
 This means urine is passed twice in succession first empty the bladder
normally in a relaxed way, wait for few minutes, and try to void again, do not
strain or push to empty.

10. LESSON PLAN ON MANAGEMENT OF BENIGN
PROSTATIC HYPERPLASIA
Pharmacological Management:
Alpha blockers
 These medications relax the bladder neck muscles and muscle fibres in the
prostate, making urination easier. Examples are Alfuzosin, Doxazosin, Tamsulosin
and Silodosin.
5-alpha reductase inhibitors
 These medications shrink prostate by preventing hormonal changes that cause
prostate growth. Examples are Finasteride and Dutasteride.
Combination treatment
 Taking an alpha blocker and 5-alpha reductase inhibitor at the same time if either
medication alone isn’t effective.

11. LESSON PLAN ON MANAGEMENT OF BENIGN
PROSTATIC HYPERPLASIA
Surgical Management:
Transurethral resection of the prostate (TURP)
 Transurethral resection of the prostate (TURP) surgery used to treat urinary
problems that caused by an enlarged prostate.
 An instrument called a resectoscope is inserted through the tip of the penis
and into the tube that carries urine from bladder (urethra). The resectoscope
helps to visualize and trim away excess prostate tissue that's blocking urine
flow.

12. LESSON PLAN ON MANAGEMENT OF BENIGN
PROSTATIC HYPERPLASIA

13. LESSON PLAN ON MANAGEMENT OF BENIGN
PROSTATIC HYPERPLASIA
Transurethral incision of the prostate (TUIP)
 Transurethral incision of the prostate (TUIP) is a procedure to treat urinary
symptoms caused by an enlarged prostate. It's generally used for men with
small to moderated sized prostates.
 The resectoscope is inserted through the tip of the penis into the tube that
carries urine from bladder (urethra).
 Incision of one or two small grooves in the area where the prostate and the
bladder are connected (bladder neck) to open the urinary channel and allow
urine to pass through more easily.

14. LESSON PLAN ON MANAGEMENT OF BENIGN
PROSTATIC HYPERPLASIA

15. LESSON PLAN ON MANAGEMENT OF BENIGN
PROSTATIC HYPERPLASIA
Transurethral needle ablation (TUNA)
 Transurethral needle ablation (TUNA) also known as radiofrequency ablation.
It is an outpatient procedure to treat urinary symptoms caused by an enlarged
prostate.
 The resectoscope is inserted through the tip of the penis into the tube that
carries urine from bladder (urethra).
 The prostate surrounds the urethra. Using the cystoscope, guides a pair of
tiny needles into the prostate tissue that is pressing on the urethra. Radio
waves are then passed through the needles, generating heat that creates scar
tissue. Special shields protect the urethra from the heat. The scarring shrinks
prostate tissue, allowing urine to flow more easily.

16. LESSON PLAN ON MANAGEMENT OF BENIGN
PROSTATIC HYPERPLASIA
VI) Nursing Management:
 Health promotion
 Acute intervention
 Ambulatory and home care

17. LESSON PLAN ON MANAGEMENT OF BENIGN
PROSTATIC HYPERPLASIA
Health promotion:
 Early detection and treatment
 Reducing intake of caffeine and alcohol
 Avoid compounds found in cough and cold preparations.
 Avoid the risk of urinary stasis and urinary retention.

18. LESSON PLAN ON MANAGEMENT OF BENIGN
PROSTATIC HYPERPLASIA
Acute intervention:
 Preoperative care
 Post-operative care
 Preoperative care:
 Urinary drainage restored before surgery
 Antibiotics administered
 Allow to express sexual concerns.

19. LESSON PLAN ON MANAGEMENT OF BENIGN
PROSTATIC HYPERPLASIA
 Post-operative care:
 Complications if any are noted
 Remove clotted blood from the bladder
 Inflow & out flow of irrigant are strictly monitored.
 Prevent urethral irritation and bladder infection.
 Reduce the bleeding site of the prostate by applying counter pressure
 Avoid bladder spasms
 Practice pelvic floor exercises
 Straining during bowel movements avoided

20. LESSON PLAN ON MANAGEMENT OF BENIGN
PROSTATIC HYPERPLASIA
Ambulatory and Home care:
 Care of catheter
 Managing urinary in-continence.
 Intake of oral fluids 2000-3000ml day
 Observing for urinary tract and wound infection
 Prevent constipation
 Avoid heavy lifting

21. LESSON PLAN ON MANAGEMENT OF BENIGN
PROSTATIC HYPERPLASIA
VII) Complications on BPH Surgery:
 Bleeding from the urethra, outer prostate or penis.
 Inflammation and pain in the urethra, prostate or penis lasting longer than 2
weeks.
 Reduced urine flow or urinary symptoms such as incontinence or urinary
urgency 6 weeks past surgery.
 Blood in the urine that is severe or last longer than 4 – 6 weeks.
 Severe clots of blood in urine or urine that is entirely red.
 Dizziness, shortness of breath or confusion.
 Severe abdominal pain or discomfort.

22. LESSON PLAN ON MANAGEMENT OF BENIGN
PROSTATIC HYPERPLASIA
VIII) Summary:
 During this class we have discussed about the definition, medical, surgical and
nursing management of Benign Prostatic hyperplasia (BPH).
IX) Recapitalization Question
 What is Benign Prostatic Hyperplasia?
 How does the doctor detect the prostate enlargement?
 What are the treatment options?
 Detail the steps involved in nursing management of Benign Prostatic Hyperplasia?

23. LESSON PLAN ON MANAGEMENT OF BENIGN
PROSTATIC HYPERPLASIA
THANK YOU