The document discusses disorders of the prostate gland, including prostatitis, benign prostatic hypertrophy (BPH), and prostate cancer, detailing their definitions, risk factors, clinical manifestations, diagnostic evaluations, and management strategies. Prostatitis includes various types and is diagnosed through physical exams and cultures, while BPH is characterized by non-cancerous enlargement leading to urinary symptoms and is managed pharmacologically or surgically. Prostate cancer is a slow-growing malignancy with specific risk factors and requires a combination of medical and surgical interventions for management.

2. PROSTATE GLAND

3. DISORDERS OF PROSTATE GLAND
1. PROSTATITIS
2. BENIGN PROSTATIC HYPERTROPHY ( BPH)
3. 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.

13. 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.

14. BENIGN PROSTATIC HYPERTROPHY
ETIOLOGY
• AGING
• EXCESSIVE ACCUMULATION OF PROSTATIC ANDROGEN
• FAMILY HISTORY
• DIET INCREASES ANIMAL FAT AND FATTY ACIDS
• ALCOHOL CONSUMPTIONETC .

15. BENIGN PROSTATIC HYPERTROPHY
PATHOPHYSIOLOGY

16. 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

17. 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

18. BENIGN PROSTATIC HYPERTROPHY
MEDICAL MANAGEMENT
• NON - PHARMACOLOGICAL MANAGEMENT
• PHARMACOLOGICAL MANAGEMENT:ALPHA -1- BLOCKERS( PROZOSIN, TERAZOSIN)
5- ALPHA REDUCTASE INHIBITOR ( FINASTERIDE) , COMBINATION DRUG THERAPY.

19. BENIGN PROSTATIC HYPERTROPHY
• SURGICAL. MANAGEMENT :
TRANSURETHRAL MICROWAVE THERMOTHERAPY TRANSURETHRAL NEEDLE ABLATION

20. BENIGN PROSTATIC HYPERTROPHY
LASER THERAPY
• ABLATIVE PROCEDURE
• ENUCLEATIVE PROCEDURE

21. BENIGN PROSTATIC HYPERTROPHY
PROSTATE LIFT
EMBOLIZATION

22. BENIGN PROSTATIC HYPERTROPHY
OPEN PROSTATECTOMY ROBOT ASSISTED PROSTATECTOMY

23. BENIGN PROSTATIC HYPERTROPHY
TRANSURETHRAL RESECTION OF THE PROSTATE (TURP)
• TRANSURETHRAL INCISION OF PROSTATE

24. 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.

26. 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.

27. PROSTATE CANCER
RISK FACTOR
• OBESITY
• AGE
• FAMILY HISTORY
• LOWER LEVEL OF VITAMIN D
• PROSTATITIS
• ELEVATED BLOOD LEVELS OF TESTOSTERONE

28. PROSTATE CANCER
PATHOPHYSIOLOGY

29. 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

30. PROSTATE CANCER
• DIAGNOSTIC EVALUATION
• HISTORY COLLECTION AND PHYSICAL EXAMINATION
• DIGITAL RECTAL EXAMINATION
• NEEDLE BIOPSY
• TRANS RECTAL USG
• PSA TEST

31. PROSTATE CANCER
• MEDICAL MANAGEMENT
• ANALGESIC AND NARCOTICS
• HORMONAL THERAPY

32. PROSTATE CANCER
• SURGICAL MANAGEMENT
• RADICAL PROSTATECTOMY
• CRYO SURGERY
• RADIATION
• TURP
• SUPRAPUBIC CYSTOSTOMY

33. PROSTATE CANCER
• NURSING MANAGEMENT
• ASSESSMENT OF PTS HEALTH
• ADMINITRATING ALL MEDICINES
• PRE- OPERATIVE MANAGEMENT
• POST OPERATIVE MANAGEMENT

34. 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 VOIDINGAS EVIDENCED BY POOR FACIAL
EXPRESSIONS, CONSTANT QUESTION AND SWEATING.

35. PROSTATE CANCER
• PRE OPRERATIVE INTERVENTION
• POST OPERATIVE INTERVENTION

37. EVALUATION
1. WHAT ARE THE DISORDERS OF PROSTATE GLAND?
2. SAY SOME PRE AND POST OPERATIVE MANAGEMENT OF SURGICAL PROCEDURES IN PROSTATE GLAND.