Benign Prostatic Hypertrophy (BPH)

  1. General information
    1. Mild to moderate glandular enlargement, hyperplasia, and overgrowth of the smooth muscles and connective tissue
    2. As the gland enlarges, it compresses the urethra, resulting in urinary retention.
    3. Most common problem of the male reproductive system; occurs in 50% of men over age 50; 75% of men over age 75
    4. Cause unknown; may be related to hormonal mechanism
  2. Assessment findings
    1. Nocturia, frequency, decreased force and amount of urinary stream, hesitancy (more difficult to start voiding), hematuria
    2. Enlargement of prostate gland upon palpation by digital rectal exam
    3. Diagnostic tests
      1. Urinalysis: alkalinity increased; specific gravity normal or elevated
      2. BUN and creatinine elevated (if longstanding BPH)
      3. Prostate-specific antigen (PSA) elevated. (Normal is <4>
      4. Cystoscopy reveals enlargement of gland and obstruction of urine flow
  3. Nursing interventions
    1. Administer antibiotics as ordered.
    2. Provide client teaching concerning medications
      1. Terazosin (Hytrin) relaxes bladder sphincter and makes it easier to urinate. May cause hypotension and dizziness.
      2. Finasteride (Proscar) shrinks enlarged prostate.
    3. Force fluids.
    4. Provide care for the catheterized client.
    5. Provide care for the client with prostatic surgery.