Overview
This lecture covers benign prostatic hyperplasia (BPH), its symptoms, diagnosis, treatment options, and details about transurethral resection of the prostate (TURP) surgery, including post-operative nursing care.
Benign Prostatic Hyperplasia (BPH)
- BPH is a non-cancerous enlargement of the prostate gland common in older men due to hormone changes.
- The enlarged prostate surrounds the urethra and can block urinary outflow.
- Symptoms include urinary frequency, urgency, incontinence, retention, post-void dribbling, hematuria, and frequent urinary tract infections (UTIs).
Diagnosis of BPH
- Diagnosis includes a digital rectal exam (DRE) to check for prostate enlargement.
- Prostate-specific antigen (PSA) levels are measured; normal PSA is <4 ng/mL, with higher levels requiring further evaluation.
- Additional labs may show increased white blood cells (if UTI) and elevated creatinine or BUN if the kidneys are involved.
Treatment of BPH
- Medications used: finasteride (androgen inhibitor), tamsulosin (alpha-1 blocker), and tadalafil (muscle relaxer).
- Finasteride decreases prostate size by inhibiting testosterone conversion.
- Tamsulosin relaxes prostate muscles to improve urine flow.
- Tadalafil relaxes muscle cells in the prostate.
TURP Surgery and Post-Operative Care
- TURP involves removing excess prostate tissue via the urethra to restore urine flow.
- A three-way catheter is used for continuous bladder irrigation (CBI) post-surgery.
- The goal is to maintain a light pink irrigation outflow.
- If outflow is bright red or contains clots, increase the CBI rate.
- For catheter obstruction (bladder spasms, decreased outflow), turn off CBI and irrigate with a large piston syringe.
- Patients often feel a continuous urge to urinate after TURP.
Medications and Patient Education After TURP
- Patients receive analgesics, antispasmodics (like oxybutynin), prophylactic antibiotics, and stool softeners.
- Advise drinking at least 2 liters of water daily and to avoid alcohol and caffeine.
- If blood appears in urine, patients should stop activity, rest, and increase fluids.
Key Terms & Definitions
- BPH (Benign Prostatic Hyperplasia) — Non-cancerous enlargement of the prostate gland.
- TURP (Transurethral Resection of the Prostate) — Surgical procedure to remove prostate tissue via the urethra.
- CBI (Continuous Bladder Irrigation) — Ongoing flushing of the bladder to prevent clots and maintain clear outflow after TURP.
- Finasteride — Androgen inhibitor medication that reduces prostate size.
- Tamsulosin — Alpha-1 blocker that relaxes prostate muscle to improve urine flow.
- Tadalafil — Medication that relaxes muscle cells in the prostate.
Action Items / Next Steps
- Review the flashcards for BPH and TURP.
- Memorize medication actions and post-TURP nursing interventions.
- Prepare for upcoming quizzes or exams on BPH and TURP care.