INCIDENCE:- At the age of 50 of man will have some degree of BPH. Increases more than 80-90 percentage in 75 years of age & is more commonly seen in white man.
DEFINITION:- It is a condition characterized by the enlargment of the prostate gland or tissue secondary to ageing.
ETIOLOGY / CAUSES :-
1. UNKNOWN OR IDEOPATHIC
2. AGEING
3. HEREDITY
4. RACE
PATHOPHYSIOLOGY:-
1. Normal shape of the bladder is trigone when there is a prostate gland enlargement this obstruct the outflow of urine from urinary bladder hence normal trigone shape disappears & bladder becomes spherical.
2. At this stage client can notice some degree of delayed out of micturation . mthere is no other symptoms .
3. As the size of the prostate gland increases detrusor muscle no longer overcome the obstruction . so at this stage the symptoms are-
a. Dificulty in nitiation of micturation
b. Flow rate of urine decreses
c. Retention of urine
4. Any activity which increases intra abdominal pressure like coughing , sneezing , bending, lifting of heavy objects causes bladder to empty involuntory & this condition is called retention with overflow of urine.
a. Recurrent UTI
b. He would have lost all reflex senses
c. Constant dripling of urine
5. As obstruction continues showing degeneration changes & connective tissue fibre starts to develop between muscles fibres & they arrange in the form of trabaculae ( branches of tree)
SIGN & SYMPTOMS:-
1. Inability the empty the bladder
2. Insbility to initiate the act of micturation
3. A sense if inadequate emptying of bladder
4. Poor stream or flow rate is decrease
5. Terminal dripling
6. Recurrent episodes of UTI
7. Onset of fever with rigors
8. Urgency & increased frequency of micturation
Diagnostic measures:-
1. Rectal examination to dectect prostate sizeand consistency
2. Abdominal ultrasound
3. Sample of urine to detect specific gravity 7 urine routine
4. Blood examination
5. Blood urea level is increasedv normal is 15-40 mg/dl
6. Serum creatinine is increased normal is 0.9-1.5
7. Flow rate is determine by using flow meter
8. Prostate specific antigen ( PACA) IS GREATER THAN 4 MG/DL IN CASE OF CANCER CLIENT
MANAGEMENT:-
It is divided into 4 categories.
1. Pharmacological
2. Non- surgical invasive
3. Surgical invasive
4. Nursing mgt
Nursing management:-
1. Reducing theanxiety
2. Restablish the communication with the pts. To assess his understanding of the diagnosis & plan surgical procedure
3. Encourage the pts to verbalize his feelings
4. Relieving discomfort
5. bed rest
6. Monittor voiding pattern
7. Catheterization if required
8. Relieving the pain
9. Assess the causes and location of the pain
10. Divertional therapy
11. Teach the pts about deep breathing maintain the patency of catheter
