BENIGN PROSTATIC HYPERPLASIA (ENLARGED PROSTATE) It is gradual enlargement of the prostate gland with hypertrophy and hyperplasia of normal

l tissues. The cause is unknown. It usually occurs among men over 50 years of age. Aging process in males results to hormonal imbalances. The estrogen levels become higher than androgen levels. This cause hyperplasia of the prostate gland The enlargement causes compression of the urethra and base of the bladder. This leads to urinary obstruction. If untreated, it results to a serious complication Clinical Manifestations NOCTURIA (frequent voiding during the night). Is usually the initial manifestations. The other manifestations are: Frequency, urgency, hesitancy (difficulty in initiating urination, takes few minutes before urine flows), decreased caliber of urinary stream and force, increased residual urine, hematuria, UTI. Collaborative Management Surgery is the only successful management of BPH The different surgical procedures of BPH: 1. Transurethral Resection of the Prostate (TURP) Prostatic tissues are excised through a resectoscope. There is no incision. Continuous bladder irrigation (CBI) or cystoclysis is done post-op to irrigate the bladder and remove blood clots. This is done through 3-way Foley catheter.

The surgery does not cause inconsistence or impotence post-op.

2. Suprapubic Prostactectomy It involves the removal of the prostate gland through abdominal and bladder incision. The client will have cystostomy tube and 2-way Foley catheter. To drain urine adequately and prevent leakage though the incision. (Whenever bladder incision is done, cystostomy tube will be in place). CBI is prescribed and administered to keep urine pink.

3. Retropublic Prostactectomy Is removal of the prostate gland through a lower abdominal incision. There is no incision into the bladder. CBI may be done. 4. Perineal Prostactectomy Is removal of the prostate gland through an incision made between the scrotum and the anus. The procedure causes inconsistence and sterility. Avoid inserting rectal tube, taking rectal temperature, or administering enemas. Post-op Care of the Client who had undergone Prostactectomy 1. Care of the client with CBI Maintain patency of the catheter. If the drainage is reddish, increase the flow rate as the drainage becomes clear. Practice asepsis. To prevent infection Use sterile NS (normal saline). To prevent infection and water intoxication. Repeated administration of hypotonic solution e.g., sterile water, may cause water intoxication. Monitor the client for hemorrhage. Monitor urinary output. Expect red to light pink urine for the first 24 hours; then it becomes amber in 3 days post-op.