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benign prostatic hypertrophy
enlargement of the prostate gland
Androgens
male sex hormones
-responsible for prostate growth
BPH risk factors
-advanced age 60+
-lack physical activity
-erectile dysfunction
-abdominal obesity
-family history
BPH history
-retention
-hesitancy, frequency, urgency, dysuria
-nocturia
-hematuria before or after voiding
-urinary stream alterations; dilated ureter
-dribbling
BPH Assessment
-hurts to pee?
-hard to start or stop?
-constant stream?
-color and odor?
-how do you know your bladder is not emptying?
-do you feel a constant need to go?
-does it wake you up at night?
BPH physical findings
, -visible midline mass above the symphysis pubis
-distended bladder
-enlarged prostate on digital rectal exam
BPH lab results
-BUN and creatinine levels elevated
-prostate specific antigen test (PSA) may be elevated, usually less than 10g/L
BPH imaging
-ultrasound reveals urinary tract obstruction
-transrectal ultrasound reveals size of prostate gland
-bladder scanner reveals postvoid residual urine volume
cystourethroscopy
procedure to view the urinary bladder and the urethra
transurethral resection of the prostate (TURP)
the surgical cure for BPH. An instrument inserted through the penile urethra is used to partially cut
away the prostate to relieve obstruction of the urinary tract.
after surgery warning
watch out for signs of postobstructive diuresis, characterized by polyuria exceeding 2 L in 8 hours
and excessive electrolyte loss. can result in vascular collapse and death if not recognized.
Tamsulosin (Flomax) indication
BPH
-increases the flow
Tamsulosin admin
-PO
-do not crush
-give drug 30 mins after same meal of the day