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Nursing Priorities and Diagnosis for Benign Prostatic Hyperplasia

Benign prostatic hyperplasia is an enlargement of prostrate which is non malignant. BPH occurs in men 45 years of age or older. 50% of all men in the US have BPH to some degree. BPH creates an enlarged and/or inflamed prostate gland and it will make urination difficult.

The Prostate is a male reproductive gland situated in front of rectum.below the bladder and surrounding the urethra. The prostate also contains some smooth muscles that help expel semen during ejaculation. The prostate gland in an adult male is slightly larger than a walnut and is palpable on per- rectal digital examination. It shows its first growth spurt at puberty- when it grows twice in size and then again starts growing at about 25 years of age and this growth continues throughout life.

The main diseases affecting the prostate are:
  1. Prostatitis
  2. Benign Prostatic Hyperplasia (BPH)
  3. and prostate cancer

The exact cause of BPH is not very well known and also the amount of enlargement is not directly proportional to the symptoms. Varieties of factors which contribute to the increase in cells are androgens (male hormone), estrogens and other signaling pathways.

The early signs of BPH are a need to urinate more often and especially at night. As the condition becomes more advanced it will become more difficult, to begin and to end urination. Some other symptoms include a burning sensation while urinating, dribbling and the feeling that the bladder is never really empty.

Some of the major symptoms are :
  1. Facing difficulty in starting urination
  2. A weak stream of urine
  3. Leaking of urine
  4. Especially after urination, dribbling of urine
  5. Frequent urination and sometimes sudden desire to urinate especially in the night
  6. Blood in the urine
  7. Feeling of not fully emptying the bladder

The following tests are used to validate the diagnosis and confirm any need for surgery. After the preliminary tests, all patients may not need to undergo all of these tests.
  1. Digital rectal examination is the cornerstone of reaching a diagnosis. By putting a gloved finger in the rectum, the surgeon can make out the size and the condition of the gland
  2. Prostate specific antigen[PSA] is a blood test, primarily done to rule out cancer. It is also useful to monitor the progress and treatment response of prostate cancer.
  3. Rectal ultrasound and prostate biopsy in case there is suspicion of prostate cancer
  4. Urine flow studies and cystoscopy

Nursing Priorities for Benign Prostatic Hyperplasia
  1. Relieve acute urinary retention.
  2. Promote comfort.
  3. Prevent complications.
  4. Help patient deal with psychosocial concerns.
  5. Provide information about disease process/prognosis and treatment needs.

Nursing Diagnosis for for Benign Prostatic Hyperplasia
  1. Urinary Retention
  2. Acute Pain
  3. Risk for Deficient Fluid Volume
  4. Fear/Anxiety
  5. Knowledge Deficit
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