Shekhan Technical College and Institute

Department of Nursing

Grade : 2nd Stage

2nd Semester 2022 – 2023

Adult Nursing
13th Lecture Title

“Benign prostatic hyperplasia ”

Subject Lecturer : Dr. Saad Hussein Murad

 Definition : Benign prostatic hyperplasia (BPH) : is one of the most
common diseases in aging men.
 Background
1. It can cause bothersome lower urinary tract symptoms that affect quality of
life by interfering with normal daily activities and sleep patterns.
2. BPH typically occurs in men older than 40 years of age. By the time they
reach 60 years of age, 50% of men have BPH.
3. It affects as many as 90% of men by 85 years of age.
4. BPH is the second most common cause of surgical intervention in men older
than 60 years of age.
 Pathophysiology
1. The cause of BPH is not well understood, but testicular androgens have been
implicated.
2. Dihydrotestosterone (DHT), a metabolite of testosterone, is a critical
mediator of prostatic growth.
3. Estrogens may also play a role in the cause of BPH; BPH generally occurs
when men have elevated estrogen levels and when prostate tissue becomes
more sensitive to estrogens and less responsive to DHT.
4. Smoking, heavy alcohol consumption, obesity, reduced activity level,
hypertension, heart disease, diabetes, and a Western diet (high in animal fat
and protein and refined carbohydrates, low in fiber) .
5. The hypertrophied lobes of the prostate may obstruct the bladder neck or
urethra, causing incomplete emptying of the bladder and urinary retention.
6. As a result, a gradual dilation of the ureters (hydroureter) and kidneys
(hydronephrosis) can occur.
7. Urinary retention may result in UTIs because urine that remains in the
urinary tract serves as a medium for infective organisms.
 Clinical Manifestations
1. Obstructive and irritative symptoms may include urinary
frequency.
2. Urgency.
3. Nocturia.
4. hesitancy in starting urination.
5. decreased and intermittent force of stream and the sensation of
incomplete bladder emptying.
6. abdominal straining with urination.
7. a decrease in the volume and force of the urinary stream, dribbling
(urine dribbles out after urination.
8. azotemia (accumulation of nitrogenous waste products) and renal
failure.
9. Fatigue.
10. Anorexia.
11. Nausea, vomiting, and pelvic discomfort.
 Assessment and Diagnostic Findings
1. The health history focuses on the urinary tract.
2. previous surgical procedures.
3. general health issues.
4. family history of prostate disease.
Reference

 Brunner, L. S., Suddarth, D. S., Smeltzer, S. C. O., & Bare, B. G. (2018),

Brunner & Suddarth's textbook of medical-surgical nursing (14th ed.),
Philadelphia: Lippincott Williams & Wilkins.