COLLEGE OF NURSING

RELATED LEARNING EXPERIENCE (RLE)

DE VERA MEDICAL CENTER

A CASE STUDY

ON

BENIGN PROSTATIC HYPERPLASIA

Presented by: BSN 4A- GROUP 4

AQUINO, RENZ
DELA CRUZ, REAN
RAMONES, LOUISE JEREMY
ALIANGAN, SHIELA MAE
CRUZ, KCEEY
SABLAY, SHIELA MAE
SANGARIBU, ETTENAJ
SISON, MARIBEL

Presented to:
Level 4 Clinical Instructors + Other Panelists

Date: March 8, 2023

General Objectives:

This study aims to enhance students' knowledge and skills in handling patients with a particular condition. In
the end of the study, the patient will be able to improve overall health status with the help of the advocacy of the
nursing student.

Specific Objectives:

 To provide health teachings about prevention of the disease to avoid recurrence and to promote health
wellness.

 To be able to know the appropriate management of specific diseases.

 To understand the pathophysiology and etiology of the case being presented.

 To identify the different signs and symptoms that may be manifested by the patient with benign prostatic
hyperplasia.

Overview

Benign prostatic hyperplasia (BPH) is a condition that occurs when the prostate gland enlarges, potentially
slowing or blocking the urine stream. BPH occurs only in men; approximately 8 percent of men aged 31 to 40
have BPH. In men over age 80, more than 80 percent have BPH.

The symptoms of BPH usually begin after age 45. The most common symptoms of BPH include frequent
urination, especially at night. A hesitant, interrupted, or weak stream of urine. These symptoms tend to appear
over time and may gradually worsen over the years. However, some men have an enlarged prostate that causes
few or no symptoms, while other men have symptoms of BPH that later improve or stay the same. In a small
percentage of men, untreated BPH can cause urinary retention, meaning that the man is unable to empty the
bladder. The risk of urinary retention increases with age and as symptoms worsen.

To know if BPH or another problem is causing your symptoms, a doctor or nurse will ask you questions,
perform an examination, and do blood and urine tests.

Treatments for BPH include medicines, lifestyle changes and surgery. In some cases, BPH symptoms improve
without treatment. However, men with moderate to severe symptoms usually require treatment.

Demographic Name:

Patient R Age: 71

Nationality: Filipino

Religion: Baptist

Occupation: Pastor

Admitting Diagnosis: Benign prostatic hyperplasia

Chief Complaint: Scanty urination

Date of admission: Feb. 21, 2023

Time of Admission: 8:29 am

Past Medical History

Prostate enlargement was identified as the patient's condition in 2019. The patient was hospitalized in 2020
owing to hypertension, and Micardis was subsequently prescribed to treat it. He has had each and every COVID
shot. No previous operations.

Personal History

He has an allergy to hair color and is not a smoker or an alcoholic beverage consumer.
Family History Disease

While the patient's father and mother have no history of hypertension, cancer, or asthma, his brother has
hypertension.

PHYSICAL ASSESSMENT
GORDONS ELEVEN FUNCTIONAL HEALTH PATTERNS
COURSE IN THE WARD

LABORATORIES AND DIAGNOSTICS

Patient Name: RC
Age: 71
Sex: Male
Study Date: FEBRUARY 14,2023

CHEMISTRY

TEST RESULT REFERENCE VALUE

FBS 5.71 3.89-5.83 mmol/L

BUN 2.5-6.5 mmol/L

SERUM CREATININE 135.7 MALE: 80.0-115.0 umol/L

HIGH FEMALE: 53.0-97.0 umol/L

poor kidney function

SERUM URIC ACID 381.7 MALE: 210.0-420.0 umol/L

FEMALE: 150.0-350.0 umol/L

SGOT/AST UP TO 40.0 U/L

SGPT/ALT 21.6 UP TO 41.0 U/L

TOTAL CHOLESTEROL 4.66 <5.2 mmol/L

TRIGLYCERIDES 1.63 0.68-1.70 mmol/L

LIPID PROTEIN PROFILE

HDL – CHOLESTEROL 0.76 0.91-1.56 mmol/L

LDL – CHOLESTEROL 3.16 1.56-4.10 mmol/L

VLDL – CHOLESTEROL 0.74 0.00-1.04 mmol/L

HDL – RATIO 6.1 BELOW 4.0

HIGH

REMARKS:

Patient Name: RC
Age: 71
Sex: Male
Study Date: FEBRUARY 14,2023

IMMUNOLOGY

TEST RESULT REFERENCE VALUE

PSA 75.3 0.0-4.0 ng/mL

HIGH

Enlarged prostate

REMARKS:
Patient Name: RC
Age: 71
Sex: Male
Study Date: FEBRUARY 14,2023
URINALYSIS

TEST RESULT NORMAL VALUES

Color YELLOW Yellow

Transparency CLEAR Clear

Reaction 4.800-
7.800
Specific Gravity 1.020 1.015-
1.025

Glucose NEGATIVE Negative

Protein NEGATIVE Negative

MICROSCOPIC

TEST RESULT NORMAL VALUES

WBC 0-1 /HPF 0.000- 1.000 hpf

RBC 0-1 /HPF 0.000- 1.000 hpf

AMORPHOUS URATES RARE FEW

EPITHELIAL CELLS FEW FEW

MUCOUS THREADS RARE FEW

BACTERIA RARE NONE

CASTS

FINE GRANULAR

HYALINE NONE SEEN

COARSE

WAXY

Patient Name: RC
Age: 71
Sex: Male
Study Date: FEBRUARY 14,2023

HEMATOLOGY
 PARAMETERS RESULT REFERENCE RANGE

WBC 5.4 x 10^9/L 5.0-10.0

LYMPH# 2.3 x 10^9/L 0.8-4.0

MID# 0.4 x 10^9/L 0.1-1.5

GRAN# 2.7 x 10^9/L 2.0-7.0

LYMPH% HIGH 42.5% 20.0-40.0

Infection

MID% 8.4% 3.0-15.0

GRAN% LOW 49.1% 50.0-70.0

Infection

HGB LOW 119 g/L 140-170

Low RBC count

RBC 4.33 x 10^12/L 4.00-6.00

HCT LOW 0.395 L/L 0.400-0.500

Insufficient RBC or large number of

WBC due to infection

MCV 91.3 fL 82.0-95.0

MCH 27.4 pg 27.0-31.0

MCHC LOW 301 g/L 320-360

RBC doesn’t have enough hemoglobin

and poor kidney function for producing
erythropoietin that stimulates RBC
production

RDW-CV 14.6% 11.0-14.5

RDW-SD 51.0 fL 35.0-56.0

PLT 180 x 10^9/L 150-450

MPV 8.5 fL 7.0-11.0

PDW 15.4 15.0-17.0

PCT 0.153% 0.108-0.282

Patient Name: RC
Age: 71
Sex: Male
Study Date: FEBRUARY 21,2023

TEST RESULT NORMAL TEST RESULT NORMAL

VALUES VALUES

Hemoglobin 14.000 - 18.000 PT Patient 13.2 10.000-15.000 seconds

g/dL
 Hematocrit 42.000- 51.000% PT Control 14.7 11.700-18.800

WBC 5.000- 10.000 x PT Activity 102.4 70.000-120.000%

10^9 cells/ L

Segmenters 50.000- 80.000% INR 0.98 < 1.2

Lymphocytes 25.000- 50.000% PTT 27.000-42.000 seconds

Eosinophils 0.000- 5.000 % Blood Type

Monocytes 2.000- 10.000 % MCV 80.000-97.000 um^3

Basophils 0.000- 2.000 % MCH 26.000-32.000 pg.

Platelet 150,000-45,000 MCH 31.000-36.000 g/dL

Count mm^3 C

ESR 0.000- 10.000 mm/ RDW- 10.000-16.000 %

hr. CV

Reticulocyte 0.500- 1.500 % Toxic

Granules
Bleeding Time 2mins 1.000- 3.000 mins MPV

Clotting 4mins 3.000- 6.000 mins. Others

Time

Patient Name: RC
Age: 71
Sex: Male
Study Date: FEBRUARY 21,2023

TEST RESULT NORMAL VALUES TEST RESULT NORMAL VALUES

Blood P: 60100: A: 70- 11 Cholesterol < 200 mg/dL

Sugar
(FBS)
1st Hour < 180 mg/dL Triglycerides < 200 mg/dL

2nd Hour <155 mg/dL LDL Cholesterol < 100 mg/dL

3rd Hour <140 mg/dL HDL M: > 55: F: > 65 mg/dL

Cholesterol

2hrs Post <140 mg/dL Ionized Calcium 1.120- 1.320 mmol/ L

Blood Sugar
 Blood 120-180 mg/dL Sodium 137.000-145.000 mmol/ L
Sugar
(RBS)

Hemoglobin 4.800- 5.900% Potassium 3.6005.000 mmol/ L

A1c

Glucose C <= 180 mg/dL Phosphorus 0.1006.460 mmol/ L

Test

Blood 3.400- 7.000mg/dL Chloride 98.000107.000 mmol/ L

Uric Acid

Blood Ure <65y:50:>65:<=71mg/dL Magnesium Premature: 0.570.78

Nitrogen mmol/ L

ALT F: <= 33: M: < = 41 U/L Children 0.70-1.05

(SGPT)

AST F: <= 32: M: < = 40 U/L Total Serum 0.20005.000 mmo/L

(SGOT) Calcium

Serum 140.7 59.000104.000 umol/ L

Creatinine HIGH poor
kidney
function

Patient Name: RC
Age: 71
Sex: Male
Study Date: FEBRUARY 21,2023

TEST RESULT NORMAL VALUES

TSH C 1.56 0.270-4.200 Uiu/mL

Patient Name: RC
Age: 71
Sex: Male
Study Date: FEBRUARY 21,2023

TEST RESULT NORMAL VALUES

SARS-COV 2 RAPID ANTIGEN TEST NEGATIVE NEGATIVE

Patient Name: RC
Age: 71
Sex: Male
Study Date: FEBRUARY 21,2023
 TEST RESULT NORMAL VALUES TEST RESULT NORMAL VALUES

Blood P: 60100: A: 70- 11 Cholesterol < 200 mg/dL

Sugar
(FBS)
1st Hour < 180 mg/dL Triglycerides < 200 mg/dL

2nd Hour <155 mg/dL LDL Cholesterol < 100 mg/dL

3rd Hour <140 mg/dL HDL M: > 55: F: > 65 mg/dL

Cholesterol

2hrs Post <140 mg/dL Ionized Calcium 1.120- 1.320 mmol/ L

Blood Sugar

Blood 120-180 mg/dL Sodium 140 137.000-145.000 mmol/ L

Sugar
(RBS)

Hemoglobin 4.800- 5.900% Potassium 4.5 3.600-5.000 mmol/ L

A1c

Glucose C <= 180 mg/dL Phosphorus 0.1006.460 mmol/ L

Test

Blood 3.400- 7.000mg/dL Chloride 98.000107.000 mmol/ L

Uric Acid

Blood Ure <65y:50:>65:<=71mg/dL Magnesium Premature: 0.570.78

Nitrogen mmol/ L

ALT F: <= 33: M: < = 41 U/L Children 0.70-1.05

(SGPT)

AST F: <= 32: M: < = 40 U/L Total Serum 0.20005.000 mmo/L

(SGOT) Calcium

Serum 59.000104.000 umol/ L

Creatinine

Patient Name: RC
Age: 71
Sex: Male
Study Date: FEBRUARY 15,2023

WHOLE ABDOMEN

Follow up study to a KUBP ultrasound dated 05 December 2019 shows the ff:

The liver is unenlarged. It exhibits normal parenchymal echogenicity. No focal lesion seen. The intrahepatic ducts and common
 bile duct are undilated. The portal vein and intrahepatic vessel are unremarkable.

The gallbladder is well distended with unthickened walls. A 2.0cm shadowing stone is seen within.

The pancreas and spleen are unenlarged and exhibit normal parenchymal echogenicity. Mo focal lesions seen. The aorta and
paraaortic areas are unremarkable.

There is no disparity in the renal sizes. The right kidney measures 10.1x4.7cm (CT:1.2cm). the left kidney measures 10.1x5.1cm
(CT:1.0cm). both kidneys are normal in size. Both kidneys exhibit normal parenchymal echogenicity with good corticomedullary
differentiation. The pelvocalyces are undilated. Two cysts are seen in the left kidney measuring 1.2cm and 0.58cm.

The urinary bladder is well distended with irregularly thickened walls. No lithiasis seen. There is a residual urine of 114cc from
prevoid volume of 160cc.

The prostate gland is not enlarged for age with volume of approximately 17cc. few inner gland calcification are seen.

The appendix is not visualized. No evidence of ascites.

IMPRESSION

1. Cholecystolithiasis
2. Renal cortical cysts, left.
3. Unenlarged prostate gland with concretions.
4. Chronic cystitis.
5. Post-void residual urine (71%).
6. Normal ultrasound of the liver, spleen, pancreas, aorta, paraaortic areas, right kidney.

Patient Name: RC
Age: 71
Sex: Male
Study Date: FEBRUARY 21,2023

CHEST X-RAY RESULTS

Follow up study to one dated 22 April 2021 still shows no active lung parenchymal infiltrates.

The heart is no longer enlarged. Calcific densities line the aortic knob.

The trachea is midline.

The costophrenic angles and hemidiaphragms are intact.

The osseous and soft tissue structures are unremarkable.

IMPRESSION:
Atherosclerotic Aorta

CBC RESULTS URINALYSIS RESULTS

Hematocrit: 0.395 Color BT: 2

Platelet: 180 Transparency CT: 4

WBC: 5.4 Specific gravity RBS:

Grans: 49.1 Protein FBS: 5.71

Lymph: 42.5 Sugar NORMAL Na: 140

Mono: Blood K: 4.5

Hemoglobin: 119 WBC PT: 13.2

RBC PA: 102%

Creatinine: 135

BLOOD TYPE:

CXR-PA: ATHEROSCLEROTIC AORTA

ECG

54/54 0.16

8 mins 0.08 8mins Bradycardia

+30 0.44

ANATOMY AND PHYSIOLOGY

PATHOPHYSIOLOGY AND DISEASE MANAGEMENT
NURSING CARE PLAN
DRUG STUDY

Drug Name Classification Mechanism of Action Indication Contra-Indication Adverse Reaction Nursing Responsibilities

Tramadol Analgesics Unknown. Thought to Moderate to Patient who are -Proteinuria -Reassess patient’s level of pain at
bind opioid receptors moderately severe hypersensitive to drug least 30 minutes after administration
and inhibit reuptake of chronic pain or opioids and those -Urinary frequency
Route: IV norepinephrine and with acute intoxication -Urine retention
serotonin from alcohol, -Don’t confuse tramadol with
Frequency: q8 x 4 hypnotics, centrally -Pelvic Pain trazodone and trandolapril
doses acting analgesics, -UTI
Dosage: 50 mg opioids or psychotropic
drugs -Warn the patient taking tramadol to
watch for slow or shallow breathing,
difficulty or noisy breathing,
confusion and excessive sleepiness.
(if any of these signs and symptoms
occurs tell them to stop drug
immediately and seek immediate
emergency medical attention

-Encourage patient to check with

prescriber before taking OTC drugs
because drug interaction can occur

Drug Name Classification Mechanism of Action Indication Contra-Indication Adverse Reaction Nursing
 Responsibilities

Cefoxitin (Monowel) Antibiotic Inhibits Cell-wall Serious infection of the Patients hypersensitive to -Acute renal failure -Monitor patient for
synthesis, promoting GU tracts drug or other superinfection or
osmotic instability; cephalosporins diarrhea and treat
Route: IV usually bacterial appropriately; especially
if large dose are given,
Frequency: 8° therapy is prolonged, or
Dosage: 1g patient is at high risk

-Tell the patient to report

adverse reactions and
sign and symptoms of
superinfection promptly

-Advise patient to report

discomfort at IV site

-Advise patient to report

loose stools or diarrhea

Drug Name Classification Mechanism Of Action Indication Contra-Indication Adverse Reaction Nursing Intervention
Paracetamol Analgesics Paracetamol is a para- Mild or moderate pain. Severe hepatic impairment Hypersensitivity -Check the expiration
aminophenol derivative or active liver disease (IV). reactions, liver date of the medication
that exhibits analgesic dysfunction before given
Route: IV and antipyretic actions
and weak anti-
Frequency: q8° x 5 doses inflammatory activity. -monitor blood pressure
Dosage: 1g to evaluate drug efficacy.

-Be alert for adverse

reaction and drug
interactions

-Routinely monitor the

effectiveness of the drug
by assessing pain levels
or fever reduction

Drug Name Classification Mechanism of Action Indication Contra-Indication Adverse Reaction Nursing
Responsibilities

Micardis Diuretics Combination of an Treatment of essential Hypersensitivity to the painful urination or Remind patients to take
 angiotensin II receptor hypertension active ingredient changes in urinary medication as directed
antagonist, telmisartan, frequency
and a thiazide diuretic,
Route: Oral hydrochlorothiazide. The Severe renal impairment Instruct patient or
combination of these family/caregivers to
Frequency: OD ingredients has an report other troublesome
Dosage: 40 mg tab additive antihypertensive side effects such as
effect, reducing blood severe or prolonged
pressure to a greater headache, nasal
degree than either inflammation, or GI
component alone problems

Watch for and report

signs of impaired renal
function, including
decreased urine output,
cloudy urine, or sudden
weight gain due to fluid
retention

Drug Name Classification Mechanism of Action Indication Contra-Indication Adverse Reaction Nursing
Responsibilities

Cefixime Cephalosporins binds to 1 or more of the Renal Impairment Hypersensitivity to Encephalopathy Monitor renal and
penicillin-binding (including convulsion, hepatic functions
 proteins (PBPs) which cephalosporins confusion, impairment of periodically.
inhibits the final consciousness,
Route: Oral transpeptidation step of UTI movement disorders)
Frequency: BID for 3 peptidoglycan synthesis Observe signs and
days in bacterial cell wall, thus symptoms of anaphylaxis
inhibiting biosynthesis Acute renal failure during 1st dose.
Dosage: 200mg tab and arresting cell wall
assembly resulting in
bacterial cell lysis and
death.

Drug Name Classification Mechanism of Action Indication Contra-Indication Adverse Reaction Nursing
Responsibilities

Metoclopramide Antiemetic/ GI Stimulates motility of To prevent or reduce Patients hypersensitive to -incontinence -Monitor bowel sounds
stimulants upper GI tract, increases postoperative nausea and drug and in those with
lower esophageal vomiting pheochromocytoma -urinary frequency -Monitor patient for
sphincter tone, and fever, CNS symptoms,
Route: IV -erectile dysfunction cardiac arrhythmias or
Frequency: PRN blocks dopamine abnormal BP
receptor trigger zone.
Dosage: 1 amp Use cautiously in patients -Urge patient to report
with history of HTN persistent or serious
adverse reactions
promptly
-Tell patient to avoid
activities that requires
alertness for 2hrs after
doses
-advise patient to not
drink alcohol

Drug Name Classification Mechanism of Action Indication Contra-Indication Adverse Reaction Nursing
Responsibilities

Nubain Analgesics (Opioid) It acts on the central -Relief of moderate to Hypersensitivity to -sedation -drowsiness -Store the drug at
nervous system (CNS) to severe pain nalbuphine HCl temperatures not
relieve pain. -sweating exceeding 30°C
-Pre-operative analgesic
Route: IV -nausea -monitor patient for
Frequency: PRN -dry mouth adverse reactions
Dosage: 5mg -dizziness
DISCHARGE PLANNING

MEDICATION/  Compliance Medication

TREATMENT  Be safe with medicines. Read and follow all instructions on the label.
 Gave verbal and written instructions to the patient and family about adherence to the
prescribed medications.
 CEFIXIME 200mg/cap 2x a day 7am-7pm
 TAMSULOSIN 400mg/tab at bed time 9pm
 ALGESIA 325/tab 3x a day 8am-1pm-8pm after meals
 HEMOSTAN 500mg/cap 3x a day 8am-1pm-8pm
 Take your antibiotics as directed. Do not stop taking them just because you feel better.
You need to take the full course of antibiotics.
 The patient was still undergoing IFC at home and was taught how to care and use a
urinary catheter at home.
ENVIRONMENT/EXERCISE  Encouraged to keep environment clean as much as possible.
 Encouraged to have a quiet and peaceful surrounding to prevent irritable mood and for
relaxation.
 Gave verbal and written instructions on how to do simple exercises and remind him to
avoid lifting objects. For 6 weeks after surgery need to avoid strenuous exercise, lifting
heavy objects, and sexual activity.
 Explained to the patient that his activity is limited temporarily; bad habits. Gave
information on the benefits of healthy lifestyle. Encouraged patient to deviate from the
old habits that might hinder with the recovery and also change lifestyle if too sedentary
 Taught patient not to lift anything heavier than 5 pounds (2 kilograms) for at least 6
weeks after surgery. Doing aerobic exercise, such as walking and stair climbing, will
help you gain strength and feel better. Gradually increase the distance you walk. Climb
stairs slowly, resting or stopping as needed. Don’t go jogging or do Pilates or yoga.
Encouraged client to do at least 3 minutes of light slow walking a day in the morning
as a form of exercise.
 Most men are up and about after 3 to 4 weeks recovery. For the first 3 to 4 weeks, you
shouldn't lift or move any heavy objects (including shopping) or do any strenuous
exercise. If possible, ask friends or family members if they can help around the house.
 Once you feel able, gentle exercise such as walking will help keep your blood
circulating and lower your risk of getting a blood clot in your legs.
 Drinking plenty of water while you're recovering may help reduce the risk of getting
a urinary tract infection (UTI) and can help clear any blood from your pee. advised to
do some pelvic floor exercises to help improve your bladder control.

HEALTH  Client was taught about the importance of good hygiene also having IFC at home the
TEACHING/HYGIENE essential part of the routine is practicing good hygiene.
 Shower as usual. Wash with mild soap and water.
 The genital areas should first be cleansed with mild soap and water. For men, retract
the foreskin of the penis and clean away from the tip of the penis. Remember to dry
genitals gently using aseptic cloths.
 While cleaning the catheter, hold it firmly at the point it enters the urethra so that it will
not get pulled out. Start cleaning the catheter from the same point and move down the
tube in the direction that is away from the body. Rinse the catheter with soap and water
and dry it with a separate cloth.
 A drainage bag is used to collect the urine. It is an extension of the catheter which can
be removed and replaced by the caregiver. When changing the drainage bag, place an
aseptic cloth or gauze piece under the connection point of the catheter. Tightly press on
the catheter with your fingers and slowly disconnect the drainage bag.
 Clean the tip of the catheter and connector with separate alcohol pads. Connect the new
bag to the catheter and then release your fingers. Dispose the used drainage bag. Make
sure that there are no kinks or twists in the catheter and drainage bag.

 Encouraged patient to check for signs of infection every day until healthcare provider
tells they’re healed. Call the healthcare provider if:
 The skin around is very red.
 Swelling around is getting worse.
 You see drainage that looks like pus (thick and milky), smells bad.
 Your pain is getting worse.
 You have a fever of 101 °F (38.3 °C) or higher.
 To prevent infection, don’t let anyone touch it. Clean your hands with soap and water
or an alcohol-based hand sanitizer before you touch it.
 Patient was taught that if he would travel after surgery make sure to get up and walk
every hour. Be sure to stretch your legs, drink plenty of liquids, and keep your feet
elevated when possible.
 Advised the patient to manage feelings because after surgery for a serious illness, he
may have new and upsetting feelings. Many people say they felt weepy, sad, worried,
nervous, irritable, and angry at one time or another. he may find that he cannot control
some of those feelings. If this happens, it’s a good idea to seek emotional support. The
first step in coping is to talk about how you feel. Family and friends can help. Your
healthcare providers can reassure, support, and guide you. It’s always a good idea to let
us know how you, your family, and your friends are feeling emotionally. Many
resources are available to you and your family. Whether you’re in the hospital or at
home, we’re here to help you and your family and friends handle the emotional aspects
of your illness.
  Drink plenty of water to help flush fluids through your bladder (8 to 10 glasses a day).
Avoid coffee, soft drinks, and alcohol. They can irritate your bladder and urethra, the
tube that brings urine from your bladder out of your body.
 You will learn exercises that strengthen the muscles in your pelvis. These are
called Kegel exercises. You can do these exercises any time you are sitting or lying
down.
 You will return to your normal routine over time. You should not do any strenuous
activity, chores, or lifting (more than 5 pounds or more than 2 kilograms) for at least 1
week. You can return to work when you have recovered and are able to do most
activities.
 Avoid sexual activity for 4 to 6 weeks.

Risks of TURP can include:

 Temporary difficulty urinating. You might have trouble urinating for a few days
after the procedure. Until you can urinate on your own, you will need to have a tube
(catheter) inserted into your penis to carry urine out of your bladder.
 Urinary tract infection. This type of infection is a possible complication after any
prostate procedure. An infection is increasingly likely to occur the longer you have a
catheter in place. Some men who have TURP have recurring urinary tract infections.
 Dry orgasm. A common and long-term effect of any type of prostate surgery is the
release of semen during ejaculation into the bladder rather than out of the penis. Also
known as retrograde ejaculation, dry orgasm isn't harmful and generally doesn't affect
sexual pleasure. But it can interfere with your ability to father a child.
 Erectile dysfunction. The risk is very small, but erectile dysfunction can occur after
prostate treatments.
 Heavy bleeding. Very rarely, men lose enough blood during TURP to require a blood
transfusion. Men with larger prostates appear to be at higher risk of significant blood
loss.
 Difficulty holding urine. Rarely, loss of bladder control (incontinence) is a long-term
complication of TURP.
 Low sodium in the blood. Rarely, the body absorbs too much of the fluid used to wash
the surgery area during TURP. This condition, known as TURP syndrome or
transurethral resection (TUR) syndrome, can be life-threatening if untreated. A
technique called bipolar TURP eliminates the risk of this condition.
 Need for re-treatment. Some men require follow-up treatment after TURP because
symptoms don't improve or they return over time. Sometimes, re-treatment is needed
because TURP causes narrowing (stricture) of the urethra or the bladder neck.
 Avoid driving until your catheter is removed and you're no longer taking prescription
pain medications.
OUTPATIENT FOLLOW UP  Call your doctor or nurse advice line now or seek immediate medical care if:
 You cannot urinate at all.
 You have symptoms of a urinary infection. For example:
 You have blood or pus in your urine.
 You have pain in your back just below your rib cage. This is called flank pain.
 You have a fever, chills, or body aches.
 It hurts to urinate.
 You have groin or belly pain.
 Watch closely for changes in your health, and be sure to contact your doctor or nurse
advice line if:
 It hurts when you ejaculate.
 Your urinary problems get a lot worse or bother you a lot.
DIET  Eat at least five servings of fruits and vegetables every day. Go for those with deep,
bright color.
 Choose whole-grain bread instead of white bread and choose whole-grain pasta and
cereals.
 Limit your consumption of red meat, including beef, pork, lamb, and goat, and
processed meats, such as bologna and hot dogs. Fish, skinless poultry, beans, and eggs
are healthier sources of protein.
 Choose healthful fats, such as olive oil, nuts (almonds, walnuts, pecans), and avocados.
Limit saturated fats from dairy and other animal products. Avoid partially
hydrogenated fats (trans fats), which are in many fast foods and packaged foods.
 Avoid sugar-sweetened drinks, such as sodas and many fruit juices. Eat sweets as an
occasional treat.
 Cut down on salt. Choose foods low in sodium by reading and comparing food labels.
Limit the use of canned, processed, and frozen foods.
 Watch portion sizes. Eat slowly and stop eating when you are full.

SPIRITUAL  Encouraged to continue to seek God’s guidance and enlightenment and importance of
prayers in healing.