CLASS PRESENTATION

ON
BPH

PRESENTED BY:
RUCHIKA KAUSHAL
M.SC. NURSING 1ST YEAR
PREVIOUS KNOWLEDGE

What is hyperplasia?

What is the full form of BPH?

INTRODUCTION OF BPH

Benign prostatic hyperplasia (BPH) is a benign enlargement of the

prostate gland. The prostate gland enlarges, extending upward into the
bladder and obstructing the outflow of urine by encroaching on the
vesicle orifice.

Prostate is a small gland that encircles the urethra in males and

produces a fluid that make up part of semen.
DEFINITION OF BPH

 It is defined as, “noncancerous increase in size of prostate

gland which involves hyperplasia of prostatic stromal and
epithelial cell resulting in formation of large, fairly discrete
nodules in transitional zone of prostate, which push on and
narrow the urethra resulting in an increase resistance to flow of
urine from the bladder.”
 INCIDENCE OF BPH:

• 50% of men having evidence of BPH by age of 50years. 

• 90% by age of 80 years.

CAUSES AND RISK FACTORS OF BPH

On
Flash Cards
PATHOPHYSIOLOGY OF BPH

On
Chart
CLINICAL MANIFESTATIONS OF BPH

On
Pamphlets
 DIAGNOSTIC EVALUATION OF BPH
• Digital Rectal Examination • Prostatic Specific Antigen
Blood Test
CONTINUED…

• Urinary flow rate study • Urethrocystoscopy

CONTINUED…

• Urinalysis • Prostate biopsy

Management of BPH
 MEDICAL MANAGEMENT OF BPH
The treatment plan depends on the cause, severity of obstruction,
and condition of the patient.
“Watchful waiting” to monitor disease progression.

Immediate catheterization if patient cannot void (an urologist

may be consulted if an ordinary catheter cannot be inserted). 

A suprapubic cystostomy is sometimes necessary. 

 PHARMACOLOGICAL MANAGEMENT

 
Alpha Adrenergic Receptor Blockers: These medications relax bladder
neck muscles and muscle fibers in the prostate, making urination easier. 

Alpha blockers such as alfuzosin (Uroxatral), doxazosin (Cardura),

tamsulosin (Flomax), and silodosin (Rapaflo). 
CONTINUED…

5-alpha reductase inhibitors: 5-alpha reductase inhibitors block

the conversion of the male hormone testosterone into its active
form in the prostate (DHT). The prostate enlargement in BPH is
directly dependent on DHT, so these drugs lead to an approximate
25% reduction in prostate size over six to 12 months.
Examples of 5-alpha reductase inhibitors include Finasteride
(Proscar) and dutasteride (Avodart).
CONTINUED…

Combination drug therapy: Doctor might recommend

taking an alpha blocker and a 5-alpha reductase inhibitor at
the same time if either medication alone isn't effective.
 
Tadalafil (Cialis): This medication is often used to treat
erectile dysfunction, can also treat prostate enlargement. 
 SURGICAL MANAGEMENT
 Transurethral resection of the prostate (TURP): TURP involves
insertion of an instrument called a resectoscope through the urethral
opening of the penis and guiding it to the constricted portion of the
urethra within the prostate gland. The gland is removed in small pieces
with an electrical cutting loop. This procedure requires no incision. 
CONTINUED…

 Suprapubic Prostectomy: An incision is made into the bladder & the

prostate gland is removed from above the pubic bone. Such an approach
can be used for a gland to any size & few complications Occur. 
CONTINUED…

Perineal Prostectomy: This method involves removing

the gland through an incision in the perineum.
 MINIMALLY INVASIVE THERAPY

Trans-urethral Microwave Thermotherapy:

Trans - urethral microwave thermotherapy
(TUMT) is an outpatient procedure that involves
the delivery of microwaves directly to the
prostate through a transurethral probe to raise
the temperature of the prostate tissue to about
113° F (45° C). The heat causes death of tissue,
thus relieving the obstruction.
CONTINUED…

Laser Prostatectomy:
The laser beam is delivered transurethrally
through a fiber instrument with ultrasound
guidance and is used for cutting,
coagulation, and vaporization of prostatic
tissue.
 CONTINUED…

Prostate stent:
A prostate stent is a tubular device
inserted through the urethra to the point
of constriction, where it is allowed to
expand. The pressure exerted by the
stent on the inside wall of the urethra
widens its bore and reduces the
obstruction to urinary flow.
CONTINUED…

 Balloon urethroplasty: A tube with a small

balloon at the end is inserted through the
urethral opening of the penis and guided to the
constricted portion of the urethra, where the
balloon is inflated. The pressure exerted by the
balloon against the inside of the urethral wall
increases the diameter of the urethra and
improves the flow of urine.
 COMPLICATIONS OF BPH
 
 Acute urinary retention
 Involuntary bladder contractions 
 Bladder diverticula 
 Cystolithiasis 
 Vesicoureteral reflux
 Hydronephrosis 
 Gross hematuria 
 UTI
 NURSING DIAGNOSIS FOR BPH
 
1. Acute Pain related to bladder distension, urinary infection.

2. Urinary Retention related to enlarged prostate.

3. Anxiety related to possibility of surgical procedure or loss of

dignity associated with genital exposure before, during, and after
treatment or concern about sexual ability.
CONTINUED…

4. Risk of urinary tract infection related to hematuria.

5. Deficient Knowledge related to disease condition and

treatment.
SUMMARIZATION
 RECAPTULIZATION
 
 What are the causes of BPH?

 What are the clinical features of BPH?

 Explain TURP.
 ASSIGNMENT

Nursing Management of BPH.

 BIBLIOGRAPHY

Hinkle J.L., Cheever K.H., Brunner & Suddarth’s A Textbook of Medical-Surgical

Nursing. 14th Edition. Wolter Kluwer Publishers. (2014). Page No.987-990.
 Kaur Davinder, Ansari J, A Textbook of Medical-Surgical Nursing-I. 2nd Edition. S.
Vikas and company (Medical publishers). (2015). Page No. 1220-1225.

WEBLIOGRAPHY 
 https://www.slideshare.net/shafaatullahkhatt/gsatritis
 https://www.scribd.com/document/269768907/-docx
Thank You