↓
DEFINITION
A condition in which the prostate gland becomes enlarged and presses against the urethra and bladder, altering the ability to urinate. This is not a precursor for cancer (Latendresse and McCance, 2012).
RISK FACTORS
Intact Testes
Aging
No evidence of increased or decreased risk with smoking alcohol, or any dietary factors
Possible worsening of symptoms with abdominal obesity (Patel and Ellsworth, 2008).
ETIOLOGY
(causes)
Primary causal factors involve androgens, growth factors, and lesions (Patel and Ellsworth, 2008).
↓ ↓ ↓
PATHOGENES
(how the disease evolves)
Current theories of BPH focus on aging and levels and ratios of endocrine factors such as androgens and estrogens. The role of chronic inflammation and autocrine/paracrine growth-stimulating and growth-inhibiting factors also play a role in BPH. More recent data reveals that human prostate stromal cells actively grant the inflammatory process the induction of inflammatory cytokines and chemokine’s. As males age, circulating androgens are associated with BPH and the prostate enlargement. The hormonal imbalance considered with aging may create mechanical tension changes consistent with prostate enlargement. BPH begins in the periurethral glands, which are the inner glands of the prostate. As the prostate enlarges nodules are formed and glandular cells enlarge. BPH develops over a period of time. Changes with urination occur gradually over time (Latendresse and McCance 2012). ↓ ↓ ↓ ↓
SIGNS & SYMPTONS
Gross hematuria
Decrease force or caliber of stream
Hesitancy w/ urination
Postvoid dribbling
Sensation of incomplete bladder emptying
Overflow incontinence
Inability to voluntarily stop stream
Urinary retention
Storage frequency
Nocturia
Urgency
Urge Incontinence (Patel and Ellsworth, 2008).
LABS TO DIAGNOSE
Urnalysis
Urine Culture
Blood urea nitrogen and creatinine
Prostate-specific antigen (Patel and Ellsworth 2008).
DIAGNOSTIC TESTS
Uroflow
Post-void residual
Transrectal ultrasound
Abdominal Ultrasound (Patel and Ellsworth (2008).
TREATMENTS
If urinary retention occurs the bladder must be drained. If catheterization is difficult consider coude catheter or flexible cystoscopy.
Post obstructive diuresis, if present, monitor electrolytes.
Avoid prolonged periods of not voiding
Avoid sympathomimetic or anticholinergic medications.
Avoid large boluses of IV fluids or alcohol intake.
Keep patient ambulatory to promote urination.
Phytotherpay
Saw palmetto (Patel and Elssworth 2008)
5Finasteride
Praxosin
