Elimination: BPH and Incontinence

Question 1

Continence

Answer 1

proper functioning of all the muscles and sphincters, and a proper functioning brain

Question 2

BPH

Answer 2

benign prostatic hyperplasia

• increase number of cells
• nonmalignant NOT cancer
• blocks flow of urine through urethra
• increase risk for retention

Question 3

Symptoms of BPH

Answer 3

weak stream, problems starting stream, post void urgency, frequency, nocturia, inability to empty bladder, distention

Question 4

Risk Factors BPH

Answer 4

age, presence of testes, high fat/meat diet, african american, hispanic

Question 5

Hydroureter

Answer 5

obstruction in ureter

Question 6

Hydronephrosis

Answer 6

dilation inside kidney

Question 7

Tests: BPH

Answer 7

PSA, DRE, UA, PVR

Question 8

PSA

Answer 8

prostate antigen protein elevated for prostate cancer

Question 9

DRE

Answer 9

digital rectal exam, want to feel smooth

Question 10

UA

Answer 10

urine analysis

Question 11

PVR

Answer 11

post void residual

Question 12

What causes BPH

Answer 12

no known cause, related to testosterone converting to DHT

Question 13

5 alpha reductase inhibitors

Answer 13

1. dutasteride
2. finasteride
   inhibits conversion of testosterone to DHT

Question 14

Alpha Adrenergic blockers

Answer 14

1. doxazosin
2. prazosin
3. tamsulsoin
4. terazosin
   block access muscle contractions (hypertensive meds)

Question 15

Anticholinergics

Answer 15

1. tolerodine
   relax muscles in bladder, prevents urgency
   SE urinary retention

Question 16

Catherization

Answer 16

retention patients, short term

Question 17

Dietary Supplements

Answer 17

no evidence in helping with BPH

Question 18

Lifestyle Modifications

Answer 18

mostly used as treatment, lose weight, avoid caffeine, alcohol, citrus fruits, just general lifestyle habits

Question 19

Surgery

Answer 19

TURP: transurethral resection of the prostate

Question 20

TURP

Answer 20

only done if severe BPH
-flushes bladder, electrical loop, cuts and cauterizes cut immediately, cuts away section of prostate and then drains everything from bladder

Question 21

TURP syndrome

Answer 21

risks immediately following surgery because of hypotonic solution

Question 22

Risks of TURP

Answer 22

• hemorrhage

- too much bleeding, clots form, blocks urethra back

Question 23

3 way urinary catheter

Answer 23

flushes bladder, drains urine until site is healed, keeps meatus open, 30mL want pressure on surgical site so patient doesn’t bleed to death

Question 24

GOAL: BPH

Answer 24

to be continent of urine and minimal pain