Flashcards in OA Elimination Deck (69)
nonmalignant enlargement of the prostate gland commonly seen in aging men
What happens due to BPH?
decreases outflow of urine by obstructing the urethra, causing difficult urination
When does BPH usually begin?
40's, but may have no symptoms until later
BPH and prostate cancer
BPH not considered precursor to prostate cancer
How does BPH begin?
as small nodules in the periurethral glands which are the inner layers of the prostate
increase in NUMBER of cells
increase in SIZE of individual cells
Hyperplasia and hypertrophy
used interchangeably even though the terms are different
Risk factors for BPH
***presence of testes
Clinical manifestations in terms of voiding
-weak urinary stream
-increase time to void
-incomplete bladder empty
Clinical manifestations in terms of storage
Complications of BPH
-incomplete bladder sensation
What can result from bladder distention?
Infection that ascends from bladder to kidneys cause...
distention of the ureter with urine
accumulation of urine in the renal pelvis as a result of obstructed outflow
Types of urinary incontinence
1. stress incontinence
2. urge incontinence
3. reflex incontinence
4. overflow incontinence
5. functional incontinence
loss of small urine amts associated with increased intra-abdominal pressure during sneezing, coughing, lifting.
due to: multiple pregnancies, decreased estrogen levels, short urethra, weak abdominal wall, prostate surgery
involuntary loss of urine associated with a strong urge to void
due to: neuro disorders, detrusor muscle overactivity associated with bladder outlet obstruction or aging
involuntary loss of urine at predictable intervals when a specific bladder volume is reached
due to: neuro impairment, tissue damage
inability to empty bladder, resulting in over distention and frequent loss of small amounts of urine
due to: spinal cord injuries below S2, diabetic neuropathy, prostatic hyperplasia, fecal impaction, drugs with anticholinergic effects
incontinence resulting from physical, environmental, or psychosocial causes
due to: confusion/dementia, physical disability or immobility, therapy or sedation, depression, and regression.
Evidence-based research shows who needs to be treated for BPH?
Surgical referral if BPH-related complications develop, medical therapy fails, or the patient chooses it.
Mild or nonbothersome BPH symptoms...
do not require treatment
Bothersome symptoms are...
managed with lifestyle modifications, medications, and surgery
First-line medications for BPH
Evidence-based research shows dietary supplements...
are not recommended for the management of BPH
(palmetto, pygeum, cernilton, beta sitosterols and acupuncture)
BPH Nursing Assessment
- >40 yrs should be assessed
- health hx
- physical exam
- dx tests
- IPSS scale
Health hx includes...
-urinary elimination patterns