Benign Prostatic Hyperplasia (BPH) and Prostate Cancer

Benign Prostatic Hyperplasia (BPH) and Prostate Cancer

 

Pathophysiology

Benign Prostatic Hyperplasia (BPH)

Enlarged prostate → urethral constriction → urinary retention → ↑risk forUTI, hydronephrosis and hydroureter

 

  • Prostate Cancer
    • Cancerous cells may metastasize to pelvis, bone, lymph nodes, and liver



Risk Factors

  • Increased Age
  • Familial history
  • African American heritage
  • Increased intake of red meat
  • Smoking



Signs and Symptoms

  • Urine Symptoms –
    • Frequency
    • Urgency
    • ↓stream
    • Hesitancy
    • Nocturia,
    • Retention
  • Sexual dysfunction
  • Prostate cancer: ↑Prostatic specific antigen (PSA)
  • Bony metastasis: Back/hip pain, ↓weight, fatigue, anemia, ↑alkaline phosphatase


Treatment
 

  • BPH:
    • Alpha-blockers (terazosin)
    • Antiandrogens (finasteride)
    • Heat or lasers
    • Surgery (Transurethral resection [TUR], suprapubic prostatectomy)

 

  • Cancer:
    • Radical prostatectomy
    • Radiation therapy
    • Hormonal therapy (orchiectomy and estrogen)


Nursing

  • Monitor S&S, indwelling catheter care
  • Postoperative Care:
    • Maintain traction on catheter balloon to ↓bleeding
    • Continuous bladder irrigation (CBI) via 3-way Foley to maintain patency
    • Discuss concerns about sexual dysfunction and urine dribbling