تضخم البروستاتا الحميد

Definition

Benign prostatic hyperplasia is non-cancerous age-related prostate enlargement narrowing the urethra.

Symptoms

• Weak, intermittent stream
• Hesitancy and terminal dribbling
• Frequent nocturia
• Urgency and a sense of incomplete emptying

Complications

• Acute urinary retention, triggered by decongestants, anticholinergics, alcohol and cold
• UTIs and bladder stones
• Hydronephrosis and kidney injury with chronic retention

Assessment

Rectal exam, urinalysis, PSA after discussion and post-void residual.

Treatment

• Alpha-blockers (tamsulosin): rapid relief, risk of orthostatic dizziness
• 5-alpha-reductase inhibitors (finasteride): shrink the prostate over months
• TURP or other procedures

Care after TURP

• Continuous bladder irrigation; true urine = output − irrigant
• Watch for clots, bleeding and bladder spasm
• Watch for hyponatraemia from irrigant absorption
• No straining or heavy lifting for weeks

Exam point

Clots blocking the catheter with pain and spasm need inflow stopped and hand irrigation as ordered.