Question

1. Differentiate the benign prostatic hypertrophy (BPH) and prostate cancer (define, signs and symptoms, treatment).

2. Differentiate the following findings that are present in patients with prostate cancer and BPH.

prostatic palpation

blood tests

extra-urinary symptoms

3. Define TURP. Nursing management and teaching preoperatively and postoperatively

Answer 1

   BPH and prostate cancer can cause an enlarged prostate..but causes and treatment will be differ from each other..
Benign prostate hypertrophy also called benign prostate hyperplasia(BPH) is a histologic diagnosis charecterized by prolifiration of the cellular elements of the prostate..
signs and symptoms:
   -urinary frequency & urgency..
   -trouble starting or weak urine stream
   -dribbling at the end of urination..
   -Nocturia
   -urinary retention,incontinence
   -pain during urination
   -unsual smell or color of urine
Medical treatment:
Alpha blockers to relax the smooth muscles of the prostate..
5-alpha reductase inhibitors block the conversion of the male hormone testosterone into its active form in the prostate..it reduce the prostate size and improve the urinary symptoms..
surgical procedures:
    -Trans urrthral resection of the prostate..the instrument inserted into urethra through the penis..
   -laser procedures,it removes the obsrtuction in prostate tissue..
   -Microwave therepy by using microwave energy delivered to the prostate to kill the cells which causing shrinkage of the prostate..
Prostate cancer:
   It is a development of cancer in the prostate gland (male reproductive system)
Signs and symptoms:
   -difficulty passing urine
   -dribbling of urine
   -low back pain
   -Pain with ejaculation
-blood in urine
-urinary incontinence
Treatment:
surgery: Radical prostatectomy is a removal of prostate..
Brachy therepy:
   Radio active seeds are implanted into the prostate to deliver the radiation..
Radiation therepy:
   ratiation beems passes only to the particular affected area to kill cancer cell..this minimize healthy tissue getting affected..
Advanced prostate cancer:
chemotherepy to kill cancer cells around the body
androgen deprivation therepy: it can slow down cancer growth by reducing androgen levels..
2, Prostate palpation: In prostate cancer and BPH doctor will perform digital rectal examination by inserting a lubricated gloved finger into a lower part of the rectum to feel the prostate for lumps or hard mass or anything unsual..Prostate cancer often begin in the back part of the gland it can be felt during rectal exam..
Blood test:    both in BPH and prostate cancer Prostate-specific antigen level to be checked (PSA) is a protein which can be elevated in prostate cancer..And blood urea nitrogen to evaluate kidney function..
extra-urinary symptoms:    Prostate cancer having symptoms same like BPH but having extra symptoms like blood in urine and difficulty passing urine..
Transurethral resection of prostate:
    It is a urological operation to treat benign prostatic hypertrophy
Nursing management prepoeratively:
   -Preoperatively explain the patient about,post operative care ,catheter drainage,irrigation..
   -expalin them incontinence of urine will be there for next 1 year after surgery..we can get rid of this with exercises..
-Bowel preparation to be done.
   -to reduce the complication opinion needed from cardiac,respiratory consultation
   -Antibiotic must be started before shifting to operation theatre..
Post operatively
-Urinary drinage must be observed for bleeding,patency to be maintained for catheter..
-Anti-cholinergic medication for reducing bladder spasm to be given
-Strict bed rest for next 24 hours..
   -encourage them to walk early to avoid thrombosis
-wound care to be given to avoid infection
-Pain medication to reduce pain
-Stool softner to prevent constipation
-avoid sexual dysfunction by encourage them to talk with partner..
Reduce anxiety by providing support..