Question

CLINICAL SCENARIO: Incontinence/Benign Prostatic Hyperplasia (BPH)

Mr. X 65 male living in a hospice care, a hypertensive patient for 20 years, with maintenance medication of Captopril, Amlodipine, Furosemide and Celecoxib for arthritis. Mr. X does not participate in social activities in the hospice and he almost resist to drink plenty of fluids. The nurse noticed that he can’t control to micturate and before he reach the comfort room his pants gets wet. Since he suffered incontinence the patient became inactive and seldom participate in their socialization. Patient was diagnose with BPH and with prescription of Tamsulosin. Her nurse advised him to limit caffeine intake and do a daily Kegel’s exercise, don’t hesitate to go to Comfort Room. Diagnostics and laboratory procedure: Prostate-Specific Antigen (PSA) elevated.

1. What non-pharmacologic measures can be incorporated into an older adult lifestyle to facilitate proper urination?

2. Why does enlargement of the prostate interfere with urination?

Answer 1

1. Non pharmacological measures include dietary and fluid modifications, behavioural therapy and pelvic floor muscle rehabilitation.

-recommended fluid intake approximately 1.5 to 2L/ day.

-they are instructed to reduce intake of caffeine, carbonated beverages and alcohol which are common bladder irritants.

-they are also instructed to do pelvic floor muscle rehabilitation exercises and bladder training.

-life modifications like smoking cessation, weight loss.

-supportive measures like education about bladder health, uses of absorbent products and skin care.

-environmental intervention like toilet proximity, raised toilet seats and toilet substitutes.

2. Enlargement of prostate interfere with urination:

An enlarged prostate gland can cause blockage of urinary flow out of the bladder. This is because prostate gland is located below the bladder, the tube that transports urine from the bladder which is called urethra passes through the centre of the prostate gland. So when prostrate gland enlarges it begins to block urine flow. That is when the prostate gland enlarges it produces a pressure on the urethra which can lead to blockage of flow of urine and leads to variety of urinary problems.