Begin Prostate Hypertrophy

It is also known as prostate gland enlargement, it  is a condition which mostaly develeps in old age peoples. it is an age associated disease.

what is prostate gland :- prostate is a walnut shaped gland which is situated at surrounding of male urithra and at the bottomaly of urinary bladder and upword of ractum

Function  of prostate gland:- 

• it secreats an alkeline fluid which combains with sperm[ produced by testicles] and fluid with other gland , together makes seman.

• The alkeline nature of fluid , it protects sperm from highly acidic [3.5- 4.5]  enviorment of vagina.

• The musscles of prostate is also plays an important role in flow of seman and ejaculation of seman in vegina.

Causes of BPH :- prostate is a gland that contineu, geowth till death of most men.

• The actula cause of BPH is still unknown but some factore are known that are following 
• harmonal factors 
• Aged factor
• Dietory factors

Sign and Sympyoms of BPH :-

• Nocturia
• Difficulty starting urination
• Incontineous of urine
• Urinary bladder fullness
• Blood in urine
• Sexual dysfunction
• Pain at  perineal area

Types of BPH  :- The types of BPH is aacording to its size whichnis measured by MRI. which are following .

1. TYPE 0:- In these there are no zonal enlargment of prostate
2. TYPE 1:-`Bialateral transition zone(TZ) enlargement
3. TYPE 2:- Retrourithral enlargement
4. TYPE 3:-Bialateral TZ and Retouritharal enlargement
5. TYPE 4:- Peduncluted enlargement 

Diagnostic Test for BPH :

• Rectal  Examination :In these test the doctor insert finger in rectum to assess the prostatic growth

• Blood test 
• Urine Analysisi
• PSA Blood test 

• PSA (prostate specific antigen) TEST :- In these test the value of PSA. PSA is manily secreated by the prostate gland and its high value indiacted prostate enlargement t

• Transrectal ultrasound 
• cystoscopy 
• prostate biopsy 

Treatment of BPH :-  There are varient treatment available for BPH like medications, minimum invasive surgeries, and open surgeries. The effect and selection of treatment method, is depended on  

• Age of patient 
• Size of prostate gland 
•   Overall condition of health ofb client
• 
  

1. Medical managment:- The medication can only treat the mild and moderate types of BPH.

• Alpha blocker :- These types of medicines workes on the neck of the bladder, and makes it smooth to make urination easier. ex- Tamsulosin, silodosin, doxazosin etc.

• 5-Alpha reductase inhibitors:- these types of drug effects the growth of prostate gland, it shrink the prostate gland by preventing the harmonal changes in the body that affects the growth of prostate. ex- finasteride, dutasteride, etc 

• combination drug theratpy:- In these the alpha bloker and 5- alpha blocker drugs are given at same time. it is manly used in moderate prostate hypertrophy.

• In some study the rechercher found that the drug which is given to treat eractile dysfunction, can also treats the prostatic hypertrophy.

2. Surgical managment :-  The surgical managment can only be useful if the patient  do not have following conditions.

• urinary tract infection
• past history of rediation therapy of prostate hypertrophy
• urithral structural disorder

In the case of BPH following surgical procedure are performed :-

1. TUMT:- Transurithral microwave therapy  This is a noninvasive method. In this procedure a tube is insered in   the urithral cannal and a microwave anatena is atteched to it. The heat of microwave kills the urithral becteria.

2.Rezum therapy:- This procedure is also known as water vapor therapy.  It is a minimallly invasive surgical  procedure and it reduses risk of of injury. In this procedure an equipment is used to generate the vapor and a transurithral delivery system.

3.TUNA:- Transurithral Needle Ablation is the full form of this. It is an old time method, at present time this is not recommended. In these procedure the Dr. insertes a heate needle through urethra, the heated needle destroyes the exess prostatic cells.

4.TURP:- Transurethral resection of prostate. these is the most commanly used treatment of BPH. There are no scar made by these. In these procedure a scope is inserted through urethra to remove prostate.

5.TUIP:- Transurethral incision of prostate. In these procedure  a small incision is made on the prostate gland to reduce the pressure made by gland on the urethra to make voiding easier.

6. open surgery :- In this procedure an incision is made through the lower abdomen and sometimes the incision  is made on perineal area. 

Nursing Diagnosis 

• Urine Retention R/T obstructed urithra
• Acute pain R/T Bladder distention
• Risk of infection R/T Surgical procedure
• Anxiety R/T Hospitalization