What is the definition of benign prostatic hyperplasia?
enlargement of prostate gland resulting from increase in number of epithelia cells and stromal tissue
Which type of individual is most likely to develop BPH?
males between age of 50-80
True/False. Having Benign Prostate Hyperplasia does not predispose a person to develop prostate cancer.
What are possible causes to developing BPH?
excessive accumulation of dihydroxytesterone
stimulation of estrogen
local growth hormone action
What are risk factors of a patient developing BPH?
increased waist circumference
polyunsaturated fatty acids
Which types of symptoms are due to urinary retention?
which types of symptoms are associated with inflammation or infection?
Decrease in caliber of force of urinary system, difficulty in initiating urination, intermittency, dribbling at end of voiding are all symptoms of what category?
Urinary frequency and urgency, dysuria, bladder pain, nocturia, and incontinence are all symptoms of what type of category?
What is the main problem with complications from BPH?
What are some complications with BPH?
Acute urinary retention
incomplete bladder emptying
calculi in bladder
hydronephrosis cause renal failure
What are ways to diagnose BPH?
history and PE
What are the major goals of the nurse in treating a patient with BPH?
1. restore bladder drainage
2. relieve symptoms
3. prevent/treat complications
4. watchful waiting
5. diet change
6. timed voiding schedule
Which medication is used to decrease the size of the prostate gland. Takes 3-6 months for improvement.
5-a Reductase inhibitors
Which medication is used to promote smooth muscle relaxation in prostate; facilitates urinary flow and takes 2-3 weeks to improve.
a-Adrenergic receptor blockers
What are side effects to 5 a-Reductase inhibitors medications? Proscar, Avodart
decreased volume of ejaculation
What are side effects of a-Adrenergic receptor blockers? (Flomax, Cardura)
orthostatic hypotension and dizziness
What types of situations will cause the need for invasive therapy for BPH?
decreased in urine flow that cause discomfort
persistent residual urine
acute urinary retention
intermittent catheterization can reduce symptoms and bypass obstruction
Is it okay for a patient with BPH to have a long-term catheterization?
no it is contraindicated because it increases the risk of infections
What types of things are based on what type of treatment will be done for a patient with BPH?
size and location of prostate
What treatment has the best outcome with low risk involved for BPH?
Transurethral resection (TURP)
Which treatment involves removal of obstructing prostate tissue using resectoscope inserted through urethra. Performed under general or spinal anesthesia and requires hospital stay?
Transurethral resection (TURP)
After a patient comes on the floor after a TURP procedure what is the importance of the nurse to do?
Bladder irrigate for first 24 hours to prevent mucus and blood clots
What are complications that may arise after having a TURP?
Which type of treatment delivers microwaves directly to prostate through a transurethral probe and the heat cause tissue death and relieves obstruction?
Transurethral microwave therapy (TUMT)
Which type of treatment for BPH uses low wave frequency that increase temperature of prostate tissue for localized necrosis and only the tissue in contact with needle is affected?
Transurethral needle ablation (TUNA)
Which type of cancer is the most common cancer in men and second leading cause of cancer death in men?
Where are majority of the tumors in prostate cancer located?
in outer aspect of the prostate gland and is usually slow growing
What are the three ways prostate cancer can spread throughout the body?
1. direct extension
2. through lymph system
3. through blood stream
What are non-modifiable risk factors for developing prostate cancer?
over 65 years old
first degree relative
What are some modifiable risk factors for developing prostate cancer?
high fat diet
exposure to certain chemicals
True/False. Having BPH is a major risk factor to developing prostate cancer.
False. BPH is NOT a risk factor
What type of symptoms will a patient develop if prostate cancer has metastasize?
pain in lumbosacral area that radiates to hips or legs and urinary symptoms
What is the major priority of the nurse when the diagnose of prostate cancer has metastasize?
What are the three primary ways of screening for prostate cancer?
1. PSA (prostate specific antigen) blood levels
2. DRE (digital rectal exam)
3. PAP (prostatic acid phosphatase) increased levels
What is the purpose of the PSA (prostate specific antigen) test?
Monitor success of treatment
elevated levels indicate prostate malfunction
When doing an digital rectal exam and the doctor feels a hard, nodular, and asymmetric phosphate what does this suggest?
diagnose of prostate cancer
What is the only way to confirm diagnosis of prostate cancer?
biopsy of prostate
When a patient is diagnosed with prostate cancer and has a life expectancy of less than 10 years, has comorbid disease, and has a low-grade, low stage tumor what is the best treatment for this patient?
If a patient with prostate cancer that has not metastasize and is < 70 years of age what treatment is best for this patient?
Which treatment for prostate cancer is considered the most effective for long-term survival?
In doing a radical prostatectomy what should the nurse educate the patient on what is going to happen during and after the procedure?
entire gland, seminal vesicles, and part of bladder neck is removed
retroperineal lymph node dissection is done
after will have a catheter for 1-2 weeks
what are some complications after having a radical prostatectomy?
Which type of treatment to treat prostate cancer involves sparing nerves that are responsible for erection and done only for cancer confined to the prostate?
nerve-sparing surgical procedure
Which type of treatment to treat prostate cancer involves a surgical technique that destroys cancer cells by freezing the tissue. It is the initial and second line treatment after radiation fails?
What are some complications of cryosurgery treatment?
damage to urethra
What is the purpose of using external beam radiation to treat prostate cancer?
most widely method of radiation used to treat cancer confined to prostate and/or surrounding tissue
Which type of treatment is best used for stage A or B prostate cancer?
What is the purpose of androgen receptor blockers as a drug therapy for treatment of prostate cancer?
to compete with circulating androgens at receptor sites
used in combination with luteinizing hormone-releasing hormone agonists
What are side effect to androgen receptor blockers?
loss of libido
What are some side effects to orchiectomy?
loss of libido
loss of muscle mass
what is the purpose of having a orchiectomy?
surgically removal of testes for advanced stages of prostate cancer
may be done alone or with prostatectomy
When is chemotherapy done to treat prostate cancer?
in patients with hormone-resistant prostate cancer in late stages
After all treatments for prostate cancer has responded poorly what is the main goal for the patient?
What is the purpose of estrogen used in hormonal therapy?
a form of androgen deprivation therapy
What is the primary therapeutic approach for treatment of prostate cancer?
What is the purpose of androgen deprivation therapy? When is it best used?
reduce levels of androgens to reduce tumor growth
Used before surgery or radiation to reduce tumor size
After a few years tumors become resistant to hormone therapy and this is known as?
What is the first sign that hormonal therapy is no longer effective?
elevated PSA levels
What are the three types of hormonal therapy?
1. Luteinizing hormone
2. Androgen receptor blockers
What are side effects to Luteinizing hormone drug therapy?
loss of libido
Which type of hormonal therapy produces a chemical castration similar to orchiectomy?