Urinary Retention related to Benign Prostatic Hyperplasia (BPH)

Benign prostatic hyperplasia (BPH), also known as benign prostatic hypertrophy, is a histologic diagnosis characterized by proliferation of the cellular elements of the prostate. Chronic bladder outlet obstruction (BOO) secondary to BPH may lead to urinary retention, renal insufficiency, recurrent urinary tract infections, gross hematuria, and bladder calculi.

BPH involves hyperplasia (an increase in the number of cells) rather than hypertrophy (a growth in the size of individual cells), but the two terms are often used interchangeably, even amongst urologists.

Urinary retention

Incomplete emptying of the bladder

Defining Characteristics:

Measured urinary residual >150 to 200 ml or 25% of total bladder capacity;
obstructive lower urinary tract symptoms (poor force of stream, intermittency of stream, hesitancy of urination, postvoiding dribbling, feelings of incomplete bladder emptying);
irritative lower urinary tract symptoms (urgency to urinate, diurnal frequency of urination, nocturia);
overflow incontinence (dribbling urine loss caused when intravesical pressure overwhelms the sphincter mechanism)


Nursing Care Plan for Benign Prostatic Hyperplasia (BPH)

Nursing Diagnosis : Urinary Retention related to mechanical obstruction, enlarged prostate, decompensated detrusor muscle.

Goal:

• Urination by a considerable amount, with no palpable bladder.
• Shows post-voiding residual of less than 50 ml in the absence of droplets / excess flow.

BPH Nursing Intervention and Rational:

1. Encourage clients to urinate every 2 to 4 hours.
R /: Minimizing excessive retention of urine in the bladder.

2. Observation of the flow of urine. Note the size of the force.
R /: Useful for evaluating obstruction and intervention options.

3. Supervise and record time, the number of each micturition. Note the decrease in spending and changes in urine specific gravity.
R /: Urinary retention increases the pressure in the upper urinary tract that can affect the kidneys.

4. Encourage drinking water to 3000 ml / day.
R /: Increased flow of fluid to maintain renal perfusion and kidney cleanse, bladder from bacterial growth.

5. Perform catheterization and perianal care.
R /: Reduce the risk of ascending infection.