a. Overgrowth of normal, nonmalignant cells that cause
progressive enlargement of the prostate gland, resulting in
bladder outlet obstruction with urinary retention, leakage,
and frequency (Shiller, 2007)
b. Additional complications: bladder wall trabeculation, detrusor
muscle enlargement, narrowing of urethra, incontinence,
and acute or chronic renal failure (Springhouse, 2005)
II. Classification (American Urological Association [AUA],
a. International scoring system has been adopted worldwide.
b. Questions, and subsequent scoring, focus on degree of
incomplete emptying, frequency, intermittency, urgency,
weak stream, straining, nocturia, as well as impact on
quality of life.
i. Score of 0 to 7: mildly symptomatic
ii. Score of 8 to 19: moderately symptomatic
iii. Score of 20 to 35: severely symptomatic
a. Cause is unknown, although testosterone and other
hormones may affect growth.
b. Microscopically characterized as a hyperplastic process
with the number of cells in the gland increasing with age
c. Most commonly seen in men older than age 50 years
a. Morbidity: An estimated 14 million men in the United States
have symptoms related to benign enlargement (Leveillee
et al, 2006); symptoms present in 50% of males by age 50
and 80% of males by age 80; accounts for 375,000 hospitalizations
annually (Gilchrist, 2004).
b. Mortality: Generally related to renal failure, infection, and
complications of surgery.
c. Cost: Direct and indirect costs to private sector related to
BPH treatment estimated to be $3.9 billion (Saigal &
Client is treated at the community level, with more acute
care provided during outpatient procedures.
Psychosocial aspects of care,
Renal failure: acute,
1. Relieve acute urinary retention.
2. Promote comfort.
3. Prevent complications.
4. Help client deal with psychosocial concerns.
5. Provide information about disease process, prognosis, and
1. Voiding pattern normalized.
2. Pain or discomfort relieved.
3. Complications prevented or minimized.
4. Dealing with situation realistically.
5. Disease process, prognosis, and therapeutic regimen understood.
6. Plan in place to meet needs after discharge.