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BENIGNA PROSTAT HYPERTROPI (BPH)

BENIGNA PROSTAT HYPERTROPI (BPH). Pembesaran progresif dari kelenjar prostat yang dapat menyebabkan obstruksi dan ristriksi pada jalan urine (urethra) >50% pria berumur >50 tahun ke atas memiliki symptoms BPH >90% pria berumur >70 tahun ke atas memiliki symptoms BPH. Etiologi

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BENIGNA PROSTAT HYPERTROPI (BPH)

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  1. BENIGNA PROSTAT HYPERTROPI (BPH)

  2. Pembesaranprogresifdarikelenjarprostat yang dapatmenyebabkanobstruksidanristriksipadajalan urine (urethra) • >50% priaberumur >50 tahunkeatasmemiliki symptoms BPH • >90% priaberumur >70 tahunkeatasmemiliki symptoms BPH

  3. Etiologi • Penyebabpastibelum di ketahui Ketidakseimbanganendokrin: • Perubahanhormon estrogen – testosteron • Berkurangnyasel yang mati • Proses penuaan

  4. TandadanGejala • Frekuensiberkemihbertambah • Berkemihpadamalamhari • Kesulitandalammemulaidanmenghentikanberkemih • Air kemihmasihtetapmenetessetelahselesaiberkemih • Rasa nyeripadawaktuberkemih • Resiko cystitis, hydroneprosisdanpyelonefritis

  5. Diagnostic Test • Cystoscopy • IVP • USG

  6. Treatment • Prostate urethral stent • TURP

  7. Preopmanagement: • Inform the patient about the procedure and the expected postoperative care, including catheter drainage, irrigation and monitoring of hematuria. • Discuss the complications of surgery which include: • Incontinence or dribbling of urine up to 1 year after surgery • Kegel’s exercise will help alleviate this problem • Retrograde ejaculation • Bowel preparation is given. • Optimal cardiac, respiratory and circulatory status should be achieved to decrease risk of complications. • Prophylactic antibiotics are ordered.

  8. Postop management: • Urinary drainage is maintained and observed for signs of hemorrhage. • Maintain patency of urethral catheter. • Avoid overdistention of bladder, which could lead to hemorrhage. • Administer anti-cholinergic medications to reduce bladder spasms. • Maintain bed rest for the first 24 hours. • Encourage early ambulation, thereafter to prevent embolism, thrombosis and pneumonia.

  9. Wound care is provided to prevent infection. • Administer pain medications. • Promote comfort through proper positioning. • Administer stool softeners to prevent straining that can lead to hemorrhage. • Reduce anxiety by providing realistic expectations about postoperative discomfort and overall progress. • Encourage patient to express fears related to sexual dysfunctions and to discuss with partner. • Teach measures to regain urinary control.

  10. Pathophysiology

  11. ASKEP

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