BENIGNA PROSTAT HYPERTROPI BPH Pembesaran progresif dari kelenjar

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 • Penyebab pasti belum di ketahui Ketidakseimbangan endokrin: • Perubahan hormon estrogen – testosteron • Berkurangnya sel yang mati • Proses penuaan

Tanda dan Gejala • Frekuensi berkemih bertambah • Berkemih pada malam hari • Kesulitan dalam memulai dan menghentikan berkemih • Air kemih masih tetap menetes setelah selesai berkemih • Rasa nyeri pada waktu berkemih • Resiko cystitis, hydroneprosis dan pyelonefritis

Diagnostic Test • Cystoscopy • IVP • USG

Treatment • Prostate urethral stent • TURP

Preop management: • 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.

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.

• 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.

• Pathophysiology

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