What is benign prostatic hypertrophy (BPH)? 

Benign prostatic hypertrophy (BPH) is the nonmalignant growth of prostate tissue. BPH increases in prevalence with age, affecting 50%–60% of men in their 60s and 70%–80% of men in their 80s.

Prostate enlargement leads to bladder outlet obstruction, with both static and dynamic components: 

• Static: enlarged prostate compresses urethra; distortion of bladder outlet
• Dynamic: increased tension in prostate smooth muscle; decreased elasticity in prostatic urethra 

Risk factors for BPH

The risk of developing BPH increases with: 

• Genetic predisposition
• Metabolic syndromes
• Hypertension
• Obesity

Symptoms of BPH 

Common symptoms of prostatic hypertrophy include: 

• Difficulty starting, stopping, maintaining urine stream
• Difficulty emptying bladder
• Urgency, frequency, nocturia

Nursing diagnosis for BPH 

Potential nursing diagnoses for benign prostatic hypertrophy include: 

• Impaired urinary elimination 
• Acute pain related to bladder distention or catheter placement
• Risk for infection related to urinary retention 

Nursing interventions for BPH

Interventions addressing nursing diagnoses

• Impaired urinary elimination: monitor frequency, amount, presence of blood in urine; encourage patient to void at regular intervals and when urge is felt; teach client to avoid fluids before bed and instruct on double-voiding 
• Acute pain: prescribed analgesics, monitor for bladder distention and catheter blockage 
• Risk for infection: maintain closed urinary drainage system if catheter is present; teach the patient proper perineal hygiene; encourage adequate fluid intake; monitor for signs of infection  

Best medication for enlarged prostate

• 5-α-reductase inhibitors (finasteride, dutasteride): shrink prostate epithelial tissue; best for mechanical obstruction
• α-1 adrenergic antagonists (tamsulosin): relaxes smooth muscle in the prostate—prostate capsule, urethra, bladder neck (trigone & sphincter);helps with dynamic obstruction

Treatment is most effective when both classes of medication are used in combination therapy. 

Best surgery for enlarged prostate

Surgical treatment options for BPH include: 

• Transurethral resection (TURP), most common
• Prostatectomy
• Laser anucleation (HoLEP)
• UroLift®

Choice of surgery depends on the individual and factors like size of the prostate, overall health, and severity of symptoms.