BENIGNA PROSTAT HYPERTROPI (BPH)

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1 BENIGNA PROSTAT HYPERTROPI (BPH)

2 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

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

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5 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

6 Diagnostic Test Cystoscopy IVP USG

7 Treatment Prostate urethral stent TURP

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9 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.

10 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.

11 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.

12 Pathophysiology

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14 ASKEP

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