Benign

Prostatic
Hyperplasia
-- ( Enlarged Prostate )--
 Benign Prostatic Hyperplasia

-=INTRODUCTION=-

- Affects 50% of men between the ages

of 51 and 60 years, & 90% of men over
age 80.
- The prostate gland enlarges,
extending upward into the bladder and
obstructing the outflow of urine by
encroaching on the vesical orifice
 Benign Prostatic Hyperplasia

-=Classification=-

MICROSCOPIC BPH - diagnosable only by

histological changes
MACROSCOPIC BPH – characterized by
palpable enlargement of the gland
during rectal exam
CLINICAL BPH – refers to observable
signs and symptoms related to BPH
 Benign Prostatic Hyperplasia

-=Signs And Symptoms=-

•Difficulty starting a stream of urine, weak stream

•Straining to urinate
•Longer time needed to urinate
•Feeling of incomplete bladder emptying
•Urinary retention may occur
Signs and Symptoms secondary to the enlarged
prostate include:
•Urinary urgency
•Frequency
•Nocturia.
 Benign Prostatic Hyperplasia

-= Assessment and Diagnostic Examination=-

Digital Rectal Examination (DRE)

 Reveals a large, rubbery, and non tender Prostate
Gland

Renal Function Test

 To determine whether there is renal impairment
from prostatic back pressure and to evaluate renal
reserve
 Benign Prostatic
Hyperplasia
-=Management=-

Pharmacologic Treatment
Alpha-adrenergic blocking medication
Terazosin(Hytrin),Doxaszosin(Cardura),Tamsulosin(Flomax)
•Relaxes smooth muscle of the bladder neck and prostate
Saw palmetto – OTC herbal Medication effective in
improving BPH signs and Symptoms
Surgery
Transurethral resection of the prostate (TURP)

Complication: Erectile Dysfunction, Retrograde

Ejaculation, Hemorrhage, Infection
 GENITO-URINARY MALIGNANCIES

Cancer of the Kidney

Risk factors
•Gender, Affects Men more than women
•Tobacco use
•Occupational exposure to industrial chemicals
•Obesity
•Unopposed estrogen therapy
•Polycystic kidney disease
 GENITO-URINARY MALIGNANCIES

-=Signs and Symptoms=-

•Anemia
•Wt loss
•Fever
•HPN
•Hypercalcemia
•Microhematuria
•Flank pain
•Mass on the affected kidney
 GENITO-URINARY MALIGNANCIES

Management
Surgery :
•Radical Nephrectomy
•Nephron Sparing
surgery
Pharmacological Treatment
•Chemotherapeutic Agent
•Radiation Therapy
•Biologic response modifier
 GENITO-URINARY MALIGNANCIES

Cancer of the Bladder

-One of the more common malignancies that affect

older adults. Men 4x to develop than women

Risk Factors:
•Cigarette smoking
•Occupational exposure to certain
chemicals known as arylamines.
 GENITO-URINARY MALIGNANCIES

-=Signs and Symptoms=-

•Microhematuria
•Urinary freq
•Urgency
•Dysuria
•Pyuria
 GENITO-URINARY MALIGNANCIES

Treatment
Surgery :
Transurethral resection of the bladder
or Fulguration
Pharmacological Treatment
•Chemotherapeutic Agent
•Radiation Therapy
•Biologic response modifier
•BCG
 GENITO-URINARY MALIGNANCIES

Prostate Cancer

•More common in men than bladder cancer

•Higher levels of sexual activity have been demonstrated
to correlate with an increased
Risk of prostate Ca: reflects the role of
androgens in both prostate Ca & sexual activity.
SCREENING TOOLS:
•Digital Rectal Examination (DRE)
•Prostate Specific Antigen (PSA) Testing
Normal PSA level – below 4ng/ml; values over
10ng/ml – indicative of prostate Ca
 GENITO-URINARY MALIGNANCIES

Treatment

If localized:

Radical Prostatectomy – removing the prostate

through a perineal or retropubic incision.
Radiation Therapy – may be applied externally
or through implants in the prostate.
Surveillance – watchful waiting
If advanced:
External Radiation or Hormonal treatment
 GYNECOLOGICAL
MALIGNANCIES
Ovarian Cancer
•is a cancerous growth arising from different parts of the
ovary.
•75% in women over the age of 55
Diagnostic Studies
BLOOD TEST:CA-125 tumor marker that is most sensitive & specific.
Signs and Symptoms
•Diffuse abdominal discomfort & GI distress
•Ascites or a palpable mass until lymph nodes are involved or
metastases are found.
Treatment:
•Surgery : Total abdominal hysterectomy bilateral salphingectomy
oophorectomy (TAHBSO)
•Chemotherapy
 GYNECOLOGICAL
MALIGNANCIES
Cervical Cancer
•Risk factors:
•Infection w/ human papillomavirus
•Early onset of sexual activity,
•History of abN pap smears,
•HIV+ status,
•Many sexual partners.

Screening: Papanicolau test

Treatment: Cryotherapy
Loop Electrocautery Excision Procedure
Hysterectomy
Chemotherapy
Radiation therapy
 GYNECOLOGICAL
MALIGNANCIES
-=Breast Cancer=-
•Risk Factors:
•advanced age
•family hx
•early menarche & late
menopause
•estrogen replacement therapy
•none or late pregnancy
•regular alcohol use
•abdominal obesity
•exposure to radiation
•personal hx of benign breast
disease.
Screening Tests:
•Mammography
•Clinical Breast Examination
•Breast Self Examination
Treatment:
Small contained tumors :
Modified Radical Mastectomy or
Lumpectomy w/ Radiation
Use of TAMOXIFEN after
surgery: increase survival from
breast Ca for older women w/
metastases to the lymph nodes
 GYNECOLOGICAL
MALIGNANCIES
-=Endometrial Cancer=-
• Most common gynecological Ca in
women
Risk Factors: Symptoms: Postmenopausal uterine
bleeding – most common sx
•Celibacy
•Late menopause Diagnosis by endometrial biopsy
•Obesity
•HPN Treatment:
•DM •Hysterectomy
•HRT particularly •Oophorectomy
estrogen •Salphingectomy
•Chemotherapy after surgery
 Menopausal Related Concern
-=Introduction=-

•Decreased vaginal lubrication

•Atrophic vaginitis (thinning & atrophy of the vaginal
epithelium usually resulting from diminished estrogen levels)
•More freq UTIs
•Vasomotor instability (hot flashes)
•Sleep disturbances
•Osteoporosis
•Increased CVD

The mediating factor in postmenopausal health concerns

appears to be estrogen.
 Menopausal Related Concern
-=Introduction=-

HRT (Hormone Replacement Therapy)– used only for the

relief of vasomotor sxs, women at risk for osteoporosis and
prevention of colorectal Ca.
Hot Flashes – mild feeling of being overly warm to intense
feelings of uncomfortable heat over the upper body.
Mgt: Soy products and Black Cohosh

Atrophic Vaginitis – result in urogenital infection, ulceration

& uncomfortable sexual intercourse.

Treatment: Topical estrogen as a cream that is applied to the

affected tissues
 BSN 4a2-5
Group 19

Bano, Kristoffer Ocan Camille Anne Victoria

Elento, Lina Sanchez, Abigail
Ferrer, Karen Kate Santiago, John Bernard
Miranda, Aaron John Tablang, Mary Judith
Musca, Gretchen Tugay, Shelley
Nilo, Katrina Mae Tecson, Alain