MedSurg Reproductive

Slow process of cell change over time

"NUTS" -
Nocturia,
Urine dribble,
Tries to void but cant
Small stream

Bladder dysfunction, abnormal distended ureters, destruction of kidney tissue, pyelonephritis

DRE (healthy men should start at age 50, men with history should start at age 40).

Signs of infection (WBC, hematuria, bacteria in urine)

may see elevated BUN and serum creatinine if long standing problem

Proscar - blocks the formation of androgens

Carduca and Minipress - relax smooth muscle in prostate

Avodart - shrinks the prostate (lowers androgen levels)

Erectile dysfunction and decreased libido

Postural hypotensio, dizziness, fatigue

Coilds, stents, prostatic balloon dilation, transurethral needle ablation, percutaneous radical cryosurgery ablation, microwave therapy

Heated probe raises gland tissue to 107.6 degrees F or greater. 1 hr tx at a time, total of 3-20 txs. (doesn't cause tissue necrosis, just makes the prostate smaller)

Transurethral ultrasound-guided laser induced ablation of prostate tissue.

Transurethral resection of prostate;


there's no incision, the prostate is just excised and cauterized. a 18-22 g 3-way catheter with a 30 cc balloon is inserted to apply pressure. Bladder irrigation is done for first 24 hours. Pt should be on strict I&Os.

Push 2-3 liters of fluids per day (don't let them get dehydrated...just because they're foley bag is full doesn't mean they are adequately hydrated). Assess for hyponatremia/fluid excess. maintain patency of catheter, pain management, mobilize pt (watch for clots), give opiate sppositories to avoid bladder spasms.

Transurethral cutting/incision of the prostate

This is used for younger patients with mild obstructions, or for high risk patients for prophylaxis. an incision/slits are made uni- or bilaterally on the prostate, to sort of direct where the overgrowth will go.

This is done if the urethra is obstructed by a very large mass. a low midline abdominal incision is made, going through the bladder to the anterior prostate. the gland is then removed and the urethra is sutured to the bladder. a supra pubic catheter is inserted through the abdominal incision and an indwelling cath is inserted with a 30cc balloon.

1) maintain patency of catheter
2) irrigate for clots
3) analgesics
4) watch VS for infection
5) I&O
6) avoid lifting > 10 lb or straining
7) increase fiber, increase fluids and give stool softeners
8) kegel exercises
9) watch for hemorrhage