The condition usually starts around 30years of age in men, but mainly surfaces with the associated symptoms around age of 50 years (Thomas & Haitham, 2003). It is a condition cannot be cured hence management usually focuses on reducing the associated symptoms. The type of management that is instituted is placed on how severe the associated symptoms are or how the complications has affected the patients’ health (Timothy & James, 2008). It is important to let the patient understand what the BPH is all about. It is a non-cancerous enlargement of the prostate.
The normal, healthy prostate is usually about the size and shape of a walnut and has its position located just between the bladder and the penis. It is important to understand that urethra, which is a pipe that carriers both the urine and semen through the penis usually runs through the prostate organ. The prostate act to produce the seminal fluid which helps to nourish and carries the semen. This is from the testicles and via the penis during the ejaculation process. The problem an enlarged prostate organ causes is that which affects the function of the urethra by causing a compression of the urethra hence affecting the urinary processes.
The patient needs to understand that this process is a gradual process. Very few patients usually need surgical procedure which seems to be the ultimate intervention to help manage the affected patients. It is important to understand that the patient’s signs and symptoms are of earlier stage. The implication of this is that various forms of treatment can be instituted for the patient. This is simply because the major urinary symptomatic complaint from the patient is that of difficulty starting stream after prolonged driving.
In this kind of situation, any of the following categories of treatment can be planned for the patient. These categories are; watchful waiting (no treatment, but medical advice), medical treatments (with drugs and observation), minimally-invasive treatments, and surgical treatment (University of Maryland medical center, 2014). We all know that surgery is still the best form of treatment that helps relieve symptoms, but it is usually of more risks when compare to other forms of management. Surgery to several patients is usually bothersome. Considering the vital signs of the patient, he can still be planned to undergo the medical treatments with strong observation or minimally invasive treatments.
Those types of drugs that will be used for the patient are either the: Alpha blockers, 5-Alpha reductase inhibitors, and combination therapy. Alpha blockers are medications used mainly for the management of the high blood pressure, but used in this situation to help reduce the smooth muscle of the prostate and bladder neck (Levi & Edward, 2013). This will help in improving the difficulty associated with the urinary flow and also help reduce the bladder outlet obstruction which caused the difficulty stream the patient mainly complains of. The problem with this drug is that they just only help reduce the complaints, but usually do not help to reduce the size of the prostate. The implication is that there is a high chance of recurrence.
The patient will have to use the drug twice in a day to help reduce the associated symptoms. The commonly prescribed alpha blockers are the Tamsulosin (Flomax), Alfuzosin and doxazosin (Levi & Edward, 2013). The associated size effects this patient is likely to have with the use of the medication is headaches, dizziness, fatigue and light-headiness. The second type of drug that can be planned for this patient is the use of the 5-Alpha reductase inhibitors, which helps to shrink the size of the prostate (Levi & Edward, 2013). This is achieved by lowering the level of the hormone inside the organ. Those drugs are the Finasteride and dutasteride. Do not usually help all men and react slowly, hence this patient will have to take it for a longer period between 6-12 months.
Taking a proper consideration as regards to the two types of medications and the symptoms this patient presented with, a combination therapy will be a helpful approach using the alpha-blockers and alpha reductase inhibitors. This two drug types will help prevent the symptom progression, acute urinary retention and the likelihood of the need for surgery.
Another important plan that can be provided for the patient because of the presentation and the result of the examination is that of the "minimally-invasive treatments". The types of this form of management are the; catheterization, Holmium laser enucleation of the prostate, Interstitial laser coagulation, and prostatic stent (Levi & Edward, 2013). Catheterization will be done by the placement of a catheter into the penis so as to help take control of the difficulty stream temporarily. The different types such as the indwelling may be used to prevent the need for intermittent passage of catheters. The problem associated with this type of treatment is the high risk of infection associated with the frequent passage while another is the formation of bladder stone. HoLEP is another type of minimally invasive procedure done by a surgeon with the use of resectoscope and it usually requires the patients to be in the hospital for 1-2 days. It also requires the patient to undergo anesthesia.
References
John Hopkins medical institution, (2014). Prostate Enlargement: Benign Prostatic Hyperplasia.
Retrieved from https://www.google.com.ng/search?q=benign+prostatic+hyperplasia+treatment
Levi, A. Deters., & Edward, Kim. (2013, Dec 16). Benign Prostatic Hypertrophy Treatment & Management. Medscape.
Retrieved from http://emedicine.medscape.com/article/437359-treatment
Patient.co.uk (2014). Benign Prostatic Hyperplasia. Professional reference
Retrieved from http://www.patient.co.uk/doctor/benign-prostatic-hyperplasia
Retrieved from http://umm.edu/health/medical/altmed/condition/benign-prostatic-hyperplasia
Timothy J, Wilt., & James N'Dow. (2008, January 17). Benign prostatic hyperplasia. Part 1- Diagnosis.
Retrieved from http://www.bmj.com/content/336/7636/146
Thomas, Beckman & Haithm, Abu-Lebdeh (2003). Benign Prostatic Hyperplasia. Men's Health. Mayo Clinic Internal Medicine Review.
Retrieved from Evaluation and medical management of benign prostatic hyperplasia.
