Men’s Health Care Plans

Chapter 12


Men’s Health Care Plans



Benign Prostatic Hyperplasia


Benign prostatic hyperplasia (BPH) is a common urological disorder in men, and its incidence is age related. The prevalence rises from approximately 20% in men 41 to 50 years of age to 50% in men 51 to 60 years of age, then to more than 90% in men 80 years of age and older. BPH is an overgrowth of muscle and connective tissue (hyperplasia) of the prostate gland. As the glandular tissue enlarges, it causes obstruction of the urethra. Severity of symptoms may be ranked according to the American Urological Symptom Index. Early diagnosis and staging have improved with the availability of prostate ultrasound technology. Treatment options include medications that cause either regression of overgrown tissue or relaxation of the urethral muscle tissue; nonsurgical treatment, including direct heat application, dilation, laser, and placement of stents to allow drainage; and surgical treatment to remove prostate tissue. The focus of this care plan is the patient with newly diagnosed BPH.




Prostate Cancer


Radical Prostatectomy; Localized Prostate Cancer


Prostate cancer is the most common nonskin cancer among males in the United States. There has been a significant increase in prostate cancer findings since the introduction of the recommended blood screening of prostate-specific antigen (PSA). Annual health screenings including digital rectal examination (DRE) and PSA test are recommended for all men older than 50 years and younger high-risk men. More than 70% of prostate cancers are diagnosed in men older than 65 years of age. African Americans have a higher risk for this cancer. With prostate cancer, the patient is generally asymptomatic until obstructive symptoms of the urinary tract appear. Transrectal ultrasound is used to detect nonpalpable tumors and stage localized cancers. Biopsy is needed to confirm diagnosis. Medical and surgical options depend on the stage of the cancer, symptoms, and response to other therapies. Treatment may include the traditional radical prostatectomy, newer laparoscopic nerve-sparing procedures for more localized cancers, radiation (external beam or seed implant), hormonal therapy, and chemotherapy. There are two approaches for a radical prostatectomy for cancer: retropubic and perineal. The approach depends on several factors, such as coexisting bladder abnormalities, size of the prostate, and the degree of risk of the surgical candidate. Each procedure has its advantages and disadvantages. Patients presenting with early-stage cancer in which only a small amount of cancer is noted on biopsy may be considered for active surveillance (watchful waiting) as an alternative to more aggressive therapies. In addition, many clinical trials are available for patients needing additional treatments. The focus of this care plan is on the patient undergoing a radical prostatectomy.


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Dec 3, 2016 | Posted by in NURSING | Comments Off on Men’s Health Care Plans

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