Benign Prostatic Hyperplasia (BPH)

Benign prostatic hyperplasia is a nonmalignant enlargement of prostate tissue, driven in part by androgen-dependent dihydrotestosterone activity. The tissue can narrow the bladder outlet in two ways: the enlarged prostate creates a static component of resistance, while increased prostatic smooth-muscle tone creates a dynamic component that can fluctuate. The result is lower urinary tract symptoms (LUTS), but LUTS alone do not prove that BPH is the cause. The bladder may initially compensate by generating more pressure to move urine through the narrowed outlet. With persistent obstruction, emptying can become incomplete, residual urine can accumulate, and retention or infection may develop. A patient can also have bothersome symptoms without severe obstruction. That is why symptom burden, bladder emptying, prostate findings, infection, neurologic status, and renal risk must be considered together. The practical nurse should recognize the symptom pattern without labeling every urinary complaint as BPH. Dysuria, fever, and cloudy or foul-smelling urine suggest infection; gross hematuria requires evaluation rather than attribution to BPH; a neurologic history may point toward impaired bladder function; and an abnormal prostate examination raises concern for malignancy....