Medical-surgical Nursing Demystified

(Sean Pound) #1

CHAPTER 9 Genitourinary System^375


control through production of renin, and red blood cell production through the pro-
duction of erythropoetin. As urine is produced within the kidneys, it travels through
the ducts (ureters) to the bladder. Once the body senses the urge to empty the blad-
der, the detruser muscles contract and the sphincter at the bladder neck relaxes to
aid in emptying the urine. The urine passes through the urethra to the outside. Male
patientshave a prostate gland located under the bladder, surrounding the urethra.
Prostatic fluid is secreted from the gland into the urethra.


Just the Facts


Benign Prostatic Hypertrophy (BPH)


WHAT WENT WRONG?


The prostate gland is found just below the bladder in men, surrounding the urethra.
As men age, the prostate enlarges, putting pressure on the surrounding structures and
causing symptoms such as frequent urination and urinary retention. The enlarge-
ment of the prostate causes narrowing of the urethra and upward pressure on the
lower border of the bladder. Urinary retention may develop, as the body has a harder
time emptying the bladder. Hydronephrosis and dilation of the renal pelvis and ureter
are complications of the urinary retention due to overgrowth of the prostate.


PROGNOSIS


The symptoms of BPH are the same as those for prostate cancer. It is important for
the patients to have regular check-ups to evaluate for risk of prostate cancer and
conduct periodic screenings for prostate cancer. Renal function may be temporar-
ily effected by hydronephrosis secondary to urinary retention.


HALLMARK SIGNS AND SYMPTOMS



  • Urinary hesitancy—difficulty initiating stream of urine due to pressure on
    urethra and bladder neck

  • Urinary frequency—need to urinate frequently due to pressure on bladder

  • Urinary urgency—need to get to bathroom quickly to urinate due to pressure
    on bladder


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