Acute Prostatitis, Benign Prostatic Hypertrophy, and Prostate Cancer
The clinical presentation of acute prostatitis, benign prostatic hypertrophy, and prostate cancer are markedly different. Nevertheless, patients cannot always differentiate between these three conditions. No less serious are the problems they face in relation to self-management, education, and follow-ups. Consequently, one of the primary obligations to be fulfilled by nurses is to provide patients diagnosed with any of these three conditions with a detailed plan to improve their health and wellbeing in the long run.
Acute prostatitis, benign prostatic hypertrophy, and prostate cancer represent three most common prostate problems. However, their epidemiology, pathophysiology, diagnosis and treatment differ considerably from one another. In simple terms, acute prostatitis is inflammation of the prostate due to infection. Benign prostatic hyperplasia (BPH) is the term used to define an enlarged prostate, a prostate that has grown to an unhealthy size. Finally, prostate cancer implies the development of tumors that damage the prostate and its function. The nature of these health conditions has far-reaching implications for the way they are diagnosed and treated.
Acute prostatitis is diagnosed, based on clinical observations and symptoms, as well as on the analysis of urine culture (Shoskes, 2008). Untreated prostatitis is likely to result in urosepsis (Shoskes, 2008). The bacterial triggers of prostatitis are quite similar to those leading to the most common urinary tract infections (Shoskes, 2008). The most common symptoms include frequent urination, pain in the genital area and pelvis. They can be further coupled with chills, fever, nausea and vomiting, as well as the sense of burning during urination (Shoskes, 2008). Treatment will vary depending on the severity of the patient’s condition and the nature of the bacterial agent that has led to inflammation. Basically, antimicrobial treatment is administered immediately to relieve the symptoms. No prostatic massage is allowed (Shoskes, 2008).
BPH is a syndrome which, according to Simpson (1997), “reflects a complex interplay between benign prostatic enlargement […] and the resulting outlet obstruction and lower urinary tract symptoms” (p. 235). The most common symptoms are called “obstructive” and include: micturition initiation hesitancy, weak stream, stream interruption, as well as terminal dribbling (Simpson, 1997). “Irritative” symptoms usually cover nocturia and a certain form of mild inflammation (Simpson, 1997). Almost every third man with BPH eventually develops acute urinary retention (Simpson, 1997). The diagnosis is made on the basis of the patient’s medical history, urinary symptoms, rectum and urine examination, as well as serum creatinin (Simpson, 1997). Treatment is mostly surgical.
Finally, prostate cancer manifests as a variety of symptoms such as blood in urine, problematic erection, slow or weak urinary stream, numbness in feet or legs, and others (American Cancer Society, 2014). Cancer is diagnosed through the medical history, detailed physical examination, prostate-specific antigen blood test, biopsy and transrectal ultrasound (ACA, 2014). Similarly to any other cancer, prostate cancer is treated by means of surgery, radiation or chemotherapy, hormone therapy, cryosurgery, and other methods (ACA, 2014).
An education plan for a patient facing prostate health problems will include the following elements: medications and dosage prescribed; side effects to observe; frequency of physician visits during the follow-up period; expected time of recovery; symptoms to be concerned about; healthy nutrition; and physical activity recommendations. For instance, in the case of BPH, the treatment strategy will include a surgery followed by the use of alpha-blockers or reductase inhibitors (Simpsons, 1997). Phytotherapy is also possible (Simpsons, 1997). Chemotherapy for prostate cancer may include docetaxel, mitoxantrone, cabazitaxel or etoposide (ACA, 2014). For all medications, patients should be aware of possible side effects and changes in health. Healthy nutrition is a must. Also, the education plan will require that the patient does not miss physician visits. Individual and group discussion opportunities will be provided to ensure that the patient has the fullest information about his health.