By E. Fairand and C. McIntyre
https://voicethread.com/share/13200327/
- Urinary Tract Infection (UTI): Caused by when a person is unable to completely void urine through the urethra related to the enlargement of the prostate. Urine becomes retained and stationary in the bladder making the individual more susceptible for infections to arise. Mr. U. Rology exhibits urinary retention as evidenced by his post void residual bladder scan of 250mL. The patients’s urine culture is also positive for bacteria, which is indicative of a UTI. This is why he was prescribed a 7 day course of oral Levaquin antibiotic.
- Bladder Outflow Obstruction: Nodular hyperplasia and cellular hypertrophy cause the tissue from the enlarged prostate to compress on the urethra and cause a urethral obstruction (see photo below). As the obstruction continues and the tissue around the prostate grows, the bladder has a difficult time emptying, leading to symptoms that include the urge to urinate, delayed initiation of urination and decreased flow of the urinary stream (McCance, Huether, Brashers, & Rote, 2019). Mr. U. Rology presents to the clinic already with urgency to urinate and delayed initiation of urination. Eventually, the volume of retained urine becomes great enough that it causes increased intraabdominal pressure and incontinence. Hematuria, hydronephrosis, and bladder calculi are other common complications. Thankfully, Mr. U. Rology does not yet exhibit the severity of these complications and we are hopeful the use of Flomax will decrease his risk of bladder outflow obstruction in the future.
(Holmium Laser Enucleation of the Prostate (HoLEP). (n.d.). Retrieved October 24, 2019) - Chronic Bacterial Prostatitis: This is the most common form of prostatitis. Characterized by recurrent urinary tract symptoms and persistent presence of pathogenic bacteria, commonly gram negative, in urine or prostatic fluids. Symptoms are similar to those of acute bladder infection, such as increased frequency, urgency, dysuria, low back pain and sexual dysfunction (McCane, et. al., 2019). The differential diagonisis of chronic bacterial prostatitis is appropriate to consider for Mr. U. Rology due to his history of frequent UTIs, thus increasing his risk of developing pathogenic bacteria which may lead to chronic bacterial prostatitis. He exhibits symptoms of urinary frequency and urgency, but is without low back pain and/or sexual dysfunction at this time.
