\u00a0\u00a0<\/p>\n
The 57-year-old patient noted urinary hesitancy and a decrease in the force of his urinary
\nstream for several months. Both had progressively become worse. His physical examination
\nwas essentially negative except for an enlarged prostate, which was bulky and soft.
\nStudies Results
\nRoutine laboratory studies Within normal limits (WNL)
\nIntravenous pyelogram (IVP) Mild indentation of the interior aspect of the bladder,
\nindicating an enlarged prostate
\nUroflowmetry with total voided
\nflow of 225 mL
\n8 mL\/sec (normal: >12 mL\/sec)
\nCystometry Resting bladder pressure: 35 cm H2O (normal: <40 cm H2O)
\nPeak bladder pressure: 50 cm H2O (normal: 40-90 cm H2O)
\nElectromyography of the pelvic
\nsphincter muscle
\nNormal resting bladder with a positive tonus limb
\nCystoscopy Benign prostatic hypertrophy (BPH)
\nProstatic acid phosphatase
\n(PAP)
\n0.5 units\/L (normal: 0.11-0.60 units\/L)
\nProstate specific antigen (PSA) 1.0 ng\/mL (normal: <4 ng\/mL)
\nProstate ultrasound Diffusely enlarged prostate; no localized tumor
\nDiagnostic Analysis
\nBecause of the patient\u2019s symptoms, bladder outlet obstruction was highly suspected. Physical
\nexamination indicated an enlarged prostate. IVP studies corroborated that finding. The
\nreduced urine flow rate indicated an obstruction distal to the urinary bladder. Because the
\npatient was found to have a normal total voided volume, one could not say that the reduced
\nflow rate was the result of an inadequately distended bladder. Rather, the bladder was
\nappropriately distended, yet the flow rate was decreased. This indicated outlet obstruction.
\nThe cystogram indicated that the bladder was capable of mounting an effective pressure and
\nwas not an atonic bladder compatible with neurologic disease. The tonus limb again
\nindicated the bladder was able to contract. The peak bladder pressure of 50 cm H2O was
\nnormal, again indicating appropriate muscular function of the bladder. Based on these
\nstudies, the patient was diagnosed with a urinary outlet obstruction. The PAP and PSA
\nindicated benign prostatic hypertrophy (BPH). The ultrasound supported that diagnosis.
\nCystoscopy documented that finding, and the patient was appropriately treated by
\ntransurethral resection of the prostate (TURP). This patient did well postoperatively and had
\nno major problems.
\nCritical Thinking Questions
\n1. Does BPH predispose this patient to cancer?
\n2. Why are patients with BPH at increased risk for urinary tract infections?
\n3. What would you expect the patient\u2019s PSA level to be after surgery?
\n4. What is the recommended screening guidelines and treatment for BPH?
\n5. What are some alternative treatments \/ natural homeopathic options for treatment?
\nNote: I need you to have at least two to three bibliographic references and ask that they be updated, less than 5 years ago.<\/p>\n","protected":false},"excerpt":{"rendered":"
\u00a0\u00a0 The 57-year-old patient noted urinary hesitancy and a decrease in the force of his urinary stream for several months. Both had progressively become worse.\u2026<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10099,10681,7636,615,10892,10680,10891],"tags":[10553,10616,10254,10896,10897,10247,10295,10898,10893,10894,10895,10899,10551],"class_list":["post-125980","post","type-post","status-publish","format-standard","hentry","category-buy-essay","category-cheap-dissertation-help-online","category-cheap-essay-writer-usa","category-homework-help-writing-service-usa","category-page-paper","category-university-dissertation-writing-service","category-write-my-assignment-ireland","tag-1-assignment-help-online-service-for-students-in-the-usa","tag-australian-best-tutors","tag-can-someone-write-my-assignment-for-me","tag-case-study-in-nursing-writing-a-nursing-case-study-essay","tag-free-nursing-case-studies","tag-help-me-write-my-dissertation","tag-homework-for-you","tag-nursing-case-study-assignment-examples","tag-nursing-case-study-examples","tag-nursing-case-study-presentation-example","tag-nursing-case-study-questions-and-answers","tag-student-nurse-case-study-assignments","tag-write-my-assignment-help-for-college-students"],"_links":{"self":[{"href":"https:\/\/www.studyproessays.com\/help\/wp-json\/wp\/v2\/posts\/125980","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.studyproessays.com\/help\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.studyproessays.com\/help\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.studyproessays.com\/help\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.studyproessays.com\/help\/wp-json\/wp\/v2\/comments?post=125980"}],"version-history":[{"count":0,"href":"https:\/\/www.studyproessays.com\/help\/wp-json\/wp\/v2\/posts\/125980\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.studyproessays.com\/help\/wp-json\/wp\/v2\/media?parent=125980"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.studyproessays.com\/help\/wp-json\/wp\/v2\/categories?post=125980"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.studyproessays.com\/help\/wp-json\/wp\/v2\/tags?post=125980"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}