Benign Prostatic Hyperplasia

Enlargement of the prostate due to unknown factors but mostly due to aging.
Risks: Aging, family History, Obesity, and Diabetes.
Symptoms: weak/forked/split urine stream, dribbling, nocturia, urgency, frequency, dysuria, urinary retention and distention, & post void residual > 200ml
Diagnosis: Prostate specific antigen PSA ↑ and Digital rectal exam (best screening test)
Treatment: 5-(alpha) α reductase inhibitor: To prevent prostate growth (Finasteride, Dutasteride) which can take up to 6 months to start working.

Acid Ash Diet

Acid ash diet to reduce inflammation
Makes urine acid
Eggs, meat, fish, oysters, prunes, cranberries, plums, tomatoes, peas, corn, legumes, and whole grains.

No anticholinergics because they cause urinary retention.
Examples of anticholinergic drugs are Oxybutin (used for incontinence), Atropine, a lot of antipsychotic drugs and antidepressants, Hydroxyzine (used for nausea), and Promethazine (Phenergan).
Other medications to avoid are decongestants because they cause are adrenergics that tighten muscles in the prostate and the bladder neck, worsening the symptoms of BPH.

After TURP: 3-way continuous bladder irrigation to keep catheter clear of clots. Use normal saline, run irrigation as fast as necessary to keep clear of clots.
No rectal temps
Stool Softeners to avoid straining
For bladder spasms: Belladonna and Opiates= B & O suppositories.
Perineal exercises, start and stop flow of urine because dribbing is common after surgery but temporary.
With TURP there is no impotence, but with perineal prostatectomy there is impotence.

Excessive absorption of electrolyte-free irrigation fluid.
Causes hyponatremia
Signs and symptoms are signs of cerebral edema and increased intracranial pressure such as Hypertension, Bradycardia, Muscle twitching, confusion, visual disturbances, nausea and vomiting.