A client is admitted to the hospital with benign prostatic hyperplasia, the nurse most relevant assessment would be:
A. Flank pain radiating in the groin
B. Distention of the lower abdomen
C. Perineal edema
D. Urethral discharge
Correct Answer: B. Distention of the lower abdomen
This indicates that the bladder is distended with urine, therefore palpable. In the elective setting, the examination should include abdominal examination (looking for a palpable bladder/loin pain) and examination of external genitalia (meatal stenosis or phimosis). Benign prostatic hyperplasia (BPH) refers to the nonmalignant growth or hyperplasia of prostate tissue and is a common cause of lower urinary tract symptoms in men.
Option A: Flank pain is a vague symptom associated with urinary system infections. Lower urinary tract symptoms can be divided into storage (frequency, nocturia, urgency) and voiding symptoms (stream, straining, hesitancy, prolonged micturition) and can help establish other causes of urinary symptoms such as urinary tract infections/overactive bladder, in addition to determining the site affected (bladder vs. prostate).
Option C: BPH only occurs in older men. Disease prevalence has been shown to increase with advancing age. Indeed the histological prevalence of BPH at autopsy is as high as 50% to 60% for males in their 60’s, increasing to 80% to 90% of those over 70 years of age.
Option D: Urethral discharge is not a manifestation of BPH. Men with BPH are likely to report predominant symptoms of nocturia, poor stream, hesitancy, or prolonged micturition. The examination should then conclude with a digital rectal examination making a note in particular of the size, shape (how many lobes), and consistency (smooth/hard/nodular) of the prostate (BPH is characterized by a smooth enlarged prostate).