hyperplasia
(hī‵pĕr-plā'zh(ē-)ă 
)
[hyper- + -plasia]
An abnormal increase in the number of normal cells in an organ or tissue with no evidence of cancer. SYN: hypergenesis.
SEE: hyperphasia (2).
hyperplastic,
(hī‵pĕr-plas'tik )
angiofollicular lymph node h.Castleman disease.
ABBR: ADH
A premalignant lesion of the breast. It is often found in biopsy specimens of patients with breast cancer. It is characterized by a small number of breast ducts with abnormal cellular and gland ular structures. It is hypothesized that ADH is one of several breast lesions that can develop into ductal carcinoma in situ and , ultimately, into an invasive cancer.ABBR: BPH
A nonmalignant enlargement of the prostate gland caused by excessive growth of prostatic nodules.BPH is the most common benign neoplasm of aging men, found on microscopic examination of the prostate in about 70% of men by age 60 and 90% of men by age 70. More than 440,000 men in the U.S. have surgery to correct the problem each year.
The prostate gland grows as a result of stimulation of the gland by sex hormones. Dihydrotestosterone directly stimulates the growth of the gland 's epithelial and stromal cells; estrogens, found in increasing concentrations in aging men, increase the number of hormone receptors in the prostate, making the gland more susceptible to stimulation by male hormones. Under these influences prostate nodules enlarge around the urethra and may compress the urinary outlet, limiting the flow of urine from the bladder.
Patients often complain of difficulty starting or stopping their urinary stream, frequent urination, a reduced urinary stream, urinary hesitancy and /or urgency, and frequent awakenings at night to urinate. They may also develop urinary tract infections and sudden obstruction of all urinary flow (acute urinary retention). Urinary retention increases the risk for development of urinary tract infection, pyelonephritis, or renal atrophy. Bladder hypertrophy, hydronephrosis, kidney damage, or sepsis may also develop.
The diagnosis of BPH is made based on a description of typical symptoms, digital rectal examination, prostate-specific antigen testing, and /or ultrasonography. The American Urological Association (AUA) has developed a self-administered screening tool (the AUA symptom index) to determine the frequency and severity of urinary symptoms.
Men with mild to moderate symptoms often get symptomatic relief from alpha-adrenergic blocking agents (such as terazosin) and /or 5-alpha reductase inhibitors (such as finasteride), which block the effect of testosterone on prostatic growth and may reduce the need for prostate surgery. Two herbal remedies are also commonly employed: saw palmetto and pygeum. When patients have recurrent urinary infections, unmanageable urinary symptoms, urinary retention, or damage to the bladder or kidneys, surgery is performed. Transurethral resection of the prostate (TURP) is the most common procedure. Alternatives to TURP include transurethral incision of the prostate (TUIP), laser reduction in the size of the gland , transurethral microwave heat treatment, transurethral needle ablation, urethral stent placement, or open prostatectomy.
The patient is evaluated for ability to effectively empty his bladder, caliber and force of his urinary stream, reduction in urinary hesitancy, difficulty initiating his stream, dribbling, incontinence, and nocturia.
A midstream urine specimen is collected for culture and sensitivity. Antibiotics are prescribed if the patient is to undergo urethral procedures involving instrumentation.
If urinary retention develops, a urinary catheter is inserted by the nurse or urologist, sometimes with guides. Suprapubic cystotomy is used if a catheter cannot be passed through the urethra. The patient is monitored for rapid bladder decompression and for signs of postobstruction diuresis (increased urine output, hypotension), which may lead to serious dehydration, lowered blood volume, shock, electrolyte losses, and anuria.
The patient with BPH is taught to avoid prescription and over-the-counter drugs that can worsen obstruction, e.g., decongestants, alcohol, caffeine, anticholinergics, tranquilizers, or antidepressants.
Postoperative Care: After excision, continuous bladder irrigation and an indwelling catheter with a large balloon may be used to control bleeding. If an open prostatectomy is needed, the patient should receive routine prophylaxis for venous thromboembolism using low-dose unfractionated heparin two or three times a day for a few days after surgery. The patient is taught to recognize and report signs of infection, which can worsen obstruction, and to seek medical care immediately if he is unable to void. He is advised that regular sexual intercourse will help to relieve prostatic congestion. Men over age 50 (and younger men with a family history of the disease) should be encouraged to have regular prostate checkups. SYN: benign prostatic hypertrophy; enlarged prostate.
SEE: prostate; prostate cancer; transurethral resection of the prostate.
SEE: Nursing Diagnoses Appendix.
ABBR: CAH
Any of a group of rare autosomal recessive disorders characterized by deficiencies of one or more enzymes essential for the synthesis of hormones made from cholesterol (cortisol, aldosterone, progesterone, and /or dihydrotestosterone). These enzyme deficiencies produce a variety of clinical syndromes resulting from the excessive concentration of precursor hormones.ABBR: CLH
Benign infiltration of the skin by reactive T- or B-cells, producing nodules that resemble lymphoma.SEE: pseudolymphoma.
diffuse idiopathic pulmonary neuroendocrine cell h.
ABBR: DIPNECH
An exceptionally rare neoplastic disorder of the lungs in which neuroendocrine cells, resembling those found in carcinoid tumors, form tiny nodules.fibrous h.An increase in connective tissue cells after inflammation.
neointimal h.An increase in the thickness of the lining of a blood vessel in response to injury or vascular reconstruction. It is an important cause of vein graft obstruction after coronary artery bypass surgery and in the premature closure of other vascular conduits, e.g., in dialysis access devices. It is characterized by the migration of smooth muscle cells into the graft, followed by the release of cytokines that damage the vessel wall and contribute to its degradation by inflammation.