A nurse is assessing a client with BPH who complains of difficulty starting the urinary stream and a weak urine flow. The nurse observes that the client's bladder is distended and palpates a firm, enlarged prostate on digital rectal examination. The nurse should recognize these findings as suggestive of:

A. Reduced urine output is not a contributing factor to recurrent UTIs. In BPH, the urinary flow is obstructed, leading to incomplete bladder emptying and residual urine in the bladder, which can increase the risk of UTIs.

B. Increased fluid intake is not directly related to the risk of recurrent UTIs in BPH.

C. Decreased prostate size is not associated with recurrent UTIs in BPH.

D. This is the correct answer. Residual urine in the bladder after voiding provides a breeding ground for bacteria, increasing the risk of UTIs. In BPH, the enlarged prostate obstructs the urethra, leading to incomplete bladder emptying and the presence of residual urine, which contributes to recurrent UTIs.

A. Radiation therapy is not a first-line treatment for BPH. It is primarily used for certain types of cancer treatment.

B. Hormone therapy may be used for advanced cases of BPH, but it is not typically the initial management.

C. This is the correct answer. Watchful waiting, also known as active surveillance, is often the initial management for mild to moderate BPH. It involves close monitoring of symptoms and the prostate's size without immediate intervention unless symptoms worsen or complications arise.

D. Invasive surgery is usually reserved for severe cases of BPH that do not respond to conservative management or when complications occur.