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Male Reproductive System

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Correctable by circumcision. Penis. Cancer of the Penis. Mostly in ... is circumcision in ... Circumcision. The excision of the foreskin, or prepuce,of ... – PowerPoint PPT presentation

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Title: Male Reproductive System


1
Male Reproductive System
  • Linda Harmon

2
Male Reproductive System
  • Several organs serve as parts of both the urinary
    tract and the reproductive systems.
  • The structures are the tests, the vas deference
    and the seminal vesicles, the penis, certain
    accessory glands, such as the prostate and
    Cowpers gland..
  • Disorders in these organs may interfere with the
    function of either or both systems.
  • Diseases are usually treated by a urologist.

3
Health History and Assessment
  • Changes in urinary function and symptoms of
    obstruction caused by an enlarged prostate
  • Changes in physical activity
  • Sexual function and any manifestations of sexual
    dysfunction
  • Factors that affect sexual functioning (stress,
    physical disease, use of medications, drugs, or
    alcohol)

4
Physical Examination
  • Digital-Rectal Exam
  • Recommended for every man over the age of 40
  • Assess the size, shape, and consistency of the
    prostate
  • Screening for cancer of the prostate
  • Testicular Exam
  • The male genitalia are inspected for
    abnormalities
  • Note nodules, masses, or inflammation
  • Instruct the patient about the technique for TSE

5
Diagnostic Studies
  • Prostate-Specific Antigen
  • The prostate gland produces a substance known as
    Prostate-Specific Antigen (PSA). This is measured
    in the blood and increases in prostate cancer. It
    needs to be drawn prior to a rectal exam or
    urinary catheterization.
  • Ultrasound
  • Transrectal ultrasound studies are used in
    detecting nonpalpable prostate cancers and in
    staging localized prostate cancers,. Needle
    biopsies of the prostate are commonly guided by
    ultrasound. Ultrasounds are more sensitive than a
    digital rectal exam.

6
Diagnostic Studies
  • Prostate Fluid or Tissue Analysis
  • A biopsy may be necessary to obtain tissue for
    histologic examination. This can be done with a
    prostatectomy or via a perineal or transrectal
    needle biopsy.
  • Test of Male Sexual Functioning
  • Usually conducted by a special team of health
    care providers.

7
Medications Associated with Erectile Dysfunction
  • Antiadrenergics and antihypertensives
  • Anticholinergics and phenothiazines
  • Antiseizure agents
  • Antifungals
  • Antihormone
  • Antipsychotics
  • Antispasmodics
  • Anxiollytics
  • Betablockers
  • Calcium channel blockers
  • Carbonic anhydrase inhibitors
  • H2 antagonists
  • Nonsteroidal anti-inflammatory drugs
  • Thiazides diuretics
  • Tricyclic antidepressant

8
Conditions of the Prostate
9
Prostatitis
  • Inflammation of the prostate gland caused by
    infectious agents or other conditions
  • Clinical manifestations perineal discomfort,
    burning, urgency, frequency and pain with or
    after ejaculation, fever, chills, rectal or low
    back pain, urinary tract infections.
  • Complications swelling, urinary retention,
    epididymitis, bacteremia, pyelonephritis.

10
Prostatitis
  • Management avoid complications, broad spectrum
    antibiotic agent, bed rest, analgesic agents,
    antispasmodics, bladder sedatives, sitz baths.
    Chronic is difficult to treat.
  • Nursing Management antibiotics, comfort
    measures, analgesics, sitz baths, teaching.
  • Self care administration of antibiotics, sitz
    baths, fluids encouraged but not forced, foods
    and liquids with diuretic action or that increase
    prostatic secretions should be avoided.

11
Benign Prostatic Hyperplasia
  • Enlargement of the prostate, extending upward
    into the bladder and obstructing the outflow of
    urine by encroaching on the vesical orifice.
  • BPH is one of the most common pathologic
    conditions in men over 50
  • Cause is uncertain
  • Hypertrophied lobes cause incomplete emptying and
    urinary retention.

12
Benign Prostatic Hyperplasia
  • Manifestations frequency, nocturia, urgency,
    hesitancy, abdominal straining, decrease in
    volume and force of stream, interruption of
    stream, dribbling, urinary retention, recurrent
    UTI, fatigue, anorexia, nausea, vomiting,
    epigastric discomfort.
  • Medical Management Plan is dependent on cause,
    severity and condition. Immediate, hormonal,
    pharmacological, surgical

13
Cancer of the Prostate
  • The most common cancer in men.
  • Prostate cancer rates twice as high in African
    American men. They are more likely to die than
    men in any other racial or ethnic group.
  • Risk factors increasing age, African American,
    familial predisposition, diet high in red meat
    and fat

14
Cancer of the Prostate
  • Manifestations urinary obstruction, difficulty
    and frequency, retention,decrease in size and
    force of stream, painful ejaculation, hematuria,
    late signs include backache, hip pain, perineal
    and rectal discomfort, anemia, weight loss,
    weakness
  • Diagnosis Early detection increases likelihood
    of cure. Over 40 requires a digital rectal exam
    (DRE) early cancer may be detected as a nodule
    within the substance of the gland or as an
    extensive hardening in the posterior lobe.
  • Men with prostate cancer experience sexual
    dysfunction before the diagnosis is made.

15
Cancer of the Prostate
  • Medical Management based on the stage, age,
    symptoms. Surgical management, radiation therapy,
    hormonal therapy, others.
  • Surgical Procedures the procedure chosen depends
    on the size of the gland, the severity of the
    obstruction, the patients age, physical status,
    presence of associated diseases, and patient
    preference.
  • Complications hemorrhage, clot formation,
    catheter obstruction and sexual dysfunction.

16
Prostatectomy
  • Assessment BPH or Cancer how has it affected
    lifestyle, presenting urinary problem, family
    history, physical condition.
  • Nursing Diagnosis Preop anxiety, acute pain,
    knowledge deficit Postop acute pain, knowledge
    deficit
  • Potential complications hemorrhage and shock,
    infection, deep vein thrombosis, catheter
    obstruction, sexual dysfunction.

17
Prostatectomy
  • Planning and Goals Preop- reduced anxiety and
    knowledge about disorder and postop experience.
    Postop fluid volume balance, relief of pain and
    discomfort, ability to perform self-care
    activities and absence of complications.
  • Preop Nursing Interventions reduce anxiety,
    relieve discomfort, provide instruction, prepare
    patient.

18
Prostatectomy
  • Postop Nursing Interventions
  • Fluid Balance carefully monitor intake and
    output including irrigation, observe for
    electrolyte imbalance, elevated blood pressure,
    confusion and respiratory distress.
  • Pain Relief determine cause and location,
    obstruction may require irrigation, walk but do
    not sit for prolonged periods.

19
Prostatectomy
  • Monitoring and managing complications
  • Hemorrhage drainage normally reddish-pink then
    clears to light pink within 24 hours after
    surgery.
  • Infection first by MD, use aseptic technique.
    Avoid rectal thermometers, rectal tubes and
    enemas, monitor for fever chills, sweats, etc.
  • Deep Vein Thrombosis high incidence of DVT and
    pulmonary embolism,
  • Obstructed Catheter observe for distention,
    restlessness, cold sweats, pallor, drop in blood
    pressure and increase pulse rate.
  • Complications after catheter removal
    incontinence
  • Sexual Dysfunction related to erectile
    dysfunction , decreased libido and fatigue.

20
Prostatectomy
  • Promoting home and community based care.
  • Length of stay depends on type of surgical
    procedure performed.
  • Instruct on how to manage drainage system, assess
    for complications, promote recovery.
  • Teach about bladder control issues, perineal
    exercises, and avoiding activities that produce
    Valsalva effects.
  • Teach signs and symptoms of complications such as
    bleeding, clots, decrease in stream, retention or
    infection.

21
Prostatectomy
  • Evaluation
  • Preoperatively
  • Reduced anxiey
  • Pain and discomfort reduced
  • Understanding of procedure and postop course
  • Postoperatively
  • Relief of discomfort
  • Fluid and electrolyte balance
  • Self-care measures
  • Free of complications

22
Conditions Affecting the Testes and Adjacent
Structures
23
Testes and Structures
  • Undescended Testis (Cryptorchidism)
  • Congenital condition, failure of one or both
    testes to descend into the scrotum.
  • Treated by orchiopexy
  • Orchitis
  • Inflammation of testes caused by pyogenic, viral,
    spirochetal, parasitic, traumatic, chemical or
    unknown factors. (Mumps)
  • Treatment directed at infecting organism, rest,
    scrotal elevation, icepacks, antibiotics analgesia

24
Testes and Structures
  • Epididymitis
  • Infection of the epididymis may be due to
    infected prostate or urinary tract, complication
    of gonorrhea. Chlamydia trachomatis
  • Treatment of organism, bed rest, scrotal
    elevation,antimicrobial agents, cold compresses,
    avoid straining , lifting and sexual stimulation.

25
Testes and Structures
  • Testicular Cancer
  • Most common cancer in men 15 to 35, highly
    treatable and usually curable
  • Treatment dependent on type of cancer.
  • Risk factors undescended testis, family
    history, race and ethnicity (Caucasian American
    men 5 times greater than African American and
    double the risk of Asian American) ,occupational
    hazards

26
Testes and Structures
  • Manifestations mass or lump, generally painless,
    heaviness in scrotum, backache, abdominal pain ,
    weight loss, general weakness. Tend to
    metastasize early.
  • Diagnosis monthly Testicular Self Examinations
    (TSE), human chorionic gonadotropin and
    alpha-fetoprotein and tumor markers that may be
    elevated in those with testicular cancer.

27
Testes and Structures
  • Medical Management
  • Orchiectomy with gel-filled prosthesis.
    Retroperitoneal lymph node dissection, radiation,
    chemotherapy, long term side effects.

28
Testes and Structures
  • Hydrocele
  • a collection of fluid in the tunica vaginalis of
    the testes
  • Varicocele
  • Abnormal dilation of the veins of the pampiniform
    venous plexus in the scrotum
  • Vasectomy
  • Legation and transaction of part of the vas
    deferens with or without removal of a segment of
    the vas deferens.

29
Conditions Affecting the Penis
30
Penis
  • Hypospadias and Epispadias
  • Congenital anomalies of the urethral opening
  • Phimosis
  • A condition in which the foreskin is constricted
    so that it cannot be retracted over the glans,
    can occur congenitally or from inflammation and
    edema. Correctable by circumcision.

31
Penis
  • Cancer of the Penis
  • Mostly in uncircumcised men.
  • Appears as a painless, wartlike growth or ulcer.
  • Bowens Disease is a form of squamous cell
    carcinoma in the situ of the penile shaft.
  • Prevention is circumcision in infancy
  • Treatment by excision, topical chemotherapy,
    radiation, partial or total penectomy.

32
Penis
  • Priapism
  • An uncontrolled, persistent erection of the penis
    that causes the penis to become large, hard, and
    painful.
  • Peyronies Disease
  • Buildup of fibrous plaques in the sheath of the
    corpus cavernosum. When erect, curvature occurs.

33
Penis
  • Urethral Stricture
  • A condition in which a section of the urethra is
    narrowed.
  • Treatment involved dilation of the urethra or
    urethrotomy.
  • Circumcision
  • The excision of the foreskin, or prepuce,of the
    glans penis. Usually performed in infancy
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