care of male patients with reproductive problems. Lecture 3. Flashcards
What is hypospadias
Urethral meatus opens on the ventral, under, side of the glans, shaft or at the penoscrotal Junction. This is a congenital defect that is important to recognize at birth.
What is the point of transillumination of the scrotum
To check for serous fluid
What is epispadias
Meatus opens on the dorsal upper side of the glands or shaft above a broad, Spadelike penis. Rare; less common than hypospadias but more disabling because of associated urinary incontinence and separation of pubic bones
What is the medical term for when The prepuce(foreskin) is constricted so that it cannot be retracted over the glans. The prepuce remains down, around the tip of the penis. And What would teach the patient?
Phimosis. Teach uncircumcised men about the importance of cleaning the prepuce.
What’s the condition called when The foreskin has not been returned it to its normal position after being retracted and forms a constricting band around the glands. This constricts lymph drainage, because of the penis is well. Bloodflow becomes impeded, and tissue death can occur. This palm is an emergency requiring immediate treatment. Uncircumcised males are at risk
Paraphimosis
What are the causes of Paraphimosis?
Infection, not returning the foreskin to the original position, poor hygiene, vigorous sexual intercourse, and Penile piercing. When caring for a man who is not circumcised, be sure to replace the foreskin over the penis after bathing or catheterizing him to prevent this paraphimosis.
How is phimosis corrected and how long will it be before the patient can resume normal activities and sexual intercourse?
Circumcision. Patient should resume normal activities within one week. And of course may be resumed after 1 to 2 weeks when pain has subsided
This disease is a Hard, nontender, subcutaneous plaques palpated on dorsal lateral surface of penis. Plaques are fibrosis of covering of corpora cavernosa. Usually occurs after 45. It’s caused by trauma to the erect penis (ex a unexpected change during intercourse). Or, the men with diabetes, Gout, and dupuytren’s contracture of the palm.
Peyronie’s disease
What is the condition when the patient has an uncontrolled, long maintained direction without sexual desire, which causes the penis to become large, hard, and painful. It affects the two corpora cavernosa. The corpus spongiosum and glans penis are not affected.
Priapism
Priapism can occur from neural, vascular, or pharmacologic causes. what are some causes of priapism
Thrombosis of the veins of the corpora cavernosa( usually resulting from trauma) leukemia, sickle cell disease, diabetes mellitus, malignancies, abnormal neurogenic reflex, psychotropic drugs, antidepressants, antihypertensive drugs, drugs used to treat erectile dysfunction.
How does sickle cell cause priapism
Through the collection of erythrocytes within the corporal bodies.
How does leukemia cause priapism
Because the increased number of white blood cells permits persistent engorgement of the corporal bodies
How does cancer cause priapism
Cancer may also little treat the corporate body is causing persistent engorgement.
Priapism is a urologic emergency because of what
The circulation to the penis may be compromised and the patient may not be able to void with an erect penis
What are some interventions for priapism
The desired outcome for intervention is to improve the venous drainage of the corporate cavernosa. Conservative measures involve prosthetic massage, sedation, ice packs, and bed rest. Demerol is usually given immediately because of its hypotensive effect. Urinary catheterization is required if the man cannot void. If conservative therapy is unsuccessful, treatment may proceed to aspiration of the corporate cavernosa with a large bore needle or surgical intervention. The priapism should be resolved within the first 24 to 30 hours to prevent Penile ischemia, gangrene, fibrosis, and ED.
What is medical term called where the new born has undecended testis. It’s also one of the most common male newborn problems
Cryptorchidism
What causes epididymitis
From infection or not infectious source such as trauma. Bacterial infection is the most common cause. The infection may spread from other structures such as the prostate, bladder, or urethra. It can be a complication of an STD, such as gonorrhea chlamydia. Staph and E.coli commonly causes it too.
With a common signs and symptoms of epididymitis
The man with epididymitis usually reports pain along the inguinal canal and along the vas deferens, followed by pain and swelling in the scrotum in the groin. If left untreated the epididymis become swollen and painful and fever may be present. Pyuria and bacteruria urea may develop with resultant chills and fever. An abscess may form requiring an orchiectomy.
What are the nursing interventions for a patient that has epididymitis
to remain in bed with his scrotum elevated to prevent traction on the spermatic cord, to facilitate venous drainage, and to relieve pain. The man should wear a scrotal support when ambulating. Get cultures of urine or prostate secretions to identify the cause of the organism. Ibuprofen or the proximal maybe used to decrease inflammation and promote comfort. Apply cold compresses or ice to the scrotum intermittently and take and sitz baths. Advise him to avoid lifting and straining or any sexual activity until the infection is under control which may take as long as four weeks.
What is always to be suspected with the patient that has epididymitis
Testicular tumor especially if the condition does not resolve in a week or two
This is a condition where there is a sudden twisting of spermatic cord occurs and late childhood, early adolescence, and rarely at her age of 20 years. It occurs usually on the left side. Faulty anchoring of testes on wall scrotum allows testes to rotate. The interior part of the testes rotate medially toward the other testes. Blood supply is cut off, resulting in ischemia and engorgement. This is an emergency requiring surgery; testes can become gangrenous in a few hours
Testicular torsion
What’s the condition called when there is a cluster of dilated veins behind and above the testes. Varicosity of the testicles may result from the increased fluid secondary to damaged or incompetent valves in the testicular veins
Varicocele
How is varicocele diagnosed
Scrotal palpation, particularly when the patient performs a Valsalva maneuver, creating additional pressure in the varicose vein’s. The scrotum feels wormlike when palpated.
What are the signs and symptoms of varicocele
Many cases they are asymptomatic and no treatment is required but in a few men it is very painful and must be removed surgically.
What can varicocele cause
Infertility. It is thought that they increase scrotal temperature from venous stasis near the testes, alternates spermatogenesis.
What are subjective experiences from testicular torsion
Excruciating pain in testicle of sudden onset, often during sleep or following trauma. May also have lower abdominal pain, nausea and vomiting, no fever.
