Care of Patients with Male Reproductive Problems Flashcards
Second most common type of cancer in men and if found early, has a near 100% cure rate - pretty good prognosis if caught before any metastasis and is pretty likely
Slowest growing cancer
Causes: number of factors
Risk factors
Health promotion and maintenance
Prostate cancer
Over the age of 65
Race
Family history of prostate cancer
Risk factors
African American males more often affected
Race
Screening
Healthy, balanced diet
Health promotion and maintenance
Essential; with blood draws; DRE to eval for enlarged prostated
Consider screening at age 50
Screening
Decrease animal fats in diet-especially red meats; high fat and low fiber diet increases risk; encourage low fat
Increase fruits, vegetables and high fiber foods
Healthy, balanced diet
History
Clinical manifestations
Lab
Other diagnostic assessment
Prostate cancer Assessment
Early symptoms: - sim to BPH
Advanced disease symptoms: - same with adv cancer
Clinical manifestations
Urinary retention
Frequent bladder infections
Difficulty starting urination/ending stream
Tumor in prostate constricts on urethra just like BPH
Early symptoms: - sim to BPH
Hematuria - specific to prostate cancer
Swollen lymph nodes, especially in the groin - initially metastasis to groin but if distant can go elsewhere
Pain
Unexpected weight loss
Advanced disease symptoms: - same with adv cancer
Prostate specific antigen (PSA)
Early prostate cancer antigen (EPCA-2)
Elevated serum acid phosphatase
Lab
Increases warrant that follow up
Elevated with prostate cancer and BPH
Used as a screening lab because other prostate problems can increase the level; not diagnostic tool
Prostate specific antigen (PSA)
Can detect changes in the prostate gland early and is very sensitive
Specific to prostate cancer
Early prostate cancer antigen (EPCA-2)
With advanced disease
Elevated serum acid phosphatase
Screening - DRE, PSA, lab work; indications prostate cancer do US then biopsy to confirm diagnosis
Transrectal ultrasound (TRUS)
Biopsy
Other diagnostic assessment
Lot options for client
Active surveillance
Surgery - remove entire prostate
Nonsurgical management
Prostate cancer interventions
Not do any treatment unless really symptomatic with it because such slow growing cancer; treatments and interventions could be worse for pat; may just check labs and eval over time and not cause symp
Common intervention because slow growth
If younger or progressing do other things
After initial diagnosis will monitor and only pursue active treatment if the symptoms become bothersome
Usually done if cancer is in the early stage because it is a very slow growing cancer
Active surveillance
Can be used as an adjunct to surgery or alternative intervention
Nonsurgical management
Used if the cancer is widespread or the patient’s condition or age prevents surgery
Radiation - implant radiation seeds in prostate
Drug therapy (hormone therapy, chemotherapy)
Can be used as an adjunct to surgery or alternative intervention
Inflammation of the prostate gland
Acute bacterial prostatitis
Chronic bacterial prostatitis
Prostatitis assessment
Typ if inflammation/infection of urethra or UTI; sometimes with STIs and travels to prostate
Occurs with urethritis or an infection of the lower urinary tract
Organisms may reach the prostate via the bloodstream or urethra
Symptoms of infection
Acute bacterial prostatitis
fever, chills, dysuria, urethral discharge, boggy and tender prostate (classic sign of prostatitis); difficulty with urinatio
Symptoms of infection - Acute bacterial prostatitis
Occurs in older men
Symptoms less dramatic - like BPH
Symptoms
Chronic bacterial prostatitis
hesitancy, urgency, dysuria, difficulty initiating and terminating the flow of urine/urine stream, and decreased strength and volume of urine, urgency
discomfort in the perineum, scrotum, and penis
Symptoms - Chronic bacterial prostatitis
Treatment
Complications
Prostatitis interventions
Primary intervention: Antibiotics - treat bacterial infection; oral but if severe may need IV in inpat setting to prevent any comps so not get systemic infection if gone untreated
Acute bacterial prostatitis may require hospitalization with aggressive IV antibiotics
Treatment
travels to other areas; that is why treat it so not have these
Epididymitis
Cystitis
Complications
Inflammation of the epididymis
Epididymitis
Inflammation of the bladder
Cystitis
Rare cancer, most often affecting men between 20 and 35 years of age; commonly in younger pop
Common manifestation
Lab assessment
Other diagnostic assessment
Testicular cancer assessment
Painless, hard swelling or enlargement of the testicle; primary symp: mass/enlargement testicle; usually unilateral and usually painless mass
Common manifestation - Testicular cancer assessment
Alpha-fetoprotein (AFP) - most common
Beta human chorionic gonadotropin (hCG)
Lactate dehydrogenase (LDH)
Lab assessment - Testicular cancer assessment
Ultrasonography
CT and MRI
Other diagnostic assessment - Testicular cancer assessment
see mass
Drain fluid to test for cytology and get biopsy eventually to confirm diagnosis
Identify fluid or solid mass and benign versus malignant
Ultrasonography
Check for metastasis
CT and MRI
Typ unilateral
Surgical management
Nonsurgical management
Testicular cancer interventions
Radical unilateral orchiectomy - best outcomes if remove one testicle
Radical retroperitoneal lymph node dissection (RPLND) may also be done - if lymph node involvement
Surgical management - Testicular cancer interventions
In addition to surgical treatment - not as only treatment
Chemotherapy
External beam radiation therapy (EBRT) - do external radiation
Nonsurgical management - Testicular cancer interventions
May be used as adjuvant therapy or as primary treatment
Chemotherapy
May be used after orchiectomy for localized disease
External beam radiation therapy (EBRT) - do external radiation
