Male reproductive disorders

Question 1

Benign Prostatic Hypertrophy (BPH)

Answer 1

• increase in the number of cells within prostate (hyperplasia)
• hypertrophy occurs (enlargement )
• caused by testosterone derivative and cell growth
• bladder outlet obstruction

Question 2

BPH

Answer 2

– bladder muscle thickens→unable to contract- increased residual urine/urine - retention
– Urine incontinence & leakage occurs
– S/S: hesitancy (difficulty starting), reduced form, incomplete bladder emptying, post-void dribbling, hematuria
– May lead to UTI and bladder stone formation
– If left untreated, chronic kidney disease (bc of backflow of urine) may occur

Question 3

DX: digital rectal exam

Answer 3

Prostate located close to rectal wall
– Bending over exam table/side lying
– Examined for size, consistency, elasticity, nontender enlargement
– Stony-hard nodule may indicate cancer; needs further testing
– Transurethral U/S, cystoscopy

Question 4

TX: drug therapy

Answer 4

– DHT - dihydrotestosterone lowering drugs to decrease size of prostate
(PROSCAR, AVODART)
– Alpha-adrenergic receptors to constrict prostate gland (FLOMAX)
– Alpha blockers to relax smooth muscle (CARDURA, HYTRIN) - monitor for
hypotension

Question 5

TX: Surgical

Answer 5

– Transurethral resection of the prostate (TURP)
– Enlarged portion of prostate is removed endoscopically
– Post-op
 Maintain catheter patency of 3-way foley
 Free from clots, color, clarity
 Monitor flow or NS irrigation
 Pain management; bladder spasms common

Question 6

Prostate Cancer

Answer 6

– Most common type of cancer in men
– Detected by DRE & Prostate specific antigen (PSA) & biopsy
– S/S: hematuria, pelvic pain, swollen lymph nodes, stony-hard palpable irregularities on prostate
– TX: surgery, chemotherapy, radiation, cryoablation

Question 7

Erectile Dysfunction

Answer 7

– Impotence; inability to achieve or maintain erection
– Organic
 Gradual deterioration of function
 Firmess diminishes, drop in frequency
 Caused by: inflammation of prostate, urethra, seminal vesicles,
prostatectomy, back injuries
– Functional
 Episodic
 Sudden onset after periods of high stress

Question 8

Testicular Cancer

Answer 8

– Occurs in younger men 15-34 years of age
– Detected Testicular self-examination (TSE)
– Occurs in one or both testicles
– DX: AFP, hCG, LDH - abnormal if found in adults, CT, MRI
– TX: surgery, chemotherapy, radiation

Question 9

Hydrocele

Answer 9

cystic mass filled with straw colored fluid around the testis ; TX: drainage with the needle

Question 10

Spermatocele

Answer 10

sperm-contain cyst on epididymis

Question 11

Varicocele

Answer 11

• cluster of dilated veins near the testis

Question 12

Scrotal torsion

Answer 12

twisted spermatic cord and blood vessels - cuts off blood supply.

Question 13

Epididymitis

Answer 13

Inflammation of the epididymis due to infection or trauma
– May spread to other structures nearby
– S/S: pain and swelling in scrotum/groin, abscess
– TX: scrotal elevation, scrotal support, antibiotics, ice, analgesics

Question 14

Orchitis

Answer 14

– Acute testicular inflammation due to infection or trauma
– Unilateral or bilateral
– S/S: scrotal pain, edema, heavy feeling near testicles, pain on ejaculation, blood in semen
– TX: scrotal elevation, ice, analgesics, antibiotics

Question 15

Nursing Assessment

Answer 15

Risk factors
 Family history
 Presence of pain or discomfort
 Inspection/clinician exam
 Urinary trends
 Sexual history

Question 16

Nursing Diagnosis

Answer 16

Anxiety & Fear
 Acute Pain or Chronic Pain
 Risk for Sexual Dysfunction
 Anticipatory Grieving
 Disturbed Body Image
 Urinary Retention/Urinary Incontinence
 Risk for Infection