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NURS 401 > Week 7: Male Disorders > Flashcards

Week 7: Male Disorders Flashcards

1
Q

How does the male reproductive system change with aging?

A
  • The frequency, duration and rigidity of erections gradually decline as men age (erectile dysfunction): blood flow decreases.
  • Levels of the male sex hormone (testosterone) tend to decrease reducing libido.
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2
Q

Andropause (Male menopause)

A

Period later in life when testosterone production has decreased enough to cause significant symptoms.

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3
Q

Low testosterone may develop certain characteristics associated with aging including:

A
  • Decreased libido
  • Decreased muscle mass
  • Increased abdominal fat
  • Thin bones that easily fracture (osteoporosis)
  • Decreased energy level
  • Slowed thinking
  • Anemia
  • Increases the risk for CAD
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4
Q

Benign Prostatic Hyperplasia

A

Enlargement of prostate gland resulting from increase in number of epithelial cells and stromal tissue.

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5
Q

Does BPH predispose men to prostate cancer?

A

It does not predispose to development of prostate cancer.

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6
Q

Etiology and Pathophysiology of BPH

A
  • Not completely understood.
  • Thought to result from endocrine changes related to the aging process.
  • Enlargement gradually compresses the urethra (partial or complete obstruction)
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7
Q

BPH: compression leads to clinical symptoms including

A

Postrenal acute renal injury

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8
Q

Risk factors for BPH

A
  • Family history
  • Environment
  • Obesity
  • Increased waist circumference
  • Diet
  • Polyunsaturated fatty acids
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9
Q

Clinical Manifestations of BPH

A
  • Symptoms usually gradual in onset
  • Early symptoms usually minimal because bladder can compensate
  • Worsen as obstruction increases.
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10
Q

Transurethral Resection (TURP)

A
  • Removal of obstructing prostate tissue using resectoscope inserted through urethra.
  • Relatively low risk
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11
Q

Transurethral Resection (TURP) Procedure

A
  • Performed under spinal or general anesthesia and requires hospital stay.
  • Bladder irrigated for first 24 hours to prevent mucus and blood clots.
  • Patients must stop anticoagulants before surgery.
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12
Q

Transurethral Resection (TURP) Complications

A
  • Bleeding
  • Clot retention
  • Hyponatremia
  • Retrograde ejaculation
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13
Q

Transurethral Needle Ablation (TUNA)

A
  • Increased temperature of prostate tissue for localized necrosis
  • Low-wave frequency used
  • Only tissue in contact with needle is affected
  • Outpatient using local anesthesia and sedation
  • Lasts 30 minutes with little pain and quick recovery
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14
Q

Prostate Cancer: Etiology and Pathophysiology

A
  • Androgen (testosterone) dependent carcinoma
  • Majority of tumors occur in outer aspect of the gland
  • Usually slow growing
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15
Q

Prostate cancer spreads by three routes

A
  • Direct extension
  • Through lymph system
  • Through bloodstream
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16
Q

Prostate Cancer Incidence

A
  • High-fat diet associated with risk
  • Exposure to certain chemical may be associated with higher risk.
  • History of BPH is NOT a risk factor.
  • African Americans have highest incidence.
  • Having a first-degree relative with prostate cancer increases risk.
17
Q

Clinical Manifestations of Prostate Cancer

A

Usually asymptomatic in early stages. May experience symptoms similar to BPH.

  • Dysuria
  • Hesitancy
  • Dribbling
  • Frequency
  • Urgency
  • Hematuria
  • Nocturia
  • Retention
  • Interruption of urinary stream
  • Inability to urinate
18
Q

What could indicate metastasis of prostate cancer?

A

Pain in lumbosacral area that radiates to hips or legs, when coupled with urinary symptoms

19
Q

Once cancer (prostate) has spread to distant sites, pain management becomes

A

A major problem

20
Q

Radial Prostatectomy

A
  • Entire prostate gland, seminal vesicles and part of bladder neck are removed.
  • Retroperineal lymph node dissection usually done.
  • Considered most effective for long-term survival.
  • Patient catheterized for 1-2 weeks postop.
21
Q

Major complications of radical prostatectomy

A

Erectile dysfunction and incontinence

22
Q

Complications of Radical Prostatectomy

A
  • Hemorrhage
  • Urinary retention
  • Infection (high risk d/t incision location)
  • Wound dehiscence
  • DVT
  • Pulmonary emboli
23
Q

Cryosurgery (Cryoablation)

A
  • Surgical technique that destroys cancer cells by freezing the tissue.
  • Initial and second-line treatment after radiation fails.
24
Q

Complications of Cryosurgery

A
  • Damage to urethra
  • Urethrorectal fistula
  • Urethrocutaneous fistula
  • Tissue sloughing
  • Erectile dysfunction
  • Urinary incontinence
  • Prostatitis
  • Hemorrhage
25
Q

Radiation Therapy

A
  • External beam radiation
  • Most widely used method of radiation for prostate cancer
  • Used to treat cancer confined to prostate and/or surrounding tissue.
26
Q

Brachytherapy

A
  • Implantation of radioactive seed into prostate gland
  • Spares surrounding tissue
  • Placement guided by trans Rectal ultrasound
  • Best suited for stage A or B
27
Q

Common side effects of brachytherapy include

A

Irritative or obstructive urinary problems

28
Q

Prostate Cancer: Drug Therapy

A
  • Hormonal Therapy

- Hormone refractory or castrate-resistant

29
Q

Prostate Cancer: Hormonal Therapy

A
  • Androgen deprivation is primary therapeutic approach
  • Focused on reducing levels of androgens to reduce tumor growth.
  • Can be used before surgery or radiation to reduce tumor size and in advance disease.
30
Q

Hormone Refractory or Castrate-Resistant

A

-Tumors can become resistant to therapy within a few years

31
Q

What is often the first sign that therapy for prostate cancer is no longer effective?

A

Elevated PSA levels

32
Q

Types of Hormonal Therapy include

A
  • Luteinizing hormone-releasing hormone agonists
  • Androgen receptor blockers
  • Estrogen
33
Q

Luteinizing Hormone-Releasing Hormone Agonists

A

Causes testicles to stop making testosterone

34
Q

Androgen Receptor Blockers

A

Prevent androgens like testosterone from mediating their biological effects in the body (i.e spironolactone)

NURS 401 (26 decks)

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