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Male Reproductive
| Question | Answer |
|---|---|
| What is Benign Prostatic Hyperplasia | - Condition involving the increase size of the prostate gland leading to a disruption of urine outflow from bladder through urethra -Results from an increase of epithelial cells and stroll tissue - 50% of men will develop BPH |
| Etiology and Patho of BPH | - Thought to result from endocrine/hormonal changes from aging - Possible causes: Stimulation by estrogen, excessive accumulation of DTH, aging, obesity, smoking, diabetes or family history - Develops in inner part of prostate, called transition zone |
| Clinical manifestations of BPH | - Gradual onset of symptoms, worsen as obstruction increases - Early symptoms usually minimal, Bladder will compensate |
| Complications of BPH | - Acute urinary retention (Most common) -UTi and Sepsis - Incomplete bladder emptying with residual urine (Can cause bacterial growth) - Renal failure - Calculi in bladder - Pyelonephritis |
| Diagnostic Studies for BHP | - History and Physical examination - digital rectal examination -Urinalysis -Serum creatinine -Uroflowmetry - Post Void Residual -Biopsy -Cystoscopy |
| Interprofessional Care of BPH | - Goals: Restore bladder drainage, relieve symptoms, prevent and treat complications - Active surveillance - Dietary changes - Timed voiding schedule - Medication, Minimally invasive Therapies, Invasive Therapy |
| Nursing Management of BPH | Past health history: family history; obesity, Medications, Surgeries or other treatments Ask about symptoms PSA screening: completed if life expectancy >10 years Men with average risk screened at 50 yrs Men with increased risk screened at 45 yrs |
| TURP Postop Care | - will have standard catheter or triple-lumen catheter - Continuous bladder irrigation - Blood clots expected first 24-36 hrs postop - Monitor for bladder spasms - Legal exercises - Observe for infection -Dietary considerations and stool softeners |
| Prostate Surgery Home Care | Care for catheter Managing urinary incontinency Maintaining oral fluids between 2 and 3 L/day Observing for signs and symptoms of UTI and infection Avoiding heavy lifting (>4.5 kg) Refrain from driving or intercourse after surgery |
| Prostate Cancer | - Malignant Tumour of Prostate - Most common male cancer. >75% of cases in men over 65 - Majority of tumours occur in outer aspect of the gland - Slow growing |
| Prostate Cancer Contributors | - Age, ethnicity, family history - High fat, large amounts of dairy, red meats and processed meats - Obesity is linked with aggressive prostate cancer |
| Prostate Cancer Clinical Manifestations | - Asymptomatic in Early Stages Dysuria, hesitancy, dribbling Frequency, urgency Hematuria Nocturia Retention Interruption of urinary stream Inability to urinate - pain |
| Prostate Cancer Diagnostic Studies | - DRE: abnormal findings are hard, nodular and asymmetrical prostate - Biopsy - PSA blood test, PAP, PCA3 |
| Prostate Cancer: Conservative Therapy | Active surveillance when: -Life expectancy is less than 10 years - Presence of significant comorbid disease -Presence of low-grade, low-stage tumour |
| Prostate Cancer: Surgical Therapy | -Radical prostatectomy-common problems are erectile dysfunction & urinary incontinence -Nerve-sparing surgical procedure -Cryosurgery-destroys cancer cells by freezing the tissue |
| Prostate Cancer: Radiation Therapy | -Most common treatment option for prostate cancer -External beam irradiation: Most widely used method of radiation for prostate cancer -Brachytherapy: Placement of radioactive seeds into impacted tissue |
| Prostate Cancer: Medication Therapy | -Androgen deprivation (hormone) therapy, chemotherapy, or combination of both |
| Acute Bacterial Prostatitis | both acute and chronic bacterial prostatitis result from organisms reaching prostate gland by: ascending from urethra, descending from bladder, or invading via bloodstream or lymphatic channels |
| Chronic Bacterial Prostatitis | involves recurrent episodes of infection |
| Chronic Prostatitis-Chronic Pelvic Pain Syndrome | prostate and urinary pain in absence of an obvious infectious process |
| Asymptomatic Inflammatory Prostatitis | no symptoms but have inflammatory process in prostate |
| Acute Bacterial Prostatitis Clinical Manifestations | Fever, chills, back pain, perineal pain, acute urinary symptoms With DRE, prostate is very swollen, tender and firm |
| Chronic bacterial prostatitis and chronic prostatitis pelvic pain syndrome Clinical Manifestations | Have similar symptoms but milder Obstruction symptoms are uncommon With DRE, prostate in enlarged, firm, tender, and ‘boggy’ |
| Prostatitis Diagnostic Studies | -Urinalysis & urine culture -WBC count -PSA test -Blood cultures -Microscopic evaluation & culture of expressed prostate secretion -Transabdominal ultrasonography -MRI |
| Prostatitis Interprofessional Management | -Antibiotics -Pain management -Treat acute urinary retention -Passage of a catheter through the inflamed urethra in acute prostatitis is contraindicated -High fluid intake -Management of fever |
| Congenital Conditions of the Penis | -Hypospadias: urological abnormality in which urethral meatus is located on ventral surface of penis -Epispadias: an opening of the urethra on dorsal surface of penis |
| Conditions of the prepuce (Foreskin) | -Phimosis: constriction of uncircumcised foreskin around head of penis, making retraction over glans penis difficult -Paraphimosis: narrowing or edema of retracted uncircumcised foreskin, preventing normal return over glans and causing strangulation |
| Conditions of erectile mechanism | Priapism: persistent erection of penis |
| Inflammatory and infectious conditions of Scrotum and Testes | -Skin conditions: Fungal infections, dermatitis, parasitic infections -Epididymitis: Inflammation of epididymis Inflammatory process usually secondary to an infectious process -Orchitis: Acute inflammation of testis painful, tender, and swollen |
| Congenital Conditions of Scrotum and Testes | Cryptorchidism (undescended testes): failure of testes to descend into scrotal sac before birth |
| Acquired Conditions of Scrotum and Testes(Hydrocele and Spermatocele) | Hydrocele:fluid filled mass that results from interference with lymphatic drainage of scrotum and swelling of sac that surrounds testis Spermatocele: firm, sperm-containing, painless cyst of epididymis- may be visible with transillumination |
| Acquired Conditions of Scrotum and Testes(Varicocele and Testicular Torsion) | Varicocele: dilation of veins that drain testes Testicular torsion: surgical emergency involving twisting of spermatic cord that supplies blood to testes and epididymis, causing an interruption to blood supply |
| Vasectomy | - Bilateral surgical ligation of vas deferens -Sperm cells are produced by testes but absorbed by body |
| Andropause | -Gradual Decline in androgen - Signs and symptoms include loss of libido, fatigue, decreased muscle mass and strength, decreased bone mineral density, and anemia |
| Infertility | - Inability to achieve conception despite 1 yr frequent intercourse - loss of libido, fatigue, decreased muscle mass and strength, decreased bone mineral density, and anemia |
Created by:
claudiaeh
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