Common Disorders Of Male Female Reproductive Systems Ppt Sept 2006


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Common Disorders Of Male Female Reproductive Systems Ppt Sept 2006

  1. 1. Common Disorders of Male & Female Reproductive Systems
  2. 2. Prostate Gland
  3. 3. Benign Prostatic Hyperplasia (BPH) <ul><li>Enlargement of the prostate gland </li></ul><ul><li>Most common problem of adult male reproductive system </li></ul><ul><li>Occurs in 50% of men over 50yrs of age </li></ul><ul><li>Thought to be the result of endocrine changes associated with ageing process </li></ul>
  4. 4. Pathophysiology of BPH <ul><li>Develops in inner part of prostate </li></ul><ul><li>This enlargement gradually compresses the urethra, eventually leading to partial or complete obstruction </li></ul>
  5. 5. Clinical Manifestations of BHP <ul><li>Symptoms result from urinary obstruction </li></ul><ul><li>Gradual onset </li></ul><ul><li>Decrease in calibre & force of urinary stream </li></ul><ul><li>Difficulty in initiating voiding </li></ul><ul><li>Intermittency (stopping & starting) </li></ul><ul><li>Dribbling at end of urination </li></ul><ul><li>Incomplete bladder emptying </li></ul>
  6. 6. Clinical Manifestations of BHP <ul><li>Urinary frequency </li></ul><ul><li>Urgency </li></ul><ul><li>Dysuria </li></ul><ul><li>Bladder pain </li></ul><ul><li>Nocturia </li></ul><ul><li>incontinence </li></ul>
  7. 7. Transurethral Resection of Prostate (TURP)
  8. 8. Prostate Cancer <ul><li>Malignant tumour of prostate gland </li></ul><ul><li>Occurs in 1:11 </li></ul><ul><li>Most common cancer amongst men </li></ul><ul><li>Third leading cause of cancer death in NZ </li></ul><ul><li>Incidence in less in Maori </li></ul><ul><li>Large increase in incidence of newly diagnosed cases attributed to widespread use of PSA as a screening procedure </li></ul><ul><li>Incidence likely to continue increasing because of population ageing </li></ul>
  9. 9. Prostate Cancer <ul><li>Usually asymptomatic in early stages </li></ul><ul><li>Patient may have symptoms similar to BPH </li></ul><ul><li>-dysuria, hesitancy, dribbling, frequency, urgency, haematuria, nocturia, retention, interruption of urinary stream & inability to urinate </li></ul><ul><li>Pain in lumbosacral area that radiates down to hips or legs may indicate metastases </li></ul>
  10. 10. Diagnostic Studies <ul><li>Blood test may show elevated Prostate-specific antigen (PSA) </li></ul><ul><li>Normal PSA is 0-4.0mg/ml </li></ul><ul><li>Rectal examination may reveal hard prostate with asymmetric enlargement with areas of induration or nodules </li></ul>
  11. 11. Pelvic Inflammatory Disease (PID) <ul><li>Infectious condition of the pelvic cavity that may involve infection of the fallopian tubes (salpingitis), ovaries (oophoritis), and pelvic peritoneum (peritonitis) </li></ul><ul><li>Often the result of untreated cervicitis – the organism infecting the cervix ascends higher into the uterus, tubes, ovaries & peritoneal cavity </li></ul><ul><li>Chlamydia trachomatis and Neisseria gonorrhoeae are the most common causative organisms </li></ul><ul><li>PID is the major cause of female infertility </li></ul><ul><li>Silent PID can cause damage that cannot be reversed </li></ul>
  12. 12. Risk Factors for PID <ul><li>Women at increased risk of chlamydial infections </li></ul><ul><li>-younger than 24 years </li></ul><ul><li>- multiple sex partners </li></ul>
  13. 13. Clinical Manifestations of PID <ul><li>Lower abdominal pain – starts gradually & is constant, intensity may vary from mild to severe </li></ul><ul><li>Pain associated with intercourse </li></ul><ul><li>Spotting after intercourse </li></ul><ul><li>Abnormal vaginal discharge </li></ul><ul><li>Fever & chills </li></ul>
  14. 14. Complications of PID <ul><li>Septic shock </li></ul><ul><li>Ectopic pregnancies </li></ul><ul><li>Infertility </li></ul><ul><li>Chronic pelvic pain </li></ul>
  15. 15. Endometriosis <ul><li>The presence of normal endometrial tissue in sites outside the endometrial cavity </li></ul><ul><li>Most frequent sites are in or near ovaries, the uterosacral ligaments & the uterovesical peritoneum </li></ul><ul><li>Usually occurs in late 20s, early 30s, white & never had a full-term pregnancy </li></ul><ul><li>Found in approx 10% of women of reproductive age </li></ul>
  16. 16. Clinical Manifestations <ul><li>Wide range of manifestations & severity </li></ul><ul><li>Dysmenorrhoea </li></ul><ul><li>Infertility </li></ul><ul><li>Pelvic pain </li></ul><ul><li>Dyspareunia </li></ul><ul><li>Irregular bleeding </li></ul>
  17. 17. Common Sites of Endometriosis
  18. 18. Uterine Prolapse <ul><li>Downward displacement of the uterus into the vaginal canal </li></ul>
  19. 19. Uterine Prolapse <ul><li>1 st degree – Downward displacement of the uterus into the vaginal canal </li></ul><ul><li>2 nd degree - Downward displacement of the uterus into the vaginal canal with the cervix at the vaginal opening </li></ul><ul><li>3 rd degree - Downward displacement of the uterus into the vaginal canal with the uterus protruding through the introitus </li></ul>
  20. 20. Uterine Prolapse <ul><li>First degree prolapse </li></ul><ul><li>Second degree prolapse </li></ul><ul><li>Third degree prolapse </li></ul>
  21. 21. Clinical Manifestations of Uterine Prolapse <ul><li>Vary with degree of prolapse </li></ul><ul><li>Patient may describe a feeing of “something coming down” </li></ul><ul><li>Dyspareunia </li></ul><ul><li>Dragging or heavy feeling in the pelvis </li></ul><ul><li>Backache </li></ul><ul><li>Bowel or bladder problems </li></ul>
  22. 22. Cystocele and Rectocele <ul><li>Cystocele occurs when support between the vagina and bladder is weakened </li></ul><ul><li>Rectocele results from weakening between the vagina and rectum </li></ul><ul><li>Woman may not be able to empty bladder or bowel </li></ul>
  23. 23. Cystocele and Rectocele <ul><li>Cystocele </li></ul><ul><li>Rectocele </li></ul>
  24. 24. Ectopic Pregnancy <ul><li>The implantation of the fertilised ovum anywhere outside the uterine cavity </li></ul><ul><li>98% occur in the fallopian tube </li></ul><ul><li>A life-threatening condition </li></ul><ul><li>Risk factors include a history of PID, prior ectopic pregnancy, use of IUD, in vitro fertilization procedures </li></ul>
  25. 25. Ectopic Pregnancy
  26. 26. Ruptured Tubal Pregnancy
  27. 27. Ectopic Pregnancy Sites
  28. 28. Clinical Manifestations Of Ectopic Pregnancy <ul><li>Abdominal or pelvic pain </li></ul><ul><li>Missed menses </li></ul><ul><li>Irregular vaginal bleeding </li></ul><ul><li>Other symptoms of pregnancy </li></ul><ul><li>With rupture the risk of haemorrhage and hypovolaemic shock is present </li></ul>