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Timby/Smith: Introductory
Medical-Surgical Nursing, 10/e
Chapter 55: Caring for Clients with
Disorders of the Male Reprodu...
Structural Abnormalities
• Cryptorchidism
– Testes undescended; Empty scrotum; Lie in
inguinal canal, abdominal cavity
– U...
Question
Is the following statement true or false?
Cryptorchidism is evidenced by painful swelling of
the scrotum.

Copyri...
Answer
False.
Cryptorchidism is asymptomatic. It is evidenced
by an empty scrotum and the testes lie in
inguinal canal, or...
Structural Abnormalities
• Torsion of the Spermatic Cord
– Twisted spermatic cord; Artery kinked;
Compromised blood flow t...
Structural Abnormalities
• Phimosis, Paraphimosis
– Occur among uncircumcised males, opening of
the foreskin is constricte...
Structural Abnormalities
• Hydrocele, Spermatocele, and Varicocele
–

Swelling of the scrotum

–

Hydrocele and spermatoce...
Infectious, Inflammatory Conditions
• Prostatitis: Inflammation of the Prostate Gland
– Escherichia coli; Microbes that ca...
Question
Is the following statement true or false?
Prostatitis has several causes.

Copyright © 2010 Wolters Kluwer Health...
Answer
True.
Prostatitis is inflammation of the prostate gland caused
by E. coli, STD microbes, psychosexual problems, etc...
Infectious, Inflammatory Conditions
• Epididymitis, Orchitis: May occur alone or
simultaneously; Uni- or bilateral epididy...
Erection Disorders: Erectile Dysfunction
• Pathophysiology and Etiology: Ineffective
– Neurologic stimulation
– Arterial b...
Erection Disorders: Erectile Dysfunction
• Diagnostic Findings
– Nocturnal penile tumescence and rigidity test
– Vascular ...
Erection Disorders: Priapism
• Priapism: Persistent erection without sexual
stimulation
– Etiology: Vascular problem; Medi...
Erection Disorders: Benign Prostatic
Hyperplasia
• Pathophysiology, Etiology: Increased number of cells
in prostate
– Resu...
Erection Disorders: Benign Prostatic
Hyperplasia
• Medical, Surgical Management
– Monitoring with DREs
– Drug therapy
– Al...
Prostate Cancer
• Pathophysiology, Etiology
– Increased testosterone; High-fat diet; Family
history
– Occurs in periphery ...
Prostate Cancer
• Diagnostic Findings: Rectal examination; PSA;
Transrectal ultrasound; Radiographs; MRI; CT; IVP;
Elevate...
Question
Is the following statement true or false?
Prostatic screening should begin for all men at age 60.

Copyright © 20...
Answer
False.
Annual prostatic screening should begin for men with a
10-year life expectancy at age 50. Screenings
should ...
Prostate Cancer
• Medical, Surgical Management (Cont’d)
– Radiation therapy: Used alone or with other
therapies; Side effe...
Testicle Cancer
• Pathophysiology and Etiology
– Cryptorchidism
– Early degeneration of cells in undescended testis
or tes...
Testicle Cancer
• Medical, Surgical Management: Treatment depends
on the stage of the disease
– Autologous bone marrow tra...
Penis Cancer
• Rare; Occurs more often in uncircumcised men
• Probable progress: Chronic irritation; Precancerous
skin les...
Elective Sterilization
• Vasectomy: Ligation of vas deferens
– Minor surgical procedure
– Permanent sterilization
• Interr...
End of Presentation

Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
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  1. 1. Timby/Smith: Introductory Medical-Surgical Nursing, 10/e Chapter 55: Caring for Clients with Disorders of the Male Reproductive System Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  2. 2. Structural Abnormalities • Cryptorchidism – Testes undescended; Empty scrotum; Lie in inguinal canal, abdominal cavity – Unknown cause; Asymptomatic – Impact on sperm production, fertility – Risk for testicular cancer – Treatment: Androgen therapy; Orchiopexy – Nursing management Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  3. 3. Question Is the following statement true or false? Cryptorchidism is evidenced by painful swelling of the scrotum. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  4. 4. Answer False. Cryptorchidism is asymptomatic. It is evidenced by an empty scrotum and the testes lie in inguinal canal, or abdominal cavity. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  5. 5. Structural Abnormalities • Torsion of the Spermatic Cord – Twisted spermatic cord; Artery kinked; Compromised blood flow to testicle – Spermatic cords congenitally unsupported • Assessment Findings: Signs and Symptoms – Sudden, sharp testicular pain; Local swelling; Nausea, vomiting, chills, and fever • Diagnostic Findings: Physical Examination • Treatment: Immediate Surgery • Nursing Management Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  6. 6. Structural Abnormalities • Phimosis, Paraphimosis – Occur among uncircumcised males, opening of the foreskin is constricted – Signs and symptoms • Pain with erection and intercourse • Difficulty cleaning under foreskin • Painful swelling of glans • Edema; Urinary retention – Treatment: Circumcision; Hygiene Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  7. 7. Structural Abnormalities • Hydrocele, Spermatocele, and Varicocele – Swelling of the scrotum – Hydrocele and spermatocele: No treatment – Varicocele: Surgically repaired; Cause of male infertility Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  8. 8. Infectious, Inflammatory Conditions • Prostatitis: Inflammation of the Prostate Gland – Escherichia coli; Microbes that cause STDs; Psychosexual problem • Signs and Symptoms – Glandular swelling; Tenderness; Perineal pain – Unusual sensation prior to/after ejaculation – Low back pain; Fever; Dysuria; Urethral discharge • Treatment: Antibiotic therapy; Analgesics; Sitz baths • Nursing Management Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  9. 9. Question Is the following statement true or false? Prostatitis has several causes. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  10. 10. Answer True. Prostatitis is inflammation of the prostate gland caused by E. coli, STD microbes, psychosexual problems, etc. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  11. 11. Infectious, Inflammatory Conditions • Epididymitis, Orchitis: May occur alone or simultaneously; Uni- or bilateral epididymitis • Causes: Infectious agent causing prostatitis; Infection in body; Noninfectious epididymitis (longterm indwelling catheter, genitourinary procedures) – Orchitis: Viral mumps after puberty • Signs and Symptoms: Pain, swelling in inguinal area, scrotum; Fever; Chills • Treatment: Bed rest; Scrotal elevation; Local cold applications; Analgesics/Anti-inflammatory agents; Antibiotic therapy; Epididymectomy • Nursing Management Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  12. 12. Erection Disorders: Erectile Dysfunction • Pathophysiology and Etiology: Ineffective – Neurologic stimulation – Arterial blood flow – Trapping of venous blood • Physical and psychological origins • Assessment Findings: Signs and Symptoms – Difficulty in achieving or maintaining an erection – Insufficient rigidity Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  13. 13. Erection Disorders: Erectile Dysfunction • Diagnostic Findings – Nocturnal penile tumescence and rigidity test – Vascular ultrasound studies • Medical, Surgical Management – Change in drugs that cause impotence – Drug therapy; Treatments to facilitate penile engorgement – Vascular surgery; Penile implants • Nursing Management Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  14. 14. Erection Disorders: Priapism • Priapism: Persistent erection without sexual stimulation – Etiology: Vascular problem; Medical condition; Side effect of medication – Symptoms: Discomfort; Interference with arterial blood flow and urinary elimination; Tissue damage – Treatment: Vasoconstrictive medications; Draining trapped blood; Emergency surgery – Emotional support Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  15. 15. Erection Disorders: Benign Prostatic Hyperplasia • Pathophysiology, Etiology: Increased number of cells in prostate – Resulting in decreased diameter of the prostatic section of the urethra • Assessment Findings: Signs and Symptoms – Gradual onset; Difficulty urinating, emptying bladder; Nocturia; Urgency • Diagnostic Findings – DRE; Cystoscopy; IVP; Blood chemistry tests – PSA; Transrectal ultrasound Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  16. 16. Erection Disorders: Benign Prostatic Hyperplasia • Medical, Surgical Management – Monitoring with DREs – Drug therapy – Alternative therapy – Surgical procedures • TURP; TUIP • TULIP; TUNA • Prostatectomy • Nursing Management Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  17. 17. Prostate Cancer • Pathophysiology, Etiology – Increased testosterone; High-fat diet; Family history – Occurs in periphery of the gland; GU symptoms; Untreated cells spread by bloodstream and lymphatics • Assessment Findings: Signs and Symptoms – Frequent urination; Nocturia; Dysuria; Hematuria; Hemospermia; Erectile dysfunction; Back pain, pain down leg—metastasis Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  18. 18. Prostate Cancer • Diagnostic Findings: Rectal examination; PSA; Transrectal ultrasound; Radiographs; MRI; CT; IVP; Elevated serum acid phosphatase • Medical, Surgical Management – Annual screening @ 50 y.o. • At age 45: African Americans; 1st degree family history < 65 y.o. – Treatment: Observation, surgery, radiation, hormone therapy, or combination – Surgery: Suprapubic prostatectomy; Radical prostatectomy; Bilateral orchidectomy; Potential complications Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  19. 19. Question Is the following statement true or false? Prostatic screening should begin for all men at age 60. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  20. 20. Answer False. Annual prostatic screening should begin for men with a 10-year life expectancy at age 50. Screenings should begin at age 45 for African Americans and men who have immediate relatives with a history of prostatic cancer before 65 years of age. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  21. 21. Prostate Cancer • Medical, Surgical Management (Cont’d) – Radiation therapy: Used alone or with other therapies; Side effects – Hormone therapy • Men with D stage carcinoma; Antiandrogenic or estrogenic drugs; Feminizing side effects • Nursing Management Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  22. 22. Testicle Cancer • Pathophysiology and Etiology – Cryptorchidism – Early degeneration of cells in undescended testis or testes; Abnormal cellular changes – Seminomas; Nonseminomas • Assessment Findings: Signs and Symptoms – Scrotal swelling; Hard, nontender nodule; Abdominal pain; General weakness; Testicular aching • Diagnostic Findings: Tumor markers; IVP; Lymphangiography; CT; MRI Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  23. 23. Testicle Cancer • Medical, Surgical Management: Treatment depends on the stage of the disease – Autologous bone marrow transplantation; Sperm banking – Surgery: Radical inguinal orchiectomy; Spermatic cord ligation; Radical retroperitoneal lymph node dissection – Chemotherapy; Radiation • Nursing Management Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  24. 24. Penis Cancer • Rare; Occurs more often in uncircumcised men • Probable progress: Chronic irritation; Precancerous skin lesion; Malignancy • Diagnosis – Biopsy; CT; MRI • Treatment – Tumor excision; Chemotherapy – External or interstitial radiation therapy – Amputation Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  25. 25. Elective Sterilization • Vasectomy: Ligation of vas deferens – Minor surgical procedure – Permanent sterilization • Interruption of the pathway that transports sperm – Procedure has no effect on erection or ejaculation • Nursing Management Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  26. 26. End of Presentation Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
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