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Male

  1. 1. Male Reproductive Disorders & STD’s Chapters 39, 41 & 42 By Angie Lawson RN, BSN
  2. 2. Male A&P Review <ul><li>External Structures </li></ul><ul><ul><li>Penis </li></ul></ul><ul><ul><li>Scrotum </li></ul></ul><ul><li>Internal Structures </li></ul><ul><ul><li>Testes </li></ul></ul><ul><ul><li>Epididymidis </li></ul></ul><ul><ul><li>Vas deferens </li></ul></ul><ul><ul><li>Seminal vesicles </li></ul></ul><ul><ul><li>Prostate gland </li></ul></ul><ul><ul><li>Bulbourethral glands </li></ul></ul>
  3. 3. Assessment <ul><li>History </li></ul><ul><ul><li>Risk for STD’s </li></ul></ul><ul><ul><li>Contraceptive use </li></ul></ul><ul><ul><li>Ability to achieve & sustain an erection </li></ul></ul><ul><ul><li>Pain during intercourse </li></ul></ul><ul><ul><li>Premature ejaculation </li></ul></ul><ul><ul><li>Infertility </li></ul></ul><ul><ul><li>Prior surgeries or treatments </li></ul></ul>
  4. 4. Assessment cont: <ul><li>Physical Examination </li></ul><ul><ul><li>Transillumination </li></ul></ul><ul><ul><li>Testicular self – exam </li></ul></ul><ul><ul><li>Breast self -exam </li></ul></ul><ul><li>Diagnostic Tests </li></ul><ul><ul><li>Ultrasound </li></ul></ul><ul><ul><li>Cystourethroscopy </li></ul></ul><ul><ul><li>Fertility tests </li></ul></ul>
  5. 5. Prostatitis <ul><li>Inflammation of the prostate gland </li></ul><ul><ul><li>Pain/discomfort </li></ul></ul><ul><ul><li>Low back pain </li></ul></ul><ul><ul><li>Fever </li></ul></ul><ul><ul><li>Chills </li></ul></ul><ul><ul><li>Dysuria </li></ul></ul><ul><ul><li>Urethral discharge </li></ul></ul>
  6. 6. Benign Prostatic Hyperplasia <ul><li>An increased number of noncancerous cells in the prostate bland </li></ul><ul><li>Symptom onset is gradual </li></ul><ul><li>Inability to void </li></ul><ul><li>Medications & Treatments </li></ul><ul><ul><li>TURP </li></ul></ul><ul><ul><li>Terazosin (Hytrin) </li></ul></ul><ul><ul><li>Finasteride (Proscar) </li></ul></ul>
  7. 7. Prostate Cancer <ul><li>Prostatic cancer grows slowly and has a high survival rate if detected early. </li></ul><ul><li>No symptoms at first, later – urinary frequency, nocturia and dysuria </li></ul>
  8. 8. Penile Disorders <ul><li>Peyronies’s Disease </li></ul><ul><li>Priapism </li></ul><ul><li>Phimosis & Paraphimosis </li></ul>
  9. 9. Priapism <ul><ul><li>Persistent Engorgement of the penis without sexual stimulation </li></ul></ul><ul><ul><li>Causes – drug side effects or vascular problem </li></ul></ul>
  10. 10. Phimosis Paraphimosis <ul><li>Pain with erection and intercourse </li></ul><ul><li>Unable to retract the foreskin </li></ul><ul><li>Painful swelling of the glans, severe edema and urinary retention. </li></ul><ul><li>Strangulation of the glans penis by the foreskin </li></ul>
  11. 11. Penile Cancer <ul><li>Rare, possibly cause by chronic skin irritations </li></ul><ul><li>Lesion on the penis, that may become infected over time. </li></ul>
  12. 12. Testicular Disorders <ul><li>Cryptorchidism </li></ul><ul><li>Hydrocele </li></ul><ul><li>Varicocele </li></ul>
  13. 13. Cryptorchidism <ul><li>No signs and symptoms noted </li></ul><ul><li>Scrotum feels empty </li></ul>
  14. 14. Hydrocele, Spermatocele & Varicocele <ul><li>All present as swelling of the scrotum </li></ul><ul><li>Hydrocele </li></ul><ul><ul><li>fluid around testicles-no teatment </li></ul></ul><ul><li>Spermatocele </li></ul><ul><ul><li>cystic mass on epididymis - no teatment </li></ul></ul><ul><li>Varicoceles </li></ul><ul><ul><li>dilated veins – untreated causes infertility </li></ul></ul>
  15. 15. Epididymitis Orchitis <ul><li>Inflammation of the epididymis </li></ul><ul><ul><li>Pain, swelling, fever, chills, scrotal skin red and tense </li></ul></ul><ul><li>Inflammation of the testis </li></ul>
  16. 16. Testicle Cancer <ul><li>Cancer in the testicle, that is a highly metastasizing cancer </li></ul><ul><li>Swelling of the scrotum, a noticeable lump, abdominal pain, weakness & aching in the testes. </li></ul>
  17. 17. Sexual Functioning <ul><li>Vasectomy </li></ul><ul><li>Erectile dysfunction </li></ul><ul><ul><li>Impotence </li></ul></ul><ul><ul><ul><li>Inability to achieve or maintain an erection </li></ul></ul></ul><ul><ul><ul><li>Causes – aging, testosterone insufficiency, drug side effects, atherosclerosis, hypertension, diabetes, anxiety or depression </li></ul></ul></ul><ul><li>Infertility </li></ul>
  18. 18. Vasectomy <ul><li>Done in a Dr. Office, ligation of the vas deferens </li></ul><ul><li>Vasovasostomy – a surgical attempt to reverse a vasectomy </li></ul>
  19. 19. Sexually Transmitted Diseases (STD’s)
  20. 20. Common STD’s <ul><li>Chlamydia </li></ul><ul><li>Gonorrhea </li></ul><ul><li>Herpes Infection </li></ul><ul><li>Venereal Warts </li></ul>
  21. 21. Chlamydia <ul><li>Most common, fastest spreading, caused by chlamydia trachomatis </li></ul><ul><li>Most are asymptomatic, if they occur, clear urethral discharge, redness, irritation, dysuria, lower abd pain, or testicular pain </li></ul>
  22. 22. Gonorrhea <ul><li>High incidence in 15-24 yr olds, caused by Neisseria Gonorrhoeae </li></ul><ul><li>Many women are asymptomatic, but may have white/yellow discharge, cervicitis, dysuria, men have urethritis </li></ul>
  23. 23. Syphilis <ul><li>Curable, transmitted from blood, caused by the spirochete, Treponema pallidum </li></ul><ul><li>Early-painless papule, later-papule ulcerates, fever, malaise, rash, headache, sore throat, lymph node enlargement </li></ul>
  24. 24. Trichomonas <ul><li>May also be transmitted through nonsexual contact </li></ul><ul><li>Redness, swelling, itching, and burning </li></ul>
  25. 25. Herpes Infection <ul><li>Highly contagious, not curable, caused by herpes simplex virus type 2 </li></ul><ul><li>Vesicles on the penis, prepuce, buttocks, thighs, introitus, or cervix, burning itching, ulcerations, flu symptoms, headache </li></ul>
  26. 26. Genital Warts <ul><li>Called condylomas, reoccuring, more susceptible in immunodeficient people </li></ul><ul><li>Painless, single or in a cluster, soft, fleshy growths, turn white when vinegar is applied </li></ul>
  27. 27. Hepatitis B <ul><li>Early signs - loss of appetite, rashes, malaise, pain, headaches, nausea, vomiting </li></ul><ul><li>Hepatitis B & liver cancer </li></ul><ul><li>Late signs – dark urine, light stool, jaundice, spleen enlargement, liver tenderness cirrhosis, coma, death </li></ul>
  28. 28. Genital Parasites <ul><li>Not a true STD, but can be transmitted through close body contact </li></ul><ul><li>Lice Scabies </li></ul>
  29. 29. Pharmacology <ul><li>Penecillin </li></ul><ul><ul><li>Uses : syphilis, gonorrhea </li></ul></ul><ul><ul><li>Adverse reactions: glossitis, stomatitis, gastritis, furry tongue, nausea & vomiting </li></ul></ul><ul><li>Norfloxacin </li></ul><ul><ul><li>Uses: uncomplicated gonorrhea, prostatitis </li></ul></ul><ul><ul><li>Adverse reactions: diarrhea, headache, abdominal discomfort, superinfections </li></ul></ul>
  30. 30. Pharmacology Cont: <ul><li>Metronidazole (flagyl) </li></ul><ul><ul><li>Uses – trichomonas </li></ul></ul><ul><ul><li>Adverse reactions- nausea, anorexia, seizures, numbness </li></ul></ul><ul><li>Spectinomycin (trobicin) </li></ul><ul><ul><li>Uses – gonorrhea </li></ul></ul><ul><ul><li>Adverse reacions – soreness at inj. site. urticaria, sudden decrease in blood pressure. </li></ul></ul>
  31. 31. Pharmacology Cont: <ul><li>Acyclovir (Zovirax) </li></ul><ul><ul><li>Uses: herpes simplex, herpes zoster </li></ul></ul><ul><ul><li>Adverse Reactions: N & V, diarrhea, headache, dizziness, lethargy, rashes </li></ul></ul><ul><li>Docosanol (Abreva) </li></ul><ul><ul><li>Uses: HSV types 1&2 </li></ul></ul><ul><ul><li>Adverse reactions: headache, skin rash </li></ul></ul>
  32. 32. Pharmacology Cont: <ul><li>Imiquimod – </li></ul><ul><ul><li>Uses: external genitalia and perianal warts </li></ul></ul><ul><ul><li>Adverse reactions: local skin irritations, itching, excoriation </li></ul></ul><ul><li>Indinavir </li></ul><ul><ul><li>Uses: HIV infections </li></ul></ul><ul><ul><li>Adverse reactions: headache, N&V, diarrhea, cough, dysuria, acne </li></ul></ul>
  33. 33. Pharmacology Cont: <ul><li>Valacyclovir (valtrex) </li></ul><ul><ul><li>Uses: HSV type 2: herpes zoster </li></ul></ul><ul><ul><li>Adverse reactions: N&V, headache, dizziness, anorexia, diarrhea </li></ul></ul><ul><li>Zidovudine AZT (retrovir) </li></ul><ul><ul><li>Uses: HIV infection </li></ul></ul><ul><ul><li>Adverse reactions: asthenia, malaise, weakness, headache, anorexia, diarrhea, N&V, dizziness, insomnia, anemia, agranulocytosis </li></ul></ul>
  34. 34. Pharmacology Cont: <ul><li>Fluconazole (diflucan) </li></ul><ul><ul><li>Uses: vaginal candidiasis </li></ul></ul><ul><ul><li>Adverse reactions: headache, N&V, diarrhea, skin rash </li></ul></ul><ul><li>Ibuprofen (motrin, advil) </li></ul><ul><ul><li>Uses: painful dysmenorrhea </li></ul></ul><ul><ul><li>Adverse reactions: nausea, dizziness, dyspepsia, gastric/duodenal ulcer formation, GI bleeding, headache </li></ul></ul>
  35. 35. Pharmacology Cont: <ul><li>Naproxen (aleve, anaprox) </li></ul><ul><ul><li>Uses: dysmenorrhea </li></ul></ul><ul><ul><li>Adverse reactions: dizziness, visual disturbances, headache, N&V, gastric/duodenal ulcers </li></ul></ul><ul><li>Rofecoxib (vioxx) </li></ul><ul><ul><li>Uses: primary dysmenorrhea </li></ul></ul><ul><ul><li>Adverse reactions: headache, dizziness, insomnia, rash, dyspepsia, fatigue </li></ul></ul>
  36. 36. Pharmacology Cont: <ul><li>Urofollitropin (Fertinex) </li></ul><ul><ul><li>Uses: induction of ovulation </li></ul></ul><ul><ul><li>Adverse reactions: ovarian enlargement, N&V, breast tenderness, ectopic pregnancy, abdominal discomfort </li></ul></ul><ul><li>Methyltestosterone (Android) </li></ul><ul><ul><li>Uses: hypogonadism, impotence, postpubertal cryptochidism, female breast cancer </li></ul></ul><ul><ul><li>Adverse reactions: gynecomastia, testicular atrophy, impotence, enlargement of penis, nausea, male pattern baldness, amenorrhea </li></ul></ul>
  37. 37. Pharmacology Cont: <ul><li>Finasteride (Proscar) </li></ul><ul><ul><li>Uses: BPH, prevention of male pattern baldness </li></ul></ul><ul><ul><li>Adverse reactions: impotence, decreased libido, decreased volume of ejaculate </li></ul></ul><ul><li>Conjugated estrogens (Premarin) </li></ul><ul><ul><li>Uses: problems assoc. with menopause </li></ul></ul><ul><ul><li>Adverse reactions: headache, migraine, dizziness, depression, insomnia, cramps, spotting, edema, breast pain, HTN, gallbladder disease </li></ul></ul>
  38. 38. Pharmacology Cont: <ul><li>Medroxyprogesterone (Provera) </li></ul><ul><ul><li>Uses: amenorrhea, endometrial hypoplasia </li></ul></ul><ul><ul><li>Adverse reactions: spotting, amenorrhea, breast tenderness, weight gain, depression </li></ul></ul><ul><li>Estrogens & Progestins Combo (Prempro) </li></ul><ul><ul><li>Uses: treament of moderate to severe symptoms of menopause </li></ul></ul><ul><ul><li>Adverse reactions: same as premarin and provera </li></ul></ul>
  39. 39. Pharmacology Cont: <ul><li>Contraceptives (oral) </li></ul><ul><ul><li>Ortho novum’s, Desogen, Triphasil, Ortho Tri-Cyclen, </li></ul></ul><ul><li>Contraceptives (implantable and injectable </li></ul><ul><ul><li>Norplant – surgical incision with implantation of 6 hormone capsules </li></ul></ul><ul><ul><li>Depo-provera – given IM every 3 months </li></ul></ul><ul><ul><li>Ortho evra - patch applied each week times 3 then off for 1 week. </li></ul></ul>
  40. 40. Pharmacology Cont: <ul><li>Hepatitis B Vaccine (Engerix – B) </li></ul><ul><ul><li>Uses: immunity against hepatitis b infections </li></ul></ul><ul><ul><li>Adverse reactions: headache, vertigo, dizziness, paresthesia, insomnia, pruritus, nausea, dyspepsia, diarrhea, local pain at site, flu like symptoms, fatigue and earache </li></ul></ul>

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