This document provides information about disorders of the male reproductive system. It begins with describing the anatomy and physiology of the male reproductive system. It then discusses common diagnostic tests used to evaluate disorders like prostate-specific antigen testing, ultrasound, and biopsy. Several common disorders are explained such as benign prostate hyperplasia, prostatitis, prostate cancer, disorders of the testes, scrotum, penis and urethra. The disorders are defined and their signs, symptoms, diagnostic workup and management are outlined.
Benign prostatic hyperplasia is an enlargement of the prostate gland resulting from an increase in the number of epithelial cells and stromal tissue and developing upward into the bladder and obstructing the outflow of urine.
Hypospadias is a relatively rare congenital condition where the opening of the penis is on the underside of the organ. This condition is more common in infants with a family history of hypospadias.
The penis may curve down in an infant and the baby may spray while urinating.
This is a lecture by Katherine A Perry from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
Kidney stones (also called renal calculi, nephrolithiasis or urolithiasis) are hard deposits made of minerals and salts that form inside your kidneys. Diet, excess body weight, some medical conditions, and certain supplements and medications are among the many causes of kidney stones.
Prostate cancer or tumor is the most common cancer in men other than non-melanoma skin cancer.
The majority (more than 75%) of cases occur in men over age 65.
Risk factors for prostate cancer including increasing age, the incidence of prostate cancer increase rapidly after the age of 50 years. And more than 70% cases occur in men older than 65 year of age.
Urinary Tract Infection with Nursing ManagementSwatilekha Das
Urinary Tract Infection introduction, definition, common microorganisms, classification, predisposing factors, clinical manifestations, pathophysiology, diagnostic studies, medical management and nursing management along with assessment, nursing diagnosis, goal, nursing interventions and expected outcome after the intervention.
Oncology Nursing:-An oncology nurse is a specialized nurse who cares for cancer patients. These nurses require advanced certifications and clinical experiences in oncology further than the typical baccalaureate nursing program provides. Oncology nursing care can be defined as meeting the various needs of oncology patients during the time of their disease including appropriate screenings and other preventive practices, symptom management, care to retain as much normal functioning as possible, and supportive measures upon the end of life.
What is oncology?
Oncology is the branch of medicine that researches, identifies, and treats cancer. A physician who works in the field of oncology is an oncologist.
Oncologists must first diagnose cancer, which is usually carried out via biopsy, endoscopy, X-ray, CT scanning, MRI, PET scanning, ultrasound, or other radiological methods. Nuclear medicine can also be used to diagnose cancer, as can blood tests or tumor markers. Oncology is often linked with hematology, which is the branch of medicine that deals with blood and blood-related disorders.
Treatment
Once a diagnosis is made, the oncologist discusses the disease stage with the patient. Staging will dictate the treatment of cancer. Chemotherapy — which is defined as the destruction of cancer cells — may be used, as well as radiation therapy. Surgery is used to remove tumors. Hormone therapy is used to treat certain types of cancers, and monoclonal antibody treatments are gaining popularity. Research into cancer vaccines and immunotherapies is ongoing. Palliative care in oncology treats pain and other symptoms of cancer.
Treatment team
Cancer is often treated in a team effort, with at least two or three types of oncologists, including medical, surgical, or radiation. The oncology treatment team may also include a pathologist, a diagnostic radiologist, or an oncology nurse. In the event of a new or a difficult-to-treat case of cancer, the oncology care team may consult a tumor board, made up of various medical experts from all relevant disciplines. The tumor board reviews the case and recommends the best course of cancer treatment for the patient.
Oncology nurse
The oncology nurse has many roles, from helping with cancer screening, detection, and prevention, to the intensive care focus of bone marrow transplantation. Work settings for oncology nurses also vary and include acute care hospitals, ambulatory care clinics, private offices, radiation therapy facilities, and home care agencies. Oncology nurses work with adult and pediatric patients with cancer.
Pediatric Oncology
Pediatric oncology is a medical specialty that focuses on cancer care for children.
The National Cancer Institute estimates that 10,270 new cases of cancer will be diagnosed in children in 2017. Of these, 1,190 children will die from the disease.
Pediatric oncology is an important medical field that treats all pediatric cancer types, including acute lymphocytic leukemia,
Benign prostatic hyperplasia is an enlargement of the prostate gland resulting from an increase in the number of epithelial cells and stromal tissue and developing upward into the bladder and obstructing the outflow of urine.
Hypospadias is a relatively rare congenital condition where the opening of the penis is on the underside of the organ. This condition is more common in infants with a family history of hypospadias.
The penis may curve down in an infant and the baby may spray while urinating.
This is a lecture by Katherine A Perry from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
Kidney stones (also called renal calculi, nephrolithiasis or urolithiasis) are hard deposits made of minerals and salts that form inside your kidneys. Diet, excess body weight, some medical conditions, and certain supplements and medications are among the many causes of kidney stones.
Prostate cancer or tumor is the most common cancer in men other than non-melanoma skin cancer.
The majority (more than 75%) of cases occur in men over age 65.
Risk factors for prostate cancer including increasing age, the incidence of prostate cancer increase rapidly after the age of 50 years. And more than 70% cases occur in men older than 65 year of age.
Urinary Tract Infection with Nursing ManagementSwatilekha Das
Urinary Tract Infection introduction, definition, common microorganisms, classification, predisposing factors, clinical manifestations, pathophysiology, diagnostic studies, medical management and nursing management along with assessment, nursing diagnosis, goal, nursing interventions and expected outcome after the intervention.
Oncology Nursing:-An oncology nurse is a specialized nurse who cares for cancer patients. These nurses require advanced certifications and clinical experiences in oncology further than the typical baccalaureate nursing program provides. Oncology nursing care can be defined as meeting the various needs of oncology patients during the time of their disease including appropriate screenings and other preventive practices, symptom management, care to retain as much normal functioning as possible, and supportive measures upon the end of life.
What is oncology?
Oncology is the branch of medicine that researches, identifies, and treats cancer. A physician who works in the field of oncology is an oncologist.
Oncologists must first diagnose cancer, which is usually carried out via biopsy, endoscopy, X-ray, CT scanning, MRI, PET scanning, ultrasound, or other radiological methods. Nuclear medicine can also be used to diagnose cancer, as can blood tests or tumor markers. Oncology is often linked with hematology, which is the branch of medicine that deals with blood and blood-related disorders.
Treatment
Once a diagnosis is made, the oncologist discusses the disease stage with the patient. Staging will dictate the treatment of cancer. Chemotherapy — which is defined as the destruction of cancer cells — may be used, as well as radiation therapy. Surgery is used to remove tumors. Hormone therapy is used to treat certain types of cancers, and monoclonal antibody treatments are gaining popularity. Research into cancer vaccines and immunotherapies is ongoing. Palliative care in oncology treats pain and other symptoms of cancer.
Treatment team
Cancer is often treated in a team effort, with at least two or three types of oncologists, including medical, surgical, or radiation. The oncology treatment team may also include a pathologist, a diagnostic radiologist, or an oncology nurse. In the event of a new or a difficult-to-treat case of cancer, the oncology care team may consult a tumor board, made up of various medical experts from all relevant disciplines. The tumor board reviews the case and recommends the best course of cancer treatment for the patient.
Oncology nurse
The oncology nurse has many roles, from helping with cancer screening, detection, and prevention, to the intensive care focus of bone marrow transplantation. Work settings for oncology nurses also vary and include acute care hospitals, ambulatory care clinics, private offices, radiation therapy facilities, and home care agencies. Oncology nurses work with adult and pediatric patients with cancer.
Pediatric Oncology
Pediatric oncology is a medical specialty that focuses on cancer care for children.
The National Cancer Institute estimates that 10,270 new cases of cancer will be diagnosed in children in 2017. Of these, 1,190 children will die from the disease.
Pediatric oncology is an important medical field that treats all pediatric cancer types, including acute lymphocytic leukemia,
A benign (not cancer) condition in which an overgrowth of prostate tissue pushes against the urethra and the bladder, blocking the flow of urine. Also called benign prostatic hyperplasia and BPH.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
2. LEARNING OBJECTIVES
• Describe structures and functions of the male
reproductive system.
• Discuss common diagnostic test for disorder of male
reproductive system.
• Explain various disorders of male reproductive system
with management.
• Discuss infertility, PID and STIs.
5. 2. Testes
A) Site of spermatogenesis & hormone production
B) Structures
1) Tunica albuginea – outer cell layer
2) Each testis is subdivided into lobules
3) Each lobule contains 1-4 highly convoluted seminiferous
tubules
a) The tubules contain the spermatogonia which will mature into
sperm
b) In between the tubules are interstitial cells which produce
hormones testosterone & inhibin
4) The tubules converge and unite to form the rete testis
5) The rete testis gives rise to several ducts which open into the
epididymis
6.
7. 3. Epididymis
• A) Site of sperm
maturation and storage
• B) Takes 20 days for
sperm to travel through it
• C) Can store sperm for
several months
8. 4. Vas deferens
• A) Conduct and store
sperm
• B) Move upward in
spermatic cord into pelvic
cavity
• C) Both sides join with
ducts of the seminal
vesicle to form
ejaculatory duct which
flows into urethra
9. 5. Prostate
• A) Chestnut shaped
• B) Encircles urethra
inferior to the bladder
• C) Expels thin, milky fluid
through a series of ducts
10. 6. Seminal vesicles
A) Yellowish, finger-shaped structures
B) Slightly inferior and posterior to bladder
C) Produces a component of semen (60%)
1) Slightly alkaline
2) Contains fructose to fuel the sperm
3) Also contains prostaglandins to initiate smooth muscle
contractions in female reproductive tract
11. 7. Bulbourethral
(Cowper’s) glands
• A) Pea-sized; empty into
the spongy urethra
• B) Secrete clear, mucus
fluid
• 1) Alkaline to neutralize
acidic urine in urethra
• 2) Provides some
lubrication for intercourse
12.
13. 8. Penis
A) Composed of 3 columns of erectile tissue
1) Corpora cavernosa (2) – lie dorsally
2) Corpus spongiosum – lie ventrally; surrounds urethra
B) Terminates in enlarged portion known as glans penis
(covered by prepuce)
1) Location of external urethral orifice
2) Highly innervated with sensory neurons
3) Involved with physiological, sexual arousal
14.
15. 9. Urethra
• A) Transports semen and
urine to the outside of the
body
• B) 3 divisions
• 1) Prostatic – passes
through prostate
• 2) Membranous – passes
through urogenital
diaphragm
• 3) Spongy – passes
through penis
17. 1. PROSTATE SPECIFIC
ANTIGEN (PSA)
PURPOSE AND DESCRIPTION
• A blood test used to diagnose prostate cancer and to
monitor treatment of prostate cancer.
• The cells within prostate gland produces a protein that
can be measured in blood called PSA.
18. Conti..
• Increase in level of PSA may indicate prostate cancer,
BPH, acute urinary retention and acute prostatitis.
• Values less than 4.0ng/ml are generally consider normal,
and values more than 4.0ng/ml are consider abnormal.
19. 2. PROSTATE ULTRASOUND
PURPOSE AND DESCRIPTION
• Conducted to identify testicular torsion or masses, and to
evaluate prostate enlargement.
• Uses high-frequency sound waves, passed through
tissues of various densities, to produce a visual graphic
of tissue being examined.
RELATED NURSING CARE
• A full bladder may be required for the study.
22. Transrectal biopsy
• A transrectal ultrasound
(TRUS) is often used to
guide the placement of the
needle during the
procedure.
• ■ A transrectal biopsy is
performed with a spring-
loaded needle, inserted
through the rectal wall and
into the prostate gland to
remove one or more tissue
samples.
23. Transurethral biopsy
• ■ A transurethral biopsy is
performed by inserting a
cystoscope through the
urethra and using a
cutting loop to remove
small samples of prostate
tissue.
24. RELATED NURSING CARE
• Advise the man to avoid strenuous activity for 4 hours
post procedure.
• Explain that there may be some discomfort in the biopsy
area for 1 to 2 days, there may be some blood in the
urine.
25. Conti..
• Following a transurethral biopsy, a urinary catheter may
remain in place for a few hours after the procedure and
antibiotics will be prescribed.
• Excess bleeding, pain, or signs of infection should be
reported to the physician.
26. 5. DIGITAL RECTAL
EXAMINATION (DRE)
• DRE is used to screen for prostate cancer and recommended
annually for every man older than 50 yrs of age.
• DRE enables the skilled examiner, using lubricated, gloved
finger placed in the rectum , to assess the size, symmetry,
shape, and consistency of the posterior surface of the
prostate gland.
27. Conti…
• The clinical assess for tenderness of the prostate gland
on palpation and for the presence and consistency of
any nodules.
• The DRE may be performed with the patient leaning over
an examination table or positioning the man in a side-
lying position with legs flexed toward the abdomen or
supine with legs resting in stirrups.
28. ROLE OF NURSE
• To provide comfortable position to the patient.
• Advice the patient to take deep breaths and exhale
slowly during procedure.
29. DISORDERS
• DISOREDR OF PENIS
• DISORDER OF PROSTATE GLAND
• DISORDERS OF TESTIS
• DISORDER OF SCROTUM
• DISORDERS OF URETHRA
31. 2. DISORDER OF PROSTATE
GLAND
• BENIGN PROSTATE HYPERTROPHY
• PROSTATITIS
• PROSTATE CANCER
32. BENIGN PROSTATE
HYPERTROPHY
INTRODUCTION
Generalized disease of the prostate due to hormonal
derangement which leads to enlargement of the gland
(increase in the number of epithelial cells and stromal
tissue)to cause compression of the urethra leading to
symptoms
33. CAUSES
• Hormonal derangement - estrogen
• Dihydrotestosteron (DHT) a metabolite of testosteron.
It’s a mediator of protatic growth.
35. PATHOPHYSIOLOGY
Due to causes and risk factors – estrogen level increases
Prostatic cells becomes more responsive to estrogen and less to DHT
Increased proliferation of prostatic cells - BPH
Obstruct bladder neck & urethra, incomplete emptying of bladder
Gradual dilation of ureters (hydroureters) & kidney
(hydronephrosis), more chances of UTI.
36. SIGNS AND SYMPTOMS
Voiding symptoms:-
• • decrease in the urinary stream
• • Straining
• • Dribbling at the end of urination
• • Intermittency
• • Hesitancy
• • Pain or burning during urination
• • Feeling of incomplete bladder emptying
• • Urinary retention (more than 60 ml of urine
remaining in bladder)
37. DIAGNOSTIC TEST
• History & Examination
• Abdominal/GU exam
• Digital rectal exam (DRE)
• Urinalysis- hematuria & UTI
• Urine culture
• BUN, Cr
• Prostate specific antigen (PSA)
• Transrectal ultrasound – biopsy
• Uroflometry
• Postvoid residual(PVR) measurement
38. MANAGEMENT
Pharmacological Treatment
Alpha-1-adrenergic antagonists
• Relax smooth muscle in the bladder neck, prostate capsule, and
prostatic urethra
• Immediate relief!
Examples
• Terazosin, Doxazosin, Tamsulosin, Alfuzosin
• Initiate at bedtime (hypotension)
Major Side Effects
• HYPOTENSION!
• Ejaculatory Dysfunction (particularly Tamsulosin)
39. CONTI..
5-alpha-reductase inhibitors
• Reduces the size of the prostate gland
• Prevents conversion testosterone TO dihydrotestosterone
(DHT)
• Indefinite treatment, as discontinuation may lead to symptom
relapse.
Examples
• Finasteride (initiated and maintained at 5 mg once daily)
• Dutasteride
Side Effects
• Sexual dysfunction
• Decrease PSA
40. CONTI..
Surgery or Minimally Invasive Surgical
Therapies
- Transurethral needle ablation (TUNA)
- transurethral microwave therapy (TUMT)
Endoscope
- Transurethral Resection of the Prostate(TURP)
MAJOR Surgery
- Open Prostatectomy
41.
42. PROSTATITIS
• Infection &/ or inflammation of the prostate gland that is
often associated with lower UTI, sexual discomfort and
dysfunction.
48. PROSTATE CANCER
RISK FACTOR-
• Family history
• Genes-
Hereditary prostate cancer 1 (HPC1)
BRCA1 and BRCA2 mutations
• Diet contain-
excessive amount of red meat or dairy products that
are high in fat
• Hormones-
Androgens & estrogen
49. SIGNS & SYMPTOMS
In case of benign
• -urinary obstruction
• -blood in urine or semen
• -painful ejaculation
• -Sexual dysfunction
In case of metastasis-
• - backache & hip pain
• -rectal discomfort
• -Anemia and weight loss
50. DIAGNOSTIC TEST
• Family history
• DRE
• Ultrasound guided TRUS with biopsy
• PSA level
• Helpful in asymptomatic patients
• > 60% of patients with prostate cancer are asymptomatic
• Diagnosis is made solely because of an elevated
screening PSA level
52. MANAGEMENT
• 1.Androgen deprivation Therapy (ADT)
• Used to suppress androgenic stimuli to the prostate by
decreasing the level of circulating plasma testosterone or
interrupting the conversion to or binding of DHT.
• Luteinizing hormone- releasing hormone (LHRH)
agonists.
• Eg- Leuprolide
• Goserelin
53. Conti..
• 2.Cryotherapy
• 3.External beam radiotherapy
• Retropubic or perineal radical prostatectomy
• -with or without postoperative radiotherapy to the
prostate margins and pelvis
• 4.Brachytherapy (either permanent or temporary
radioactive seed implants)
• -with or without external beam radiotherapy to the
prostate margins and pelvis.
57. HYDROCELE
• •Is is characterised by collection of fluid between visceral
& parietal membranes of the tunica vaginalis
(membranes that surrounds the testis).
• TYPES:-
• 1. Acute Hydrocele (adult >40yrs)
• 2. Chronic Hydrocele (imbalanced in fluid secretion and
reabsorption in tunica vaginalis)
58. • Fluid in the tunica vaginalis.
• Usually idiopathic
• A hydrocele may contain 100 cc or more of serous fluid.
• A hydrocele will appear and disappear as the patient
changes position.
• One can distinguish a hydrocele from a tumor mass by
trans-illuminating it with a bright flashlight in a dark
room.
63. MANAGEMENT
• •None unless swelling large & uncomfortable
• •Fluid aspiration – may be repeated 1-3 times
• •Hydrocelectomy –excision or suturing of membranes of
vaginalis
65. URETHRAL STRICTURE
• Urethral stricture is a condition in which a section of the
urethra is narrowed.
CAUSES
• It can occur congenitally or from a scar along the
urethra.
• Traumatic injury to urethra (e.g., from instrumentation or
infections)
66. Clinical features
• strictures that restrict urine flow
• decrease the urinary stream
• leading to spraying or double stream
• post voiding dribbling,
• dilation of the proximal urethra and prostatic ducts.
67. TREATMENT
• MEDICAL MANAGEMENT
• Antimicrobial agents are necessary for resolution of
UTIs, followed by long term prophylactic therapy until
stricture is corrected.
• Mannual dilations of urethra
• Treatment sholud not be considered successful until at
least 1 year has passed, because stricture may recur
anytime during that period.
• SURGICAL MANGEMENT
• Urethrotomy (surgical removal of the stricture)
75. Etiology – Male Factors
• Varicocele – varicose of swollen vein in the testicle
• Cryptorchidism – undescended testicle at birth
• Occupational exposure to heat
• Immunological Factors
Autoimmune reaction
Production of antibodies that destroy sperm
• Obstruction in Sperm Transport
Mumps
Epididymitis
STD’s
76. Diagnostic Studies –
Female
• Basal Body Temperature (BBT)
• Oral temp taken each day prior to arising
• Results are graphed
• Sudden dip occurs the day prior to ovulation & is
followed by a rise of 0.5 –1.0 degrees F, which indicates
ovulation
77. • Serum Hormone Testing
• Venous blood is drawn to assess levels of FSH and LH
• These are indicators of ovarian function
78. • Postcoital Exam
• Couple has sexual intercourse 8 – 12 hours prior to
exam, 1-2 days before expected ovulation
• A 10 cc syringe with catheter attached is used to collect
a specimen of secretions from the vagina
• Secretions are examined for: S/S infection, # of active
& non-motile sperm, sperm-mucus interactions, &
consistency of cervical mucus
79. • Endometrial Biopsy
• Paracervical Block to decrease cramping / pain
• Pinch of endometrium obtained to check for a luteal
phase defect (lack of progesterone)
80. • Hysterosalpingogram (HSG)
• Detects uterine anomalies (septate, unicornate,
bicornate)
• Detects Tubal anomalies or blockage
• Iodine-based radio-opaque dye is instilled through a
catheter into the uterus and tubes to outline these
structures and x-rays are taken to document findings
81. • Laparoscopy
• General or epidual anesthesia
• Abdomen is insufflated with carbon dioxide
• One or more trochars are inserted into the peritoneum
near the umbilicus & symphysis pubis
• Laparoscope visualizes structures in the pelvis
• Can perform certain surgical procedures
82. Diagnostic Studies –
Male
• Semen analysis
• Ejaculates into a specimen container
• Ejaculate examined for:
Number
Morphology
Motility
83. Normal Semen Analysis
Results
• Volume >2.0 mL
• pH 7.0 – 8.0
• Total sperm count >20 million per mL
• Motility 50% or greater
84. Diagnostic Studies –
Male & Female Partner
• Anti-sperm antibody evaluation of cervical mucus and
ejaculate are tested for agglutination
• Indication that secretory immunological reactions are
occurring between cervical mucus and sperm
85. MANAGEMENT
• Intrauterine Insemination (a form of artificial
insemination)
• Sperm are collected within 3 hours of colitus and are
inserted via a catheter into the uterus
• Donor sperm may be used
• Identify of the sperm donor is kept confidential
86. • In Vitro Fertilization (IVF)
• Multiple ova are harvested via a large-bore needle and
syringe transvaginally under ultrasound guidance
• Ova are then mixed with sperm
• Up to 4 of the resultant embryos are returned to the
uterus 2-3 days later
88. PELVIC INFLAMMATORY
DISEASE (PID)
• It is an inflammatory condition of the pelvic cavity that
may begin with cervicitis and involve the uterus
(endometritis), fallopian tube (salpingitis), ovaries
(oopharitis), pelvic peritoneum, or pelvic vascular
system.
89. ETIOLOGY
Infection caused by:-
• Virus
• Fungus
• Parasite
• Bacteria
More common:- Gonorrheal and chlamydial organisms
• STDs
• Invasive procedures- endometrial biopsy, abortion,
hysteroscopy etc.
92. DIAGNOSTIC TEST
On pelvic examination:-
• Intense tenderness of the uterus palpated Or Movement
of cervix (cervical motion tenderness)
• Blood test
• Endocervical culture
93. MANAGEMENT
Treated on outpatient basis with Broad spectrum antibiotic
therapy prescribed in combination:-
• Ceftriaxone(Rocephin)
• Azithromycin
• Doxycycline
Indications for hospitalization include surgical emergencies,
pregnancy, no clinical response to oral antibiotic therapy
and tubo-ovarian abscess
95. STDs
STDs are diseases and infections which are capable of
being spread from person to person through:
Sexual Intercourse
vaginal
anal
oral
Blood-to-blood contact
Sharing needles or other drug-use equipment
Tattoo or body piercing
Infected mother to her baby
97. CHLAMYDIA
• Causative Agent:- Chlamydia Trachomatis
• More common in young women between 15 and 19 yrs
of age.
SYMPTOMS:
• fever, weight loss for no reason, swollen glands, fatigue,
diarrhea, white spots on the mouth and trunk.
•
98. FEMALE SYMPTOMS:
• Vaginal discharge (white
or grey) or burning with
• urination
• Lower abdominal pain
• Bleeding between
menstrual periods.
• Low-grade fever (later
symptom)
99. MALE SYMPTOMS:
• Discharge from the penis
and/or burning when
urinating
• Burning and itching around
the opening of the penis
• Pain and swelling in the
testicles
• Low –grade fever
(associated with
epididymitis –inflammation
of the testicles)
100. DIAGNOSTIC TEST
• Gram stain
• Direct fluorescent antibody test
In female- sample taken from:-
• Endocervix
• Anal canal
• Pharynx
In male patient-
• Urethra
• Anal canal
• pharynx
101. MANAGEMENT
Recommended Regimens By CDC
guidelines 2015
• Azithromycin 1 g orally in a single dose
• OR Doxycycline 100 mg orally twice a day for 7 days
102. Gonorrhea
• People get gonorrhea from close sexual contact (anal
sex, oral sex., and vaginal).
• Gonorrhea can also be spread from mother to child
during birth.
• Gonorrhea infection can spread to other unlikely parts of
the body
• Causative Agent:- N. Gonorrhoeae
103.
104. Symptoms of Gonorrhea
• Appear 5-7 days or can take up to 30 days to appear
• sore or red throat if you have gonorrhea in the throat
from oral sex
• rectal pain
• blood and pus in bowel movements if you have
gonorrhea in the rectum from anal sex.
105. FEMALE SYMPTOMS:
• Symptoms may show up 2-21 days after having sex
• May notice a yellow or white discharge from the vagina
• May be a burning or pain when urinating
• Bleeding between periods
• Heavier and more painful periods
• Cramps or pain in the lower abdomen, sometimes with
nausea or fever
106. GONORRHEA
MALE SYMPTOMS:
• Yellow or white
drip/discharge from penis
• Burning or pain when
urinating
• Frequent urinating
• Swollen testicles
108. MANAGEMENT
Gonococcal Infections of the Cervix,
Urethra, Pharynx and Rectum
Recommended Regimen
• Ceftriaxone 250 mg IM in a single dose
• PLUS Azithromycin 1g orally in a single dose
109. • persons infected with N. gonorrhoeae frequently are
coinfected with C. trachomatis; this finding has led to the
longstanding recommendation that persons treated for
gonococcal infection also be treated with a regimen that
is effective against uncomplicated genital C. trachomatis
infection
110. Syphilis
• The long range effects can be very serious, including
death.
• passed from person to person through direct contact with
a syphilis sore
• Sores mainly occur on the external genitalia, vagina,
anus, or rectum. Sores can also occur on the lips and in
the mouth.
• Transmission of the organism occurs during vaginal,
anal, or oral sex.
• Causative agent- Treponema Pallidum
111. • A bacterial infection that progresses in stages:-
• Primary: (2-3 weeks) starts as a small, painless sore
called a chancre; goes away on it’s own within 2 months.
• Secondary: (2 – 8weeks) rash on the body, palms of
hands & soles of feet, hair loss, feeling sick
• Latent: lesions or rashes can recur
112.
113.
114. Untreated syphilis may lead to tertiary syphilis, which is a
slowly progressive inflammatory disease and can damage:
• The cardiovascular system (heart & blood vessels)
• The neurological system(neurosyphilis, dementia,
meningitis, stroke)
• Other major organs of the body
• Complications may lead to death
115. Diagnostic test
Nontreponemal or reagin test
• Venereal Disease Research Laboratory (VDRL) or
• Rapid plasma reagin circle test (RPR-CT)
Treponemal test
• Fluorescent treponemal antibody absoption test (FTA-
ABS)
• Micro- hemagglutination test for Treponema Pallidum
(MHA-TP)
116. MANAGEMENT
Primary and Secondary Syphilis among Persons
Recommended Regimen
• Benzathine penicillin G, 2.4 million units IM in a single
dose
Recommended Regimen Tertiary Syphilis with Normal
CSF Examination
• Benzathine penicillin G 7.2 million units total,
administered as 3 doses of 2.4 million units IM each at 1-
week intervals
117. Genital Warts / Veniral Warts
• Growths that appear on the vagina or penis, near the
anus, and sometimes in the throat.
• They are caused by viruses and spread through sexual
contact.
• The virus that causes genital warts is spread by vaginal
or anal intercourse and by oral sex.
• Warts may appear within several weeks after sex with a
person who has HPV; or they may take months or years
to appear; or they may never appear.
• A person can be infected and pass on the virus without
knowing it.
118. Symptoms
• Usually the warts look like tiny cauliflowers, but
sometimes they are flat.
• The warts may cause itching, burning and some pain,
but often don’t cause any pain at all.
• Warts may be inside the vagina or on the cervix, or in the
rectum or throat, so you might not notice them.
• They might also be so small that you cannot see them.
119. MANAGEMENT
Recommended Regimens for External Anogenital Warts (i.e.,
penis, groin, scrotum, vulva, perineum, external anus, and
perianus*)
Patient-Applied:
• Imiquimod 3.75% or 5% cream†
• OR
• Podofilox 0.5% solution or gel
• OR
• Sinecatechins 15% ointment
120. Provider–Administered:
• Cryotherapy with liquid nitrogen or cryoprobe
• OR
• Surgical removal either by tangential scissor excision,
tangential shave
• excision, curettage, laser, or electrosurgery
• OR
• Trichloroacetic acid (TCA) or bichloroacetic acid (BCA)
80%–90%
• solution
121. Candidiasis – Yeast Fungus
• Yeast fungus that may or may not be transmitted by
sexual intercourse.
• Caused by high doses of antibiotics. It is usually caused
by altering the Ph of the vagina.
SYMPTOMS:
• A thick cheesy vaginal discharge
• Severe itching
122. MANAGEMENT
• Short-course topical formulations (i.e., single dose and
regimens of 1–3 days) effectively treat uncomplicated
VVC.
• The topically applied azole drugs are more effective than
nystatin.
124. COMMON NURSING
DIAGNOSIS
Nursing diagnoses commonly used for problems of the male
reproductive system may include:
1. Urinary retention related to urinary obstruction
2. Anxiety related to inability to empty bladder completely or
dribbling
3. Pain related to pressure of pelvic mass or distended bladder;
surgical incisions; or bladder spasms
4. Sexual dysfunction related to inability to achieve erection
5. Ineffective sexuality pattern related to decreased libido
6. Disturbed body image related to changes in sexual function
7. Potential fluid volume excess related to bladder irrigation.
8. Risk for infection related to stasis of urine
125. REFERENCES
• 1. Rita Funnell, Gabby Koutoukidis. Tabbner’s Nursing
Care: Theory and Practice. Elsevier Australia
publications. Page no. 717-723
• 2. Linda S Williams, Paula D Hopper. Understanding
Medical Surgical Nursing. F.A. Davis publications. Page
no. 1004-1024
• 3. Brunner & Suddarth. Textbook of Medical Surgical
Nursing. Vol- 2. 12th Edition. Wolters Kluwer. Page no.
1504-1539,1438-1447
• 4. https://nursekey.com
Editor's Notes
VERUMONATUM- an elevation in the floor of the prostatic portion of urethra where the seminal duct enters.
Radical prostectomy- complete removal of prostate
Robotic