NURSING ASSESSMENT – HISTORY AND PHYSICAL ASSESSMENT OF MALE REPRODUCTIVE SYSTEM…

1. NURSING ASSESSMENT –
HISTORY AND PHYSICAL
ASSESSMENT OF MALE
REPRODUCTIVE SYSTEM… .
ANILKUMAR BR
MSC .N

2. Introduction
Mae sexulaity is a complex
phenomenon that is strongly
influenced by personal, cultural and
social factors.

3. Assessment of male reproductive
function begins with an evaluation of
urinary function and symptoms.
This assessment includes a focus an
sexual function as well as
manifestations of sexual dysfunction.

4. The patient is asked about his usual state
of health and any recent change in
general, physical and sexual activity.

5. Any symptoms or changes in
function are explored fully and
described in detail.

6.  These symptoms, collectively referred to as
prostatism, may include those associated with
an obstruction caused by an enlarged prostate
gland, increased urinary frequency, decreased
force of urinary stream, double or triple
voiding.
 The patient also assessed for dysuria,
hematuria and hematospermia (blood in the
ejaculation)

7. Assessment of sexual function and
dysfunction is an essential part of every
health history.
The extent of history depends on the patient
presenting symptoms and the presence of
factors that may affect the sexual function.
Chronic illness (DM, HTN, Multiple sclerosis,
stroke & cardiac disease.)

8.  use of medications that affects the
sexual function (,anti hypertensive,
antipsychotics, OTC etc)
 also collect history regarding stress
and alcohol, and smoking.

9. Assessment of male reproductive
function
 PAST HEALTH HISTORY
In the past health history should
include information about major
illness, hospitalization, and surgeries
and also inquire about any infectious
involving the reproductive system.

10. Common reproductive illness that affects
reproductive function are mumps and
rubella.

11. In health history the nurse should ask if
male patient have had mumps, have been
immunized with mumps vaccine, or have
any indicatios of sterility.
 The nurse also question the client
regarding the patient current health status
and presence of any acute or chronic
conditions.

12.  Medications : A list of all
prescription and OTC medications
that the patient should be
documented including reason for
medications the dosage and duration
of using.

13. PHYSICAL ASSESSMENT
 DRE (Digital rectal examination)
 Testicular examination (TSE)
Testicular self examination

14. DIAGNOSIS EJACULATION
 Prostate – specific antigen test
(PSA)
 Ultrasonagraphy
 Prostate fluid and tissue analysis
 Test of male sexual function

15. DRE (Digital rectal examination)
 The DRE is recommended as part of the
regular health check up for every men older
than 40 years of age.
 THE DRE enables the examiner to assess
the size, shape, and consistency of the
prostate gland.
Tenderness of the prostate gland on
palpation and the presence and
consistency of any nodules are noted.

16. Testicular examination
 The male genitalia are inspected for abnormalities
and for palpated for masses.
 The scrotum is palpated carefully for nodules,
masses or Inflammation.
 Examination of the scrotum can reveal such disorder
as hydrocele, hernia or tumour of the testis.
 The penis is inspected and palpated for ulcerations,
nodules, inflammation and discharge.

17. Diagnostic evaluation
PROSTATE – SPECIFIC ANTIGEN TEST
(PSA).
• The prostate gland produces substances
known as “prostate specific antigen (PSA).
• It can be measured in a blood specimen
and levels increase with prostate cancer (A
number of other conditions example. BPH.
TURP, acute urinary retention, acute
prostatitis)

18. Continue..
 PSA levels are measue in Nano
grams per milliliter ( ng/ml) normal
0.2 to 4.0 ng/ml. Valves more than
4.0 is considered elevate.

19. Ultrasonagraphy
 TRUS (Trans rectal ultrasound)
may performed in patients with
abnormalities detected by DRE and
in those with elevated PSA levels.

20. Prostate fluid or tissue analysis
Specimens of prostate fluid or tissue
may be obtained for culture if
disease or Inflammation of the
prostate gland is suspected

21. Test for male sexual function
If the patient can not engage in sexual
intercourse to his satisfaction, a detailed
history is obtained, additional test, in
lncluding psychological evaluations are
also part of tests, including
psychological evaluations are part of the
diagnostic workup and are usually
conducted by special team.