male reproductive problems

• glandular units in the prostate that undergo an increase in the number of cells, resulting in enlargement of the prostate gland
• when it enlarges it causes bladder outlet obstruction

increase in number of cells

enlargement

• Urinary retention
• Overflow urinary incontinence
• UTIs
• Bladder stones
• Inability to void
• Hydroureter
• Hydronephrosis

• urinary pattern - frequency, nocturia
• lower urinary tract symptoms - hesitancy, intermittency, reduced force and size of urinary stream, sensation of incomplete bladder emptying, post-void dribbling
• hematuria - possibly related to UTI

palpated through the rectal wall by digital examination

• Prostate-specific antigen - for prostate cancer, prostatitis
• BUN/Creatinine
• CBC - infection, anemia

• 5-alpha reductase inhibitor
• Flomax - increase urine flow
• alpha blockers
• estrogens and androgens
• antimuscarinic

• Drug therapy
• Thermotherapy

transurethral resection of the prostate - lighted scope up penis and remove prostate in small pieces - remove enough to open up urethra so they can urinate - prostate may grow again

• three way urinary catheter with 30-45 mL retention balloon
• traction via taping to patient's abdomen or thigh
• patient will have an uncomfortable urge to void continuously
• give antispasmodic meds for bladder spasms
• at risk for bleeding 24 hrs post-op - want to see only watered down, dark red bleeding (not bright red or ketchup)

• monitor fluid intake - 2000-2500/day to decrease dysuria and keep urine clear
• teach patient that they may feel burning in urination, and have some urinary frequency, dribbling and leakage but this will resolve in several days

• most common invasive cancer among men in the US
• one of the slowest growing malignancies and metastasizes in a predictable pattern
• first symptoms are related to BPH

Stony/hard

• PSA - above 4 ng/mL
• a biopsy is necessary to confirm

Yes - surgery if it's caught early

No it just promotes urination

palliative - slows spread of disease by removing main source of testosterone

• hydration IV therapy
• wound drains
• prevent emboli/pulmonary complications
• antibiotics
• analgesics
• laxatives/stool softeners
• indwelling urinary catheter - will be discharged with it
• antispasmodics

• Urinary incontinence
• ED

• radiation
• hormone - androgen deprivation
• chemotherapy
• cryotherapy
• CAM - lykopene (tomato substances), omega 3 fatty acids and soy protein

inability to achieve or maintain an erection for sexual intercourse

gradual deterioration of function r/t diabetes, HTN, smoking, alcohol, surgery or other causes

Psychological - related to stress, alcohol consumption

• drug therapy (first line) - Viagra, Levitra, Cialis
• no alcohol before intercourse

• headache
• facial flushing
• stuffy nose
• don't take nitrates = profound hypotension and reduced blood flow to vital organs

• cylinder that fits over the penis and sits firmly against the body
• the vacuum draws blood into the penis to maintain an erection
• a rubber ring (tension band) is placed around base of penis to maintain the erection and the cylinder is removed

vasodilating - Caverject, Paverine, Regitine

• alprostadil is self-administered suppository that is placed in the urethra with an applicator
• erection occurs in about 10 min and lasts 30-60 min
• burning of the urethra can occur after application, as well as syncope

• prosthesis - penile implant which is semirigid, malleable or hydraulic inflatable and multicomponent or one-piece
• the reservoir is placed in the scrotum
• major disadvantage - device failure; infection

it is rare but it is the most common malignancy in men 15-34 years old

• testicular self-examination
• biomarker proteins (present during embryonic development but abnormal in adults)- Alpha-fetoprotein (AFP); Beta human chorionic gonadotropin (hCG); elevated LDH
• ultrasound
• CT scan
• MRI

• Germ cell - arise from sperm-producing cells
• Non-germ

• surgery - main treatment
• sperm banking pre-op
• nonsurgical - chemo/radiation

• cystic mass filled with straw colored fluid that forms around the testis resulting from impaired lymphatic drainage of the scrotum, causing swelling of the tissue surrounding the testes
• usually painless
• can be ginormous
• more common in older men

• drained via needle and syringe
• removed surgically

• sperm containing cyst the develops on the epididymis alongside the testicle
• normally small and asymptomatic and require no interventions

• cluster of dilated veins behind and above the testis
• can cause infertility
• removed through an inguinal incision and the spermatic veins are ligated in the spermatic cord

Circumcision in infancy

Penile cancer

• in uncircumcised men
• constricted prepuce that cannot be retracted over the glans
• prepuce remains down around the tip of the penis
• emergency situation = circumcision required

• in uncircumcised men
• prepuce has not been returned to normal position after being retracted and forms a constricting band around the glans
• emergency situation = circumcision required

• uncontrolled and long-maintained erection without sexual desire
• causes penis to become large and painful
• shuts of fresh blood supply
• can't pee

• thrombosis of veins of corpora cavernosa
• leukemia
• sickle cell disease
• DM
• malignancies
• abnormal reflex
• some drug effects
• recreational drugs
• prolonged sexual activity

• to improve the venous drainage of the corpora cavernosa
• meperidine
• warm enemas
• urethral or suprapubic catheterization
• large-bore needle or surgical intervention

• inflammation of the prostate gland
• - acute bacterial or chronic bacterial
• nonbacterial/chronic pelvic pain syndrome
• asymptomatic inflammatory prostatitis

• inflammation of the epididymis resulting from an infection or noninfectious sources (trauma)
• treatment = bedrest with scrotum elevated on a towel and scrotal support when ambulating
• comfort measures

• acute testicular inflammation resulting from trauma or infectoin
• treatment = bedrest with scrotal elevation, ice and analgesics/antibiotics

get this 20 days after adult male has mumps after pubery - 20% of men