CHAPTER 17 REPRODUCTIVE SYSTEM DISEASES AND DISORDERS Anatomy

CHAPTER 17 REPRODUCTIVE SYSTEM DISEASES AND DISORDERS

Anatomy and Physiology � Female external structures ○ Vulva ○ Labia majora and labia minora ○ Clitoris ○ Vestibule and vestibular glands ○ Hymen ○ Vaginal orifice 2

Anatomy and Physiology � Female internal structures �Ovaries �Fallopian tubes �Uterus �Cervix �Vagina � Hormones: estrogen and progesterone 3

Anatomy and Physiology � Male external organs �Scrotum and penis 4

Anatomy and Physiology � Male internal organs �Testes �Epididymis �Vas deferens �Urethra �Seminal vesicles �Bulbouretheral and prostate glands 5

Common Signs and Symptoms � Female �Abdominal and pelvic pain �Fever and malaise �Abnormal vaginal discharge �Burning and/or itching of the genitals 6

Common Signs and Symptoms � Female �Pain during sexual intercourse �Any change in breast tissue �Abnormal discharge from the nipple 7

Common Signs and Symptoms � Male �Urinary disorders including frequency, dysuria, nocturia, and incontinence �Pain in the pelvis, groin, or reproductive organs �Lesions on external genitals 8

Common Signs and Symptoms � Male �Swelling or abnormal enlargement of the reproductive organs �Abnormal penile discharge �Burning and/or itching of the genitals 9

Diagnostic Tests � Female �Bimanual examination �Hysterosalpingogram �Papanicolaou smear of cervix �Cervical biopsy �Cone biopsy 10

Diagnostic Tests � Female �Dilatation and Curettage �Laparoscopy �Mammography �Blood tests 11

Diagnostic Tests � Male �Digital rectal examination �Cystoscopy �Biopsy �Laboratory tests including PSA 12

Premenstrual Syndrome � Symotoms prior to menses � Symptoms begin mid-cycle �Headache and nausea �Back and joint pain �Edema and bloating �Weight gain 13

Premenstrual Syndrome � Symptoms begin mid-cycle �Breast tenderness �Sleep disturbances �Irritability �Mood swings �Depression 14

Premenstrual Syndrome � Treatment �Individualized �Dietary changes �Avoid caffeine, chocolate, nicotine, salt, sugar, and alcohol 15

Menstrual Abnormalities � Amenorrhea � Dysmenorrhea � Menorrhagia � Metrorrhagia 16

Endometriosis � Abnormal growth of endometrial tissue outside of the uterus � Common sites of implantation include ovaries, fallopian tubes, abdominal wall, and intestines 17

Endometriosis � Symptoms �Dysmenorrhea �Low back, vaginal, and pelvic cramping �Heavy menses and dyspareunia 18

Endometriosis � Treatment �Hormones �Remission with pregnancy, nursing, and menopause �Panhysterectomy 19

Pelvic Inflammatory Disease � Inflammation of some or all of the pelvic reproductive organs � May include cervicitis, salpingitis, endometritis, oophoritis � Most commonly caused by STDs 20

Pelvic Inflammatory Disease � Symptoms �Fever �Chills �Pain in pelvic area �Leukorrhea � Treatment: antibiotics, analgesics, and rest 21

Ovarian Cyst � Commonly benign fluid-filled sacs on or near the ovary � Two types �Physiologic �Neoplastic 22

Ovarian Cyst � Symptoms �Low back pain �Pelvic pain �Dyspareunia �Nausea and vomiting � Treatment depends on type and size � May resolve by itself or require laparoscopy 23

Fibroid Tumor � Also known as leiomyomas � Benign tumors of smooth uterine muscle � Symptoms �Abnormal uterine bleeding �Excessive menstrual bleeding and pain 24

Fibroid Tumor � Treatment depends on woman’s age and desire for children � Surgical removal of fibroids or hysterectomy � Uterine embolization � Hormone therapy 25

Vaginitis � Inflammation of vagina � Symptoms �Burning and itching �Swelling of vagina and external genitalia 26

Vaginitis � Common type of vaginitis �Candida: fungus or yeast �Trichomonas: parasite �Atrophic: post-menopausal 27

Toxic Shock Syndrome � Found almost exclusively in menstruating women using tampons � Organism: staphylococcus aureus � Symptoms: high fever, vomiting, diarrhea, and dropping blood pressure � Treatment: IV fluids, antibiotics 28

Toxic Shock Syndrome � Symptoms �High fever �Vomiting �Diarrhea �Decreasing blood pressure � Treatment: IV fluids, antibiotics 29

Menopause � Natural halting of menstruation � Occurs between ages 45 and 55 30

Menopause � Common symptoms �Hot flashes and night sweats �Vaginal dryness �Depression �Sleep disorders �Decreased libido � Treatment: hormone therapy, exercise 31

Uterine Prolapse � Uterus protrudes into vagina � Symptoms �Heaviness in pelvis �Urinary stress �Dysuria �Low back pain � Treatment: hysterectomy 32

Cystocele � Herniation of urinary bladder through anterior vaginal wall � Symptoms: pelvic pressure, urinary urgency, frequency, and incontinence � Treatment: depends on degree of herniation 33

Rectocele � Herniation of rectum through posterior vaginal wall � Symptoms: discomfort, constipation, fecal incontinence � Treatment: surgical repair 34

Cervical Cancer � Fifth leading cause of cancer-related death in females � Symptoms: abnormal cervical bleeding � Treatment: surgical removal of tumor 35

Uterine Cancer � Develops in endometrium and spreads to uterine wall � Symptoms: abnormal bleeding in menopausal women � Treatment: surgical removal of uterus and ovaries with radiation 36

Ovarian Cancer � Quite common and often fatal � Symptoms: pressure on the bladder, abdominal or pelvic pain, general feeling of ill health � Treatment: complete hysterectomy, radiation, and chemotherapy 37

Fibrocystic Disease � Most common breast disorder of premenopausal females between the ages of 30 and 55 � Cysts are linked to estrogen levels 38

Fibrocystic Disease � To decrease breast pain: �Reduce caffeine and salt �Use of mild diuretics �Use of mild analgesics the week prior to menstruation is recommended 39

Mastitis � Inflammation of breast tissue � Symptoms �Redness �Heat �Swelling �Pain and often bloody nipple discharge 40

Mastitis � Treatment �Antibiotics �Application of heat �Analgesics �Firm supporting bra to decrease discomfort 41

Breast Cancer � Adenocarcinoma of the breast ducts � Most common breast neoplasm (affects one out of nine females) � Risk factors �Age 40 and over �Family member affected with breast cancer 42

Breast Cancer � Risk factors �Onset of menses before age 13 �Menses continuing after age 50 �Nullipara �First child after age 30 �Obesity �Chronic breast disease 43

Breast Cancer � Symptoms �Non-tender lump of varying size �Occurs most often in upper outer quadrant of breast often with dimpling � Treatment �Mastectomy, chemotherapy, and/or radiation 44

Ectopic Pregnancy � Fertilized ovum attaches to tissue outside the uterus, usually in fallopian tubes � Symptoms �Acute pelvic pain �Vaginal bleeding �Positive pregnancy test 45

Ectopic Pregnancy � Treatment �Prompt surgery to terminate pregnancy �Every effort is taken to preserve ovary and tube if future pregnancy is desired 46

Spontaneous Abortion � “Miscarriage” � Natural termination of pregnancy before fetus is viable � Symptoms �Vaginal bleeding �Cramping and pelvic pain 47

Spontaneous Abortion � Once it starts, progression is difficult to stop � D & C may be necessary to remove any tissue remaining in the uterus 48

Morning Sickness � Associated with first trimester of pregnancy � Symptoms: nausea and vomiting � Treatment �Not necessary unless vomiting �Light meals several times a day 49

Morning Sickness � Treatment �Dry food before drinking �Avoid fatty foods �Rest after meals 50

Hyperemesis Gravidarum � Excessive vomiting during pregnancy � Treatment includes IV fluids and withholding all foods and oral fluids � Usually subsides by second pregnancy 51

Toxemia � Usually appears during 3 rd trimester � Symptoms �Hypertension �Sudden weight gain �Proteinuria �Edema in face, hands, and feet 52

Toxemia � Treatment �Frequent monitoring of blood pressure �Weight and urine protein 53

Abruptio Placentae � Separation of placenta from uterus � Degrees of symptoms �Partial separation may be asymptomatic �Complete separation may cause severe abdominal pain and vaginal bleeding �Shock and decrease in fetal heart tones 54

Abruptio Placentae � Treatment �Prompt delivery either vaginally or by c- section �Blood replacement may also be necessary 55

Placenta Previa � Abnormal positioning of placenta in lower uterus near or over cervical os � Symptoms: painless, bright red vaginal bleeding during third trimester 56

Placenta Previa � Treatment-vaginal delivery is asymptomatic or if bleeding is not severe; emergency c-section if maternal bleeding or fetal anoxia 57

Placenta Previa � Treatment �Vaginal delivery is asymptomatic if bleeding is not severe �Emergency c-section if maternal bleeding or fetal anoxia 58

Prostatitis � Inflammation of prostate gland � Symptoms �Dysuria �Pyuria �Fever and low back pain � Treatment: antibiotics, warm sitz baths, increased fluid intake, analgesics 59

Benign Prostatic Hyperplasia � Enlargement of prostate gland due to normal cells overgrowing and enlarging � Common in men over age 60 60

Benign Prostatic Hyperplasia � Symptoms �Nocturia �Inability to start urination �Weak urinary stream �Inability to empty stream 61

Benign Prostatic Hyperplasia � Treatment �Prostatic massage �Sitz bath �Catheterizations �Regular sexual intercourse �Surgery 62

Prostatic Carcinoma � Neoplasm of prostate gland affecting men over 50 � Second most common cause of cancerrelated deaths in men 63

Prostatic Carcinoma � Symptoms are similar to BPH � Treatment �Depends on age and physical condition of individual �Degree of metastasis 64

Epididymitis � Inflammation of epididymis � Symptoms �Swollen, hard, and painful epididymis �Often accompanied by severe scrotal pain and swelling 65

Epididymitis � Treatment �Rest �Analgesics �Use of a scrotal support �Avoidance of alcohol, spicy foods, and sexual stimulation 66

Orchitis � Inflammation of one or both testes due to viral or bacterial infection � Symptoms: swelling, pain, tenderness of one or both testes, fever, malaise � Treatment: dependent on cause 67

Testicular Tumor � Commonly affect young men age 20 -35 � Most common type of cancer in this group � Symptoms: painless mass felt in testicle � Treatment: orchiectomy, chemotherapy, and radiation 68

Cryptorchidism � Undescended testicle � Premature birth is common cause � Treatment: surgery 69

Genital Herpes � Viral infection � 1 in 6 individuals in United States is infected � Not curable � Periods of remission and exacerbation 70

Genital Herpes � Symptoms �Blister-like lesions causing dysuria �Severe itching � Treatment is symptomatic �Antiviral medications �Sitz baths �Ice therapy and analgesics 71

Gonorrhea � “Clap” � Symptoms �Purulent discharge from penis and vagina �Dysuria �Urinary frequency in males and females �Female - cervicitis �Genital itching and burning pain 72

Gonorrhea � Treatment �Antibiotics including Penicillin �Tetracycline �Ceftiaxone 73

Syphilis � Treatment: Penicillin or Tetracycline is very effective � Three stages �Primary - appearance of painless chancre �Secondary - chancre heals �Period of rest lasting 6 weeks to 1 year 74

Syphilis � Secondary - rash appears � Tertiary �Bacteria invade organs throughout body causing gumma �Curable with antibiotics during this stage but effects of lesions are irreversible 75

Chlamydia � Known as “silent” STD - Bacterial � Symptoms �Drainage with burning and itching �Urination due to urethritis and epididymitis � Treatment: antibiotics 76

Trichomoniasis � Caused by protozoan � Symptoms �Male - urethritis, epididymitis, and prostatitis �Female - green frothy vaginal discharge, itching and burning of genital area 77

Trichomoniasis � Treatment �Antiparasitic medications such as Flagyl 78

Genital Warts � Viral infection � Symptoms �Possible tenderness in affected area � Treatment �Chemical or surgical removal � Cervical cancer related to genital warts 79

Dyspareunia � Pain or discomfort with sexual intercourse � May affect men and women � Treatment is dependent on cause 80

Premature Ejaculation � Expulsion of seminal fluid during foreplay, prior to complete erection, or immediately after sexual intercourse � Common in young males � Treatment is based on cause 81

Infertility � Inability of couple to achieve pregnancy after one year of unprotected sex 82

Infertility � Causes �Presence of STD �Hormonal disorders �Abnormality of reproductive organs �Endometriosis �Scarring or blockage of fallopian tubes �Vaginal antibodies that kill sperm 83

Infertility � Treatment �Based on cause �Surgery �Medication therapy �Hormone imbalance 84

Hydiatidiform Mole � Grape-like cysts in uterus that mimic pregnancy � Treatment: D & C � At higher risk to develop choriocarcinoma requiring frequent follow-up examinations 85