Nursing Management Male Reproductive Problems Chapter 55 Overview

Nursing Management: Male Reproductive Problems Chapter 55 Overview Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc.

Problems of the Prostate Gland Fig. 55 -1. Areas of the male reproductive system in which problems are likely to develop. Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 2

Benign Prostatic Hyperplasia l Etiology and Pathophysiology Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 3

Benign Prostatic Hyperplasia Fig. 55 -2. Benign prostatic hyperplasia. The enlarged prostate compresses the urethra. Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 4

Benign Prostatic Hyperplasia Clinical Manifestations l Complications l Diagnostic Studies l Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 5

Benign Prostatic Hyperplasia l Collaborative Care • Drug therapy • 5 -reductase inhibitors • -adrenergic receptor blockers Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 6

Benign Prostatic Hyperplasia l Collaborative Care, continued • Minimally invasive therapy • Transurethral microwave thermotherapy • Transurethral needle ablation of prostate • Laser prostatectomy • Intraprostatic urethral stents Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 7

Benign Prostatic Hyperplasia l Collaborative Care, continued • Invasive therapy • Transurethral resection of prostate Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 8

Benign Prostatic Hyperplasia Fig. 55 -3. Transurethral resection of the prostate. Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 9

Benign Prostatic Hyperplasia l Collaborative Care • Invasive therapy, continued • Transurethral incision of prostate Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 10

Nursing Management: Benign Prostatic Hyperplasia Nursing Assessment l Nursing Diagnoses l Planning l Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 11

Nursing Management: Benign Prostatic Hyperplasia l Nursing Implementation • Health promotion • Acute intervention • Preoperative care • Postoperative care • Ambulatory and home care l Evaluation Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 12

Prostate Cancer Etiology and Pathophysiology l Clinical Manifestations and Complications l Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 13

Prostate Cancer Fig. 55 -4. Metastasis of prostate cancer to the pelvis and lumbar spine. Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 14

Prostate Cancer Diagnostic Studies l Collaborative Care l • Conservative therapy • Surgical therapy • Radical prostatectomy Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 15

Prostate Cancer Fig. 55 -5. Common approaches used to perform a prostatectomy. A, Retropubic approach involves a midline abdominal incision. B, Perineal approach involves an incision between the scrotum and anus. Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 16

Prostate Cancer l Collaborative Care • Surgical therapy, continued • Nerve-sparing procedure • Cryotherapy Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 17

Prostate Cancer l Collaborative Care, continued • Radiation therapy • External beam radiation • Brachytherapy Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 18

Prostate Cancer Fig. 55 -6. A, Prostate brachytherapy. Implantation of seeds with a needle guided by ultrasound a template grid. B, Radioactive seeds. Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 19

Prostate Cancer l Collaborative Care, continued • Drug therapy • Hormonal therapy • Luteinizing-hormone–releasing hormone (LHRH) agonists and antagonists • Androgen receptor blockers • Estrogen • Orchiectomy • Chemotherapy Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 20

Culturally Competent Care: Prostate Cancer Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 21

Nursing Management: Prostate Cancer Nursing Assessment l Nursing Diagnoses l Planning l Nursing Implementation l • Health promotion • Acute intervention • Ambulatory and home care l Evaluation Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 22

Prostatitis Etiology and Pathophysiology l Clinical Manifestations and Complications l Diagnostic Studies l Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 23

Nursing and Collaborative Management: Prostatitis Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 24

Problems of the Penis Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 25

Congenital Problems Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 26

Problems of Prepuce Fig. 55 -7. A, Phimosis. Unable to retract the foreskin due to secondary lesions on the prepuce. B, Paraphimosis. Ulcer with edema from foreskin remaining contracted over the prepuce. Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 27

Problems of Erectile Mechanism Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 28

Cancer of Penis Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 29

Problems of the Scrotum and Testes Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 30

Inflammatory and Infectious Problems Skin Problems l Epididymitis l Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 31

Inflammatory and Infectious Problems Fig. 55 -8. Scrotal masses. Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 32

Inflammatory and Infectious Problems l Orchitis Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 33

Congenital Problems Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 34

Acquired Problems l Hydrocele Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 35

Acquired Problems Fig. 55 -9. Hydrocele. Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 36

Acquired Problems Spermatocele l Varicocele l Testicular Torsion l Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 37

Testicular Cancer Etiology and Pathophysiology l Clinical Manifestations and Complications l Diagnostic Studies l Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 38

Nursing and Collaborative Management: Testicular Cancer l Testicular Self-Examination Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 39

Nursing and Collaborative Management: Testicular Cancer Fig. 55 -10. Testicular self-examination. Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 40

Nursing and Collaborative Management: Testicular Cancer l Collaborative Care Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 41

Sexual Functioning Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 42

Vasectomy Fig. 55 -11. Vasectomy procedure. The vas deferens is ligated or resected for the purpose of sterilization. Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 43

Erectile Dysfunction Etiology and Pathophysiology l Clinical Manifestations and Complications l Diagnostic Studies l Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 44

Erectile Dysfunction l Collaborative Care • Oral drug therapy • Vacuum constriction device • Intraurethral devices • Penile implants • Sexual counseling Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 45

Nursing Management: Erectile Dysfunction Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 46

Andropause Table 55 -12. Clinical Manifestations of Andropause. Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 47

Infertility Copyright © 2011, 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 48