Male Reproductive System.pptx
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Care of the Adult Male Patient with Disorders of Sexuality Presented by Mrs. K. Jones-Fraser RN, BScN, Cert. Nsg. Ed. MScN, PhD Candidate Objectives At the end of the lesson students should be able to: i...
Care of the Adult Male Patient with Disorders of Sexuality Presented by Mrs. K. Jones-Fraser RN, BScN, Cert. Nsg. Ed. MScN, PhD Candidate Objectives At the end of the lesson students should be able to: identify correctly the structures of the male reproductive system based on class discussion state four main functions of the male reproductive system as outlined in the text explain correctly the management of the adult patient with disorders of sexuality (male) based on class discussion outline correctly the nursing management of the adult patient with disorders of sexuality (male) using the nursing process Male Reproductive System Structures of the Male Reproductive system Testes Ducts - ductus deferens, ejaculatory ducts and urethra Accessory sex glands – seminal vesicles, prostate glands and bulbourethral glands Supporting structure – scrotum and penis Functions of the Male Reproductive System Testes – produces sperm and the male sex hormone testosterone Ducts – transport, store and assist in maturation of sperm Accessory sex glands – secrete most of the liquid portion of semen Penis – contains the urethra, a passageway for ejaculation of semen and excretion of urine Scrotal Problems Hydrocele Orchitis Hydrocele Hydrocele is a swelling of the scrotum caused by accumulation of fluid, especially in the tunica vaginalis surrounding the testes (Wells & Weller, 2004) Hydrocele Signs and symptoms There are two types Painless swelling to of hydroceles: scrotum 1. communicating 2. non-communicating Hydrocele Communicating hydroceles - are present at birth and occur because of the failure of the "tail" end of the process vaginalis to completely close off. Non- communicating hydrocele – are also present at birth and in older males. The tail end of the process vaginalis has closed. The fluid surrounding the testicle is created by the lining cells of the process vaginalis and is unable to either drain or be reabsorbed efficiently and thus accumulates. Hydrocele Process vaginalis sac or hallow organ of the peritoneal membrane that during embryonic development extends through the inguinal canal. In males it descends into the scrotum to form the tunica vaginalis testis Normal Anatomy Communicating Hydrocele Non –Communicating Hydrocele Hydrocele Diagnostic investigation History Physical examination Otoscope - the fluid filled nature of the hydrocele side is distinctly different from the non-involved side of the scrotum. Ultrasound or X-ray Hydrocele Management Surgery - a hydrocelectomy is performed Nursing management Assessment Problem identification Interventions Orchitis Definition Orchitis is inflammation of the testes Etiology Viral mumps infection sexually transmitted diseases (STD), such as gonorrhea or chlamydia. Orchitis Signs and symptoms Blood in the semen Discharge from penis Fever Groin pain Pain with intercourse or ejaculation Dysuria Scrotal swelling Tender, swollen, heavy feeling in the testicle Orchitis Diagnosis History Physical examination Tests may include: Complete blood count Testicular ultrasound Tests to screen for chlamydia and gonorrhea (urethral smear) Urine culture -- may need several samples, including initial stream, midstream, and after prostate massage Orchitis Management Antibiotics Anti-inflammatory medications Bed rest with the scrotum elevated and ice packs applied to the area Prostatitis Prostatitis is an inflammation of the prostate gland (Brunner & Suddarth’s, 2008) Etiology Infectious agents – bacteria, fungi Urethral stricture, benign prostatic hyperplasia Prostatitis Types of prostatitis Acute bacterial prostatitis Chronic bacterial prostatitis Chronic nonbacterial prostatitis/chronic pelvic pain syndrome. Asymptomatic inflammatory prostatitis Prostatitis Clinical manifestations Hyperthermia Dysuria Nocturia Frequent urination Lower abdominal pain Prostatitis Diagnosis History Physical examination A digital rectal exam - to determine if prostate gland is enlarged or tender Prostate fluid analysis -for signs of infection Transrectal ultrasound Biopsy Voiding studies - to determine which part of the urinary system is infected. Prostatitis Management Pharmacologic agents - Anti-inflammatory, antibiotic medication and muscle relaxants. Surgery - surgical removal of the infected portions of the prostate. Prostatitis Nursing management History Physical assessment Problem identification Interventions Benign Prostatic Hyperplasia Benign prostatic hyperplasia (benign prostatic hypertrophy, BPH)- is enlargement of the prostate gland Causes Genetics Age Changes in hormone balance and in cell growth Benign Prostatic Hyperplasia Clinical manifestations Trouble getting a urine stream started and completely stopped (dribbling). Often have an urge to pass urine A weak urine stream. A sense that the bladder is not completely empty after you urinate. Benign Prostatic Hyperplasia Investigations History Physical examination Urinalysis Blood test - serum creatinine Digital rectal exam - feel the size of the prostate. A prostate-specific antigen (PSA) test is done to rule out prostate cancer Benign Prostatic Hyperplasia Complications Acute urinary retention Urinary tract infections (UTIs Bladder stones. Benign Prostatic Hyperplasia Management Medication therapy Alpha blockers -relax bladder neck muscles and muscle fibers in the prostate itself and make it easier to urinate. Example doxazosin (Cardura), tamsulosin (Flomax), 5 alpha reductase inhibitors - shrink the prostate by preventing hormonal changes that cause prostate growth, e.g finasteride (Proscar) Surgery - prostatectomy Benign Prostatic Hyperplasia Nursing management History Physical examination Nursing process Cancer of the Prostate Prostate cancer is a Risk factors: malignant (cancerous) Black men are twice disease that consists of cells from the prostate likely as Caucasian gland. to get it Etiology Family history Unknown Obesity Mutations in the Smoking abnormal cells' DNA Sedentary lifestyle cause the cells to grow and divide Cancer of the Prostate Clinical manifestations Trouble urinating Decreased force in the stream of urine Blood in the urine Blood in the semen Swelling in the legs Discomfort in the pelvic area Bone pain Cancer of the Prostate Diagnosis Digital rectal exam Prostate-specific antigen (PSA) test Transrectal ultrasound Sample of prostate tissue Bone scan – to determine the extent of the cancer Computerized tomography (CT) scan - to determine the extent of the cancer Magnetic resonance imaging (MRI)- to determine the extent of the cancer Cancer of the Prostate Management Radiation therapy Hormone therapy Surgery Vasectomy Vasectomy is the surgical excision of part of the vas deferens (Wells & Wellers, 2004) A vasectomy is considered a permanent method of birth control. It prevents the release of sperm when the man ejaculates. Vasectomy Advantages Disadvantages A vasectomy does not Vasectomy is a permanent protect against sexually method of birth control. transmitted diseases(STDs). Once your semen does not It is expensive contain sperm, there is no It should be used with a need to worry about using condom to prevent the other birth control transfer of infections methods. It may take a few months Vasectomy is a safe before the semen is free procedure from sperm. Vasectomy Management Before procedure Counseling Education Stop taking aspirin or other blood-thinning medications Wash your genital area thoroughly Vasectomy After procedure Counseling Education Support the scrotum Limit activity Use an ice pack Avoid blood-thinning medications for three to seven days after surgery Refrain from bathing or swimming Avoid any sexual activity for a week Keep appointment Report signs of infection Erectile Dysfunction Erectile dysfunction (ED) is the inability to achieve or sustain an erection suitable for sexual intercourse. Erectile Dysfunction Etiology - can be both physical and psychological Physical causes Chronic illnesses - hypertension, high cholesterol and diabetes Hormonal problems Ineffective blood flow to penis Surgery or injury Psychological causes Anxiety Depression Relationship problems Erectile Dysfunction Signs and symptoms Inability to get and maintain an erection for satisfactory intercourse. Erectile Dysfunction Diagnostic investigations History Physical examination Digital rectal examination Blood investigation – hormone level of testosterone Psychological assessment Erectile Dysfunction Management Medication- hormone replacement Psychological treatment Surgery Disorders of Sexuality (male) Testicular cancer Cancer of the penis References Smeltzer, S.C., Bare, B.G., Hinkle, J.L., & Cheever, K.H, (2008). Textbook of medical and surgical nursing. Philadelphia PA: Lippincott Williams & Wilkins. Tortora, G.J, & Grabowski, S., (2002). Principles of anatomy and physiology. USA: John Wiley & Sons. www.medicinenet.com/prostate_cancer/ article.htm
