Miscellaneous Male Disorders PDF

Priapism, Hydrocele, Spermatocele, Varicocele, and Testicular Torsion. D R. S I B I P E T E R , P H D , R N, C C R N Priapism  Priapism Is a painful erection lasting longer than 6 hours. Caused by: an obstruction of the venous outflow in the penis. The condition...

Priapism, Hydrocele, Spermatocele, Varicocele, and Testicular Torsion. D R. S I B I P E T E R , P H D , R N, C C R N Priapism  Priapism Is a painful erection lasting longer than 6 hours. Caused by: an obstruction of the venous outflow in the penis. The condition may constitute a medical emergency.  Priapism Few conditions that can cause priapism are: Thrombosis of the Leukemia. corpora cavernosal veins. Neoplasm's of the brain or spinal cord. Sickle Cell Anemia. Medications like sildenafil (Viagra), Diabetes Mellitus. trazodone, or cocaine.  Priapism’s treatment includes: Sedatives. Injection of smooth muscle relaxants directly into the penis. Aspiration and irrigation of the corpora cavernosa with a large bore needle. Or the surgical creation of a shunt to drain the corpora.  Complications of priapism: Penile tissue necrosis. Inability to achieve a normal erection.  Peyronie’s disease A crooked or curved penis during an erection. Caused by plaque formation in one of the corpora cavernosa of the penis. Not dangerous but can cause: painful erections, erectile dysfunction, and/or embarrassment. If conservative measures cannot fix then surgery may be necessary.  Hydrocele Is a non-tender, fluid filled mass. Caused by: an interference with the lymphatic drainage of the scrotum. Resulting in: swelling of the tunica vaginalis that surrounds the testis.  Hydrocele Diagnosis is accomplished by transillumination of the scrotum. Treatment is not indicated unless the swelling becomes very large and uncomfortable, in which case aspiration or surgical drainage of the mass is performed.  Spermatocele  Is a firm, sperm- containing, painless cyst of the epididymis.  Cause: unknown  Treatment: surgical removal.  Patient should seek additional care from health care provider if scrotal lumps are felt during self examination. Varicocele  Is a dilation of the veins that drains the testis.  Cause: unknown.  Assessment: feels wormlike when palpated.  Located usually on the left side of the scrotum.  Surgery indicated if the patient is infertile.  Repaired either by injection of a sclerosing agent or by surgical ligation of the spermatic vein.  Testicular Torsion Involves a twisting of the spermatic cord which supplies blood to the testis and the epididymis. Common in males younger than 20.  Testicular Torsion Symptoms exhibited Diagnose by: are:  Severe scrotal pain Cremasteric reflex  Tenderness absent on side of  Swelling swelling.  Nausea Nuclear scan of the  Vomiting testes or doppler  Pain that does not ultrasound used to subside with rest or asses blood flow to elevation of the confirm diagnosis. scrotum.  Testicular Torsion Can resolve spontaneously. If unable to resolve surgery is required immediately to untwist the cord and restore blood supply. Restoration of blood flow is a surgical emergency. If the blood supply to the affected testicle is not restored within 4 to 6 hours, ischemia to the testis will occur.  NCLEX Question In assessing a patient for testicular cancer, the nurse understands that manifestations of this disease often include: a. acute back spasms and testicular pain. b. rapid onset of scrotal swelling and fever. c. fertility problems and bilateral scrotal tenderness. d. painless mass and heaviness sensation in the scrotal area.  NCLEX Question Answer D  The patients most common complaint is a dull ache or heavy sensation in either the lower abdomen, perianal area, or scrotum. The cancer also manifests as a painless mass.  NCLEX Question A patient recently admitted in the ER presents symptoms of hydrocele. In assessing the patient what can a nurse do? a. Assess the events leading up to the patients painful erection. b. Use transillumination. c. Palpate for a wormlike scrotum. d. Obtain a culture of the wound.  NCLEX Question Answer B With the use of transillumination the nurse will be able to easily see the fluid filled mass.  NCLEX Question In assessing a patient who possibly has testicular torsion which of the following actions can the nurse do? a. Palpate for scrotal lumps. b. Use transillumination. c. Observe for an absent cremaster reflex. d. Obtain a chest x-ray of the patient.  NCLEX Question Answer C When a patient is admitted with the possibility of having testicular torsion the nurse can do the cremaster reflex which will result in a absent response confirming diagnosis.  NCLEX Question During patient teaching about testicular self- examination, the nurse instructs the patient to report a finding of: a. An irregular-feeling epididymis. b. One testis larger then the other c. The spermatic cord within the testicle d. A firm, nontender nodule on the testis.  NCLEX Question Answer D Testicular tumors most often present on the testis as a lump or nodule that is very firm, nontender, and cannot be transilluminated. There may also be scrotal swelling and a feeling of heaviness. All the other options are normal findings.