Download Male Reproductive Problems

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

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
 Complications
 Diagnostic Studies

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
5
Benign Prostatic Hyperplasia

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

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

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

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
 Nursing Diagnoses
 Planning

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
11
Nursing Management: Benign
Prostatic Hyperplasia

Nursing Implementation
• Health promotion
• Acute intervention
• Preoperative care
• Postoperative care
• Ambulatory and home care

Evaluation
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
12
Prostate Cancer
Etiology and Pathophysiology
 Clinical Manifestations and
Complications

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
 Collaborative Care

• 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

Collaborative Care
• Surgical therapy, continued
• Nerve-sparing procedure
• Cryotherapy
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
17
Prostate Cancer

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 and a
template grid. B, Radioactive seeds.
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
19
Prostate Cancer

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
 Nursing Diagnoses
 Planning
 Nursing Implementation

• Health promotion
• Acute intervention
• Ambulatory and home care

Evaluation
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
22
Prostatitis
Etiology and Pathophysiology
 Clinical Manifestations and
Complications
 Diagnostic Studies

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
 Epididymitis

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

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

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
 Varicocele
 Testicular Torsion

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
37
Testicular Cancer
Etiology and Pathophysiology
 Clinical Manifestations and
Complications
 Diagnostic Studies

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
38
Nursing and Collaborative
Management: Testicular Cancer

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

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
 Clinical Manifestations and
Complications
 Diagnostic Studies

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
44
Erectile Dysfunction

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