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109 Ch. 49

Male Reproductive Problems

where does the prostate gland lie just below neck of bladder and has 4 zones/4 lobes
what glands lie below the prostate Cowper's glands, provide lubrication during ejaculation
what happens with age in men's reproductive prostate gland enlarges, secretion decr, scrotum lower, testes decr in wt., atrophy/softer, decr in testosterone/progesterone
what is male hypoganadism decr fx of testes at 50 age, decr testosterone
what is prostatism s/s r/t bladder fx and urination
If male pees on/off can be indicative of what enlarged prostate dysuria- painful pee
what is the PLISSIT model for assessment P-permission to talk sex LI-limited info SS-specific suggestions for interventions IT-intensive therapy
what is BETTER model B-bring up topic E-explain T- telling T-timing E- educate R- record
what are two types of physical assessment DRE- screen prostate cancer, yrly 50+ Testicular Exam -
diagnostic tests like the prostate specific antigen (PSA) protein produced by prostate and can test tested...high levels may indicate cancer Other tests: ultrasound, prostate fluid test, test of sex fx
what is erectile dysfx psycho and organic causes Tx: PDE-5 inhibitors: viagra, cialis, levitra: incr blood flow allows muscle relaxing **not if on nitrates**
what is priapism persistent abnormal erection, no longer than 4hrs 3types: ischemic(low flow)- emergency, nonischemic, stuttering
what is prostatitis inflam prostate assoc wtih lower UTI or sex discomfort, ecoli, 4 types
what are other tx for ED drugs, injection, suppository, implants, neg. pressure vacuum Tx: fluids, but keep med level
what is BPH benign prostatic hyperplasia: most common, UTI s/s, older 50%/50yr, 80%/80yr BPH: elevated estrogen and not respong to DHT(metabolite of testosterone) cause dilation of ureters/kidneys
what is tx of BPH drugs(Flomax), catherization, prostate surgery(TURP): insert in urethra and gland is removed in sm. chips
What is most common Ca for men, what is 2nd 1st: skin Ca 2nd: prostate Ca, detect early, 1 in 5 Risk factors: age 65+, hx, Af.Am, fat diet, hx of BPH NOT risk factor
what are two diagnostic tests for prostate Ca DRE: digital rectal exam find hard, nodular PSA: prostate-specific antigen: blood test NOT DEFINITIVE
what is Whitmore-Jewett Staging Classification of Prostate Ca Stage A: clinically unrecog B: intracapsular: contained C: extracap, uncontained D: metastatic disease
what is late s/s for prostate Ca lumbosacral pain - spread into bone
what is standard first line tx for prostate Ca radical prostatectomy: remove prostate, seminal vesicles, tips of vas deferens, nerves/fat/blood vessels @ area
two major radiation therapies external/internal
Hormonal therapy for prostate Ca androgen deprivation therapy(ADT): decr testosterone done by orchiectomy(remove testes)
Other types of surgery for prostatic removal Suprapubic: abd approach and shell it Perineal: incision in perineum Retropubic: low abd incision Transurethral(TUIP): urethra and incise prostate
what risk do all prostectomies pose: impotence b/c of damage to pudendal nerves plus urinary incontinence up to 2yrs
which disorder can make complications more severe after prostectomy BPH bc hyperplastic prostate gland is very vascular and makes hemmorrhage more dangerous
what is greatest risk after prostectomy bleeding, hemorrhagic shock
what are 4 problems with scrotum/testes Epididymitis:infec in epididymis, usually ecoli Orchitis: inflam testes Hydrocele: nontender, fluid-filled mass in tunica vaginalis,scrotal swelling, transmits light Varicocele: dilation of veins that drain testes
what is testicular tortion emergency! Rotation of testis and impedes blood supply to testicle/scrotum
what is most common Ca in men 15-35 testicular Ca, curable, scrotal swelling, painless lump
what are two types of testicular Ca tumors germinal(semisoma)- slow growing, grow from cells produce sperm nongerminal: more metastasis
what is most common secondary cause of testicular Ca lymphoma
Risk factors for testicular Ca cryptorchidism- undescended testicles, hx Tx: remove affected testis
what is involved in vasectomy cut vas deferens, 10-20 ejaculations give sterility or 6wks
what is phimosis? paraphimosis phimosis: foreskin(prepuce) can't be retracted over glans paraphimosis: foreskin once retracted can't be returned
Created by: palmerag