Test 5 Male Reproductive Shi

Question 1

What symptoms can be related to urinary obstruciton?

Answer 1

Increased urinary frequency
Decreased force of stream
Double or triple voiding
Nocturia, dysuria, hematuria, hematospermia

Question 2

Plissit model

Answer 2

Used to assess and address patients sexual concerns in a sensitive way

P- Permission
L- Limited Information
S- Specific Suggestions
I- Intensive Therapy

Question 3

Digital Rectal Exam facts

Answer 3

Recommended annualy for men over 50
Recommended over 45 of age for high risk ; African American and men w family history

Question 4

Diagnostic tests for male stuff

Answer 4

Prostate Specific Antigen PSA
Ultrasonography
Prostate Fluid or tissue analysis
Tests of male sexual function

Question 5

Disorders of male sexual function

Answer 5

Erectile Dysfunction
* Can be from anxiety, fatigue, depression
* From vascular problems, endocrine, neurologic, alcohol
* Medications can cause

Ejaculation Problems
* Premature
* Retrograde

Question 6

Medical Management of ED

Answer 6

Sildenafil : can cause headache, flushing, dyspepsia ; caution w retinopathy ; contraindicated with nitrate use

Question 7

What is prostatitis?

Answer 7

Inflammation caused by infectious agent
Acute bacterial: Sudden onset of fever dysuria, perineal prostatic pain
Chronic Bacterial: Typically Asymptomatic
Chronic Prostatitis/ Chronic pelvic pain syndrome: Genitourinary Symptoms with no bacteria in urine
Asymptomatic inflammatory prostatitis: Diagnosed incidentally, elevated PSA

Treatment: Anti- infective agent and measures to alleviate pain and spasm

Question 8

What is Benign Prostatic Hyperplasia? (BPH)

Answer 8

Enlarged Prostate
Affects half of older men older than 40 and half od men older than 60
Manifestations: Urinary Obstruction, retention, UTI’s
Develops over a period of time ; changes in urinary tract slow and insidious
Symptoms: Depend on severity ; dysuria, hesitancy, sensation of incomplete bladder emptying

Question 9

Management of BPH

Answer 9

Medical:
* Alpha- andrenergic blockers
* Measures to reduce pain and spasms
* Catheter for acute condition ; unable to void

Surgical
* Minimal invasive therapy
* Surgical resection
* TURP

Question 10

Prostate Cancer

Answer 10

Risk Factors: Increasing Age, familial predisposition, being black

Manifestations: Early on has few or no symptoms
Urinary obstruction, blood in urine or semen, painful ejaculation
Symptoms of metastasis may be the first manifestations

Treatment: Therapeutic Vaccine , prostatectomy, radiation therapy, hormonal therapy, chemotherapy

Question 11

What’s orchitis?

Answer 11

Inflammation of one or both testes ; commonly viral or bacterial
Manifestations: Testicular Pain, swelling, fever, systemic symptoms like malaise
Management: Supportive Care, pain relief, scrotal support, antibiotics if bacterial

Question 12

Epididymitis

Answer 12

Inflammation of the epididymis ; due to STI like chlamydia, gonnorhea, UTI’s, or trauma
Manifestations: Scrotal Pain, unilateral swelling, fever, bloody semen, dysuria
Management: Antibiotics, scrotal support, pain relief, Partner treatment is required if sti is found ; No sex or masturbation , scrotal elevation and sitz bath

Question 13

Testicular Cancer

Answer 13

Most Common cancer in men 15-40
Highly treatable and curable
Risk Factors: Undescended Testicles, positive fam history, cancer of one testicle, caucasian
ManifestationsL Painless lump or mass in ball
Early diagnosis: Monthly testicualr exam and annual exam
Treatment: Orchidectomy, retroperitoneal lymph node dissection (open or laparascopic) , radiation therapy, chemo

Question 14

Nursing Management of testicular cancer

Answer 14

Assessment of physical and psychological status
Support and coping
Address issues of body image and sexuality
Encourage a positive attitude
Patient education
TSE and follow up care

Question 15

Conditions effecting the penis

Answer 15

Hypospadias and epispadias: Urethral meatus is displaced
Phimosis: Tightening of foreskin ; treat w topic corticosteroids or circumcision
Penile Cancer: Bowen disease ; rare early stage squamous cell carcinoma found on skin of penis ; treat with topical stuff, laser therapy, cryotherapy, surigical excision,
Priapism: Boner lasting 4 or more hours not associated w sexual arousal , surgical emergency, aspiration of blood
Peyronies Disease: Scar tissue causes dih to bend , oral meds like pentoxifylline , injection therapy like collagenase, surgery
Urethral SStricture: Narrowing of the urethra ; manage using urethral dilation