Male Reproductive Disorders

1
Male Reproductive Disorders STDs

• Chapters 39, 41 42
• By Angie Lawson RN, BSN

2
Male AP Review

• External Structures
• Penis
• Scrotum
• Internal Structures
• Testes
• Epididymidis
• Vas deferens
• Seminal vesicles
• Prostate gland
• Bulbourethral glands

3
Assessment

• History
• Risk for STDs
• Contraceptive use
• Ability to achieve sustain an erection
• Pain during intercourse
• Premature ejaculation
• Infertility
• Prior surgeries or treatments

4
Assessment cont

• Physical Examination
• Transillumination
• Testicular self exam
• Breast self -exam
• Diagnostic Tests
• Ultrasound
• Cystourethroscopy
• Fertility tests

5
Prostatitis

• Inflammation of the prostate gland
• Pain/discomfort
• Low back pain
• Fever
• Chills
• Dysuria
• Urethral discharge

6
Benign Prostatic Hyperplasia

• An increased number of noncancerous cells in the
  prostate bland
• Symptom onset is gradual
• Inability to void
• Medications Treatments
• TURP
• Terazosin (Hytrin)
• Finasteride (Proscar)

7
Prostate Cancer

• Prostatic cancer grows slowly and has a high
  survival rate if detected early.
• No symptoms at first, later urinary frequency,
  nocturia and dysuria

8
Penile Disorders

• Peyroniess Disease
• Priapism
• Phimosis Paraphimosis

9
Priapism

• Persistent Engorgement of the penis without
  sexual stimulation
• Causes drug side effects or vascular problem

10
Phimosis Paraphimosis

• Pain with erection and intercourse
• Unable to retract the foreskin

• Painful swelling of the glans, severe edema and
  urinary retention.
• Strangulation of the glans penis by the foreskin

11
Penile Cancer

• Rare, possibly cause by chronic skin irritations
• Lesion on the penis, that may become infected
  over time.

12
Testicular Disorders

• Cryptorchidism
• Hydrocele
• Varicocele

13
Cryptorchidism

• No signs and symptoms noted
• Scrotum feels empty

14
Hydrocele, Spermatocele Varicocele

• All present as swelling of the scrotum
• Hydrocele
• fluid around testicles-no teatment
• Spermatocele
• cystic mass on epididymis - no teatment
• Varicoceles
• dilated veins untreated causes infertility

15
Epididymitis Orchitis

• Inflammation of the epididymis

• Inflammation of the testis

• Pain, swelling, fever, chills, scrotal skin red
  and tense

16
Testicle Cancer

• Cancer in the testicle, that is a highly
  metastasizing cancer
• Swelling of the scrotum, a noticeable lump,
  abdominal pain, weakness aching in the testes.

17
Sexual Functioning

• Vasectomy
• Erectile dysfunction
• Impotence
• Inability to achieve or maintain an erection
• Causes aging, testosterone insufficiency, drug
  side effects, atherosclerosis, hypertension,
  diabetes, anxiety or depression
• Infertility

18
Vasectomy

• Done in a Dr. Office, ligation of the vas
  deferens
• Vasovasostomy a surgical attempt to reverse a
  vasectomy

19
Sexually Transmitted Diseases(STDs)
20
Common STDs

• Chlamydia
• Gonorrhea
• Herpes Infection
• Venereal Warts

21
Chlamydia

• Most common, fastest spreading, caused by
  chlamydia trachomatis
• Most are asymptomatic, if they occur, clear
  urethral discharge, redness, irritation, dysuria,
  lower abd pain, or testicular pain

22
Gonorrhea

• High incidence in 15-24 yr olds, caused by
  Neisseria Gonorrhoeae
• Many women are asymptomatic, but may have
  white/yellow discharge, cervicitis, dysuria, men
  have urethritis

23
Syphilis

• Curable, transmitted from blood, caused by the
  spirochete, Treponema pallidum
• Early-painless papule, later-papule ulcerates,
  fever, malaise, rash, headache, sore throat,
  lymph node enlargement

24
Trichomonas

• May also be transmitted through nonsexual contact
• Redness, swelling, itching, and burning

25
Herpes Infection

• Highly contagious, not curable, caused by herpes
  simplex virus type 2
• Vesicles on the penis, prepuce, buttocks, thighs,
  introitus, or cervix, burning itching,
  ulcerations, flu symptoms, headache

26
Genital Warts

• Called condylomas, reoccuring, more susceptible
  in immunodeficient people
• Painless, single or in a cluster, soft, fleshy
  growths, turn white when vinegar is applied

27
Hepatitis B

• Early signs - loss of appetite, rashes, malaise,
  pain, headaches, nausea, vomiting
• Hepatitis B liver cancer
• Late signs dark urine, light stool, jaundice,
  spleen enlargement, liver tenderness cirrhosis,
  coma, death

28
Genital Parasites

• Not a true STD, but can be transmitted through
  close body contact
• Lice Scabies

29
Pharmacology

• Penecillin
• Uses syphilis, gonorrhea
• Adverse reactions glossitis, stomatitis,
  gastritis, furry tongue, nausea vomiting
• Norfloxacin
• Uses uncomplicated gonorrhea, prostatitis
• Adverse reactions diarrhea, headache, abdominal
  discomfort, superinfections

30
Pharmacology Cont

• Metronidazole (flagyl)
• Uses trichomonas
• Adverse reactions- nausea, anorexia, seizures,
  numbness
• Spectinomycin (trobicin)
• Uses gonorrhea
• Adverse reacions soreness at inj. site.
  urticaria, sudden decrease in blood pressure.

31
Pharmacology Cont

• Acyclovir (Zovirax)
• Uses herpes simplex, herpes zoster
• Adverse Reactions N V, diarrhea, headache,
  dizziness, lethargy, rashes
• Docosanol (Abreva)
• Uses HSV types 12
• Adverse reactions headache, skin rash

32
Pharmacology Cont

• Imiquimod
• Uses external genitalia and perianal warts
• Adverse reactions local skin irritations,
  itching, excoriation
• Indinavir
• Uses HIV infections
• Adverse reactions headache, NV, diarrhea,
  cough, dysuria, acne

33
Pharmacology Cont

• Valacyclovir (valtrex)
• Uses HSV type 2 herpes zoster
• Adverse reactions NV, headache, dizziness,
  anorexia, diarrhea
• Zidovudine AZT (retrovir)
• Uses HIV infection
• Adverse reactions asthenia, malaise, weakness,
  headache, anorexia, diarrhea, NV, dizziness,
  insomnia, anemia, agranulocytosis

34
Pharmacology Cont

• Fluconazole (diflucan)
• Uses vaginal candidiasis
• Adverse reactions headache, NV, diarrhea, skin
  rash
• Ibuprofen (motrin, advil)
• Uses painful dysmenorrhea
• Adverse reactions nausea, dizziness, dyspepsia,
  gastric/duodenal ulcer formation, GI bleeding,
  headache

35
Pharmacology Cont

• Naproxen (aleve, anaprox)
• Uses dysmenorrhea
• Adverse reactions dizziness, visual
  disturbances, headache, NV, gastric/duodenal
  ulcers
• Rofecoxib (vioxx)
• Uses primary dysmenorrhea
• Adverse reactions headache, dizziness, insomnia,
  rash, dyspepsia, fatigue

36
Pharmacology Cont

• Urofollitropin (Fertinex)
• Uses induction of ovulation
• Adverse reactions ovarian enlargement, NV,
  breast tenderness, ectopic pregnancy, abdominal
  discomfort
• Methyltestosterone (Android)
• Uses hypogonadism, impotence, postpubertal
  cryptochidism, female breast cancer
• Adverse reactions gynecomastia, testicular
  atrophy, impotence, enlargement of penis, nausea,
  male pattern baldness, amenorrhea

37
Pharmacology Cont

• Finasteride (Proscar)
• Uses BPH, prevention of male pattern baldness
• Adverse reactions impotence, decreased libido,
  decreased volume of ejaculate
• Conjugated estrogens (Premarin)
• Uses problems assoc. with menopause
• Adverse reactions headache, migraine, dizziness,
  depression, insomnia, cramps, spotting, edema,
  breast pain, HTN, gallbladder disease

38
Pharmacology Cont

• Medroxyprogesterone (Provera)
• Uses amenorrhea, endometrial hypoplasia
• Adverse reactions spotting, amenorrhea, breast
  tenderness, weight gain, depression
• Estrogens Progestins Combo (Prempro)
• Uses treament of moderate to severe symptoms of
  menopause
• Adverse reactions same as premarin and provera

39
Pharmacology Cont

• Contraceptives (oral)
• Ortho novums, Desogen, Triphasil, Ortho
  Tri-Cyclen,
• Contraceptives (implantable and injectable
• Norplant surgical incision with implantation of
  6 hormone capsules
• Depo-provera given IM every 3 months
• Ortho evra - patch applied each week times 3
  then off for 1 week.

40
Pharmacology Cont

• Hepatitis B Vaccine (Engerix B)
• Uses immunity against hepatitis b infections
• Adverse reactions headache, vertigo, dizziness,
  paresthesia, insomnia, pruritus, nausea,
  dyspepsia, diarrhea, local pain at site, flu like
  symptoms, fatigue and earache