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Transcript Document 7177820
Male Reproductive Disorders
& STD’s
Chapters 39, 41 & 42
By Angie Lawson RN, BSN
Male A&P Review
External Structures
Penis
Scrotum
Internal Structures
Testes
Epididymidis
Vas deferens
Seminal vesicles
Prostate gland
Bulbourethral glands
Assessment
History
Risk for STD’s
Contraceptive use
Ability to achieve & sustain an erection
Pain during intercourse
Premature ejaculation
Infertility
Prior surgeries or treatments
Assessment cont:
Physical Examination
Transillumination
Testicular self – exam
Breast self -exam
Diagnostic Tests
Ultrasound
Cystourethroscopy
Fertility tests
Prostatitis
Inflammation of the prostate gland
Pain/discomfort
Low back pain
Fever
Chills
Dysuria
Urethral discharge
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)
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
Penile Disorders
Peyronies’s Disease
Priapism
Phimosis & Paraphimosis
Priapism
Persistent Engorgement of the penis
without sexual stimulation
Causes – drug side effects or vascular
problem
Phimosis
Pain with erection
and intercourse
Unable to retract
the foreskin
Paraphimosis
Painful swelling of
the glans, severe
edema and urinary
retention.
Strangulation of
the glans penis by
the foreskin
Penile Cancer
Rare, possibly cause by chronic skin
irritations
Lesion on the penis, that may become
infected over time.
Testicular Disorders
Cryptorchidism
Hydrocele
Varicocele
Cryptorchidism
No signs and symptoms noted
Scrotum feels empty
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
Epididymitis
Inflammation of
the epididymis
Orchitis
Inflammation of
the testis
Pain, swelling, fever, chills, scrotal skin red
and tense
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.
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
Vasectomy
Done in a Dr. Office, ligation of the
vas deferens
Vasovasostomy – a surgical attempt
to reverse a vasectomy
Sexually Transmitted
Diseases
(STD’s)
Common STD’s
Chlamydia
Gonorrhea
Herpes Infection
Venereal Warts
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
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
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
Trichomonas
May also be transmitted through
nonsexual contact
Redness, swelling, itching, and
burning
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
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
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
Genital Parasites
Not a true STD, but can be
transmitted through close body
contact
Lice
Scabies
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
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.
Pharmacology Cont:
Acyclovir (Zovirax)
Uses: herpes simplex, herpes zoster
Adverse Reactions: N & V, diarrhea,
headache, dizziness, lethargy, rashes
Docosanol (Abreva)
Uses: HSV types 1&2
Adverse reactions: headache, skin rash
Pharmacology Cont:
Imiquimod –
Uses: external genitalia and perianal
warts
Adverse reactions: local skin irritations,
itching, excoriation
Indinavir
Uses: HIV infections
Adverse reactions: headache, N&V,
diarrhea, cough, dysuria, acne
Pharmacology Cont:
Valacyclovir (valtrex)
Uses: HSV type 2: herpes zoster
Adverse reactions: N&V, headache,
dizziness, anorexia, diarrhea
Zidovudine AZT (retrovir)
Uses: HIV infection
Adverse reactions: asthenia, malaise,
weakness, headache, anorexia, diarrhea,
N&V, dizziness, insomnia, anemia,
agranulocytosis
Pharmacology Cont:
Fluconazole (diflucan)
Uses: vaginal candidiasis
Adverse reactions: headache, N&V,
diarrhea, skin rash
Ibuprofen (motrin, advil)
Uses: painful dysmenorrhea
Adverse reactions: nausea, dizziness,
dyspepsia, gastric/duodenal ulcer
formation, GI bleeding, headache
Pharmacology Cont:
Naproxen (aleve, anaprox)
Uses: dysmenorrhea
Adverse reactions: dizziness, visual
disturbances, headache, N&V,
gastric/duodenal ulcers
Rofecoxib (vioxx)
Uses: primary dysmenorrhea
Adverse reactions: headache, dizziness,
insomnia, rash, dyspepsia, fatigue
Pharmacology Cont:
Urofollitropin (Fertinex)
Uses: induction of ovulation
Adverse reactions: ovarian enlargement,
N&V, 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
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
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
Pharmacology Cont:
Contraceptives (oral)
Ortho novum’s, 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.
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