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
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Testes
Epididymidis
Vas deferens
Seminal vesicles
Prostate gland
Bulbourethral glands
Assessment
 History
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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
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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
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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
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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
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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