Nursing Care of the Client Experiencing Alterations in the Male Reproductive Process

Group Issues Guidelines on Prostate Cancer Screening . . . The American Cancer Society has released updated guidelines calling on doctors to discuss with their patients the risk and benefits of prostate-specific antigen tests by age 50 before allowing them to undergo screening. The guidelines come after two studies showed conflicting findings about whether routine PSA tests improve survival

Men at Mid-Life - The Prostate Generation Nursing Care of the Client Experiencing Alterations in the Male Reproductive Process Men at Mid-Life - The Prostate Generation

Conditions of the Prostate Benign Prostatic Hypertrophy/Hyperplasia (BPH) Prostate Cancer Prostatitis

Prostate Gland

Benign Prostatic Hypertrophy/Hyperplasia (BPH) Enlarged gland obstructs urinary outlet More common in men over 50

Symptoms Voiding Symptoms Decreased force in voiding Hesitancy Intermittency Dribbling Incomplete emptying

Irritative Symptoms Frequency Urgency Dysuria Bladder Pain Nocturia Incontinence

Complications of BPH Urinary Retention UTI Hydronephrosis Hydroureter Renal Failure

Catheterization Coude Stylet

Treatment Watchful waiting Medications Herbal Therapy Surgery Anti-androgen finasteride (Proscar) Adrenergic blockers terazosin (Hytrin) Herbal Therapy Saw Palmetto Surgery

Prostate Cancer Most common cancer in men Second most common cause of cancer death in men > 55 Higher incidence in African American males Diet

Clinical Manifestations Initially symptom less Later see signs and symptoms of urinary obstruction Metastasizes to the bone and lymph nodes

Detection Routine Screening Ultrasound Biopsy Prostate Specific Antigen (PSA) Digital Rectal Exam Ultrasound Biopsy

Treatment Hormonal Manipulation Surgery Radiation Orchiectomy Medications Surgery Radical Prostatectomy Radiation Curative, adjunctive, palliative

Radioactive Seeds

Prostatectomy Closed procedures Open procedures Transurethral resection (TUR) Transurethral incision of the prostate (TUIP) Open procedures Suprapubic Perineal Retropubic

Transurethral Resection (TUR)

Radical Prostatectomy - Open Procedures

Complications Erectile dysfunction Incontinence Hemorrhage Infection Continuous Bladder Irrigation (CBI) Infection Deep vein thrombosis Obstructed catheter

Continuous Bladder Irrigation (CBI)

Prostatitis Bacterial or Abacterial Complications Treatment UTI’s, septicemia Treatment Antibiotics Comfort measures

Disorders of Male Sexual Function Erectile Dysfunction

Treatment Medical Treat underlying condition Pharmacological (anti-impotence agents) sildenafil (Viagra) vardenafil (Levitra) tadalafil (Cialis)

Treatment - Continued Surgical Psychological therapy Education Penile Implants Psychological therapy Education Andropause

World Health Organization Sexual health is the integration of somatic, emotional, intellectual, and social aspects of sexual being in ways that are enriching and that enhance personality, communication, and love.