Nursing Management: Male Reproductive Problems Chapter 55 Overview Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Problems of the Prostate Gland Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 2 Fig Areas of the male reproductive system in which problems are likely to develop.

Benign Prostatic Hyperplasia Etiology and Pathophysiology Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 3

Benign Prostatic Hyperplasia Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 4 Fig Benign prostatic hyperplasia. The enlarged prostate compresses the urethra.

Benign Prostatic Hyperplasia Clinical Manifestations Complications Diagnostic Studies Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 5

Benign Prostatic Hyperplasia Collaborative Care Drug therapy 5  -reductase inhibitors  -adrenergic receptor blockers Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 6

Benign Prostatic Hyperplasia Collaborative Care, continued Minimally invasive therapy Transurethral microwave thermotherapy Transurethral needle ablation of prostate Laser prostatectomy Intraprostatic urethral stents Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 7

Benign Prostatic Hyperplasia Collaborative Care, continued Invasive therapy Transurethral resection of prostate Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 8

Benign Prostatic Hyperplasia Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 9 Fig Transurethral resection of the prostate.

Benign Prostatic Hyperplasia Collaborative Care Invasive therapy, continued Transurethral incision of prostate Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 10

Nursing Management: Benign Prostatic Hyperplasia Nursing Assessment Nursing Diagnoses Planning Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 11

Nursing Management: Benign Prostatic Hyperplasia Nursing Implementation Health promotion Acute intervention Preoperative care Postoperative care Ambulatory and home care Evaluation Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 12

Prostate Cancer Etiology and Pathophysiology Clinical Manifestations and Complications Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 13

Prostate Cancer Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 14 Fig Metastasis of prostate cancer to the pelvis and lumbar spine.

Prostate Cancer Diagnostic Studies Collaborative Care Conservative therapy Surgical therapy Radical prostatectomy Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 15

Prostate Cancer Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 16 Fig Common approaches used to perform a prostatectomy. A, Retropubic approach involves a midline abdominal incision. B, Perineal approach involves an incision between the scrotum and anus.

Prostate Cancer Collaborative Care Surgical therapy, continued Nerve-sparing procedure Cryotherapy Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 17

Prostate Cancer Collaborative Care, continued Radiation therapy External beam radiation Brachytherapy Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 18

Prostate Cancer Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 19 Fig A, Prostate brachytherapy. Implantation of seeds with a needle guided by ultrasound and a template grid. B, Radioactive seeds.

Prostate Cancer Collaborative Care, continued Drug therapy Hormonal therapy Luteinizing-hormone–releasing hormone (LHRH) agonists and antagonists Androgen receptor blockers Estrogen Orchiectomy Chemotherapy Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 20

Culturally Competent Care: Prostate Cancer Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 21

Nursing Management: Prostate Cancer Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health promotion Acute intervention Ambulatory and home care Evaluation Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 22

Prostatitis Etiology and Pathophysiology Clinical Manifestations and Complications Diagnostic Studies Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 23

Nursing and Collaborative Management: Prostatitis Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 24

Problems of the Penis Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 25

Congenital Problems Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 26

Problems of Prepuce Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 27 Fig A, Phimosis. Unable to retract the foreskin due to secondary lesions on the prepuce. B, Paraphimosis. Ulcer with edema from foreskin remaining contracted over the prepuce.

Problems of Erectile Mechanism Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 28

Cancer of Penis Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 29

Problems of the Scrotum and Testes Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 30

Inflammatory and Infectious Problems Skin Problems Epididymitis Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 31

Inflammatory and Infectious Problems Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 32 Fig Scrotal masses.

Inflammatory and Infectious Problems Orchitis Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 33

Congenital Problems Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 34

Acquired Problems Hydrocele Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 35

Acquired Problems Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 36 Fig Hydrocele.

Acquired Problems Spermatocele Varicocele Testicular Torsion Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 37

Testicular Cancer Etiology and Pathophysiology Clinical Manifestations and Complications Diagnostic Studies Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 38

Nursing and Collaborative Management: Testicular Cancer Testicular Self-Examination Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 39

Nursing and Collaborative Management: Testicular Cancer Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 40 Fig Testicular self-examination.

Nursing and Collaborative Management: Testicular Cancer Collaborative Care Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 41

Sexual Functioning Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 42

Vasectomy Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 43 Fig Vasectomy procedure. The vas deferens is ligated or resected for the purpose of sterilization.

Erectile Dysfunction Etiology and Pathophysiology Clinical Manifestations and Complications Diagnostic Studies Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 44

Erectile Dysfunction Collaborative Care Oral drug therapy Vacuum constriction device Intraurethral devices Penile implants Sexual counseling Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 45

Nursing Management: Erectile Dysfunction Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 46

Andropause Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 47 Table Clinical Manifestations of Andropause.

Infertility Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 48