Chapter 59 Assessment and Management of Patients w/ male reproductive Disorders

How would you care for a foley catheter?

idk look at the book he said to know it

What is phimosis?

infection around the foreskin

How do you diagnose erectile dysfunction?

sexual and health history assesment

What are 3 types of PDE5?

sildenafil, vardenafil, and tadalafil

What is brachytherapy?

small pellets are implanted into the prostate to help kill off the cancer.

What do you feel for on a self testicular exam?

starting at the spermatic cord, gently roll the testes in the hand, one at a time.

How do you treat phimosis?

steroid cream cronic phimosis - adult circumcision

What are manifestations of testicular torsion?

sudden pain, nausea, light headedness, and redness and swelling around the scrotum.

What would you include in a male health medical history?

surgery, STD's, circumcision

What are manifestations of BPH?

-Weak stream & urinary retention, leading to hydronephrosis and UTI's.

When are PDE5 inhibitors contraindicated? 4 reasons

-aortic stenosis -MI/CVA in 6 months -unstable angina -hypotension

How does erectile dysfunction work?

-decreased elasticity of collagen -decreased sensory and sensation to the penis -hormonal reasons, decreased blood flow - surgical.

How much fluid should you have exit if you put in 1 liter?

1 liter

What is transurethral resection of the prostate?

an invasive procedure in which a resectoscope is inserted through the urethra and removes a small amount of the tissue.

What is the first indicator of prostate cancer - which is the best question to be included in the hx and physcsial exam?

"Have you noticed a decrease in the volume or your urinary stream?"

How do you treat BPH with medication?

5 alpha reductase inhibitor (decrease realease of dihydrotestosterone) finasteride (proscar) - & Alpha andreneric blockers tamsulosin - flomax

How old should you be to start getting annual DRE?

50 years old

What is testicular torsion?

A rotation of the testes with blood supply being cut off of the testes.

What are the tumor markers for testicular cancer?

AFP (alpha fetoprotein) and Beta human chorionic gonadotropin (beta-hCG)

What can cause an elevated PSA level?

BPH, cancer, infection, urinary retention (pressure from bladder to prostate)

What is a tissue analysis used to look for?

Cancer

What is the best treatment for epididymitis?

Ice packs, elevation, supportive underwear, and bed rest.

What does a test of sexual function check for?

If the sperm is able to perform reproduction.

What is treatment of testicular torsion?

It is a medical emergency that can only be treated by surgery within 6 hours.

How can you treat erectile dysfunction? 4 ways

Medications, penile injections (helps increase blood flow to the penis), penile implants, and shockwave therapy.

WHen is the best time to do a testicular exam?

Monthly after a warm shower

What is BPH?

Non-cancerous growth of the prostate gland

What is erectile Dysfunction? (ED)

Persistent inability to maintain penile erection sufficient for normal sexual activity

A young client who awoke with sudden, severe testicular pain with edema arrives at the ED unable to walk and nauseated. After examination, what treatment would the physician likely order?

Surgery (testicular torsion)

What is the best indication of urinary retention in BPH?

Urgency

What is nocturnal penile tumescence?

an erection at night. should get 2-3

What is an ultrasound of the prostate?

an invasive probe picture

How do you treat priaprism?

a needle drains the blood out

What is an external device to treat ED?

a vacuum device, used right before intercourse and is short term.

What blood flow conditions cause erectile dysfunction?

atherosclerosis and hypertension

What is a PDE5 inhibitor?

causes smooth muscle and vascular constriction

What else should you get with a DRE?

colonoscopy

What are some age related changes in the male reproductive system?

decrease in sexual energy level, loss of testicular firmness, and thickening of the seminiferous tubules

What is the hormone involved with erectile dysfunction?

decreased testosterone.

What is transurethral microwave therapy (heat therapy)

decreases the size of the prostate with heat

What are ways to reduce chances of prostate cancer?

diet (high fat), genetics, hx of visectomy, greater than 65, african american

What hormone is released to cause BPH?

dihydrotestosterone

What indicates prostate cancer?

elevated PSA (greater than 4)

What is priaprism?

erection lasting longer than 4 hours.

what do you do during a digital rectal exam?

feel the prostate thru the anus

What are manifestations epididymitis?

fever, chills, and heaviness in the affected testicle.

What is an implantable prostesis used to threat ED? there are 2 types

inflatable penile prostesis (IPP) and malleable (semi-ridid) implant

What is continuous bladder irrigation?

irrigation solution flows into the bladder and flushes the bladder out and goes into a bladder reservoir.

What is a normal PSA level?

less than 4

What do you feel for on testicular exam?

lump, masses, and tenderness.

What do you monitor for after a prostatectomy?

monitor I&O, pain control, sex education, catheterization,

What is a tissue analysis?

needle biopsy sample

How can you treat prostate therapy?

needle therapy (radiation, brachytherapy, hormone therapy, and surgical.

What is TUNA -transurethral needle ablation?

needles heated that decrease the size of the prostate

What are signs and symptoms of prostate cancer?

painless, poor urination stream

What color should the continuous bladder irrigation fluid be in the catheter bag?

pink

What is a PSA level?

prostate surface antigen - bloodwork

Why would you use continuous bladder irrigation?

to prevent infection and to flush out or break down blood clots.

What is a prostatectomy used for?

to treat BPH or prostate cancer

What are risk factors of testicular cancer?

undescended testicle, family history, caucasian men.