Chapter 52 Disorders of the Male Genitourinary System

A circumcised male presents with erythema of the glans and prepuce with a malodorous discharge. These symptoms support which medical diagnosis?

A. Acute superficial balanoposthitis (The symptoms for this patient are suggestive of acute superficial balanoposthitis. Balanitis xerotica obliterates typically occurs in uncircumcised males.)

Testicular cancer is highly curable if found and treated early. What are signs of metastatic spread of testicular cancer? Mark all that apply.

A. Hemoptysis B. Back pain C. Neck mass

Which chronic health issues increase a man's risk for developing erectile dysfunction? Select all that apply.

A. Hypertension B. Diabetes Mellitus D. Hyperlipidemia (Common risk factors for generalized penile arterial insufficiency (erectile dysfunction) include hypertension, hyperlipidemia, cigarette smoking, diabetes mellitus, and pelvic irradiation.)

Which statements are true regarding priapism? Select all that apply.

A. It can be triggered by sickle cell disease. B. It is not always related to sexual stimulation. D. It can result in ischemia of the erectile tissue of the penis. (Priapism is an involuntary, prolonged (>4hrs), abnormal, and painful erection that continues beyond, or is unrelated to sexual stimulation. Priapism is a true urologic emergency because the prolonged erection can result in ischemia and fibrosis of the erectile tissue. Priapism can occur at any age, Sick cell disease or neoplasms are he most common cause for boys age 5-10.)

What late complication of a transurethral prostatectomy (TURP) will the nurse address to the patient as a part of discharge teaching?

B. Erectile dysfunction (Lat complications of a TURP include erectile dysfunction, Immediate complications of TURP include the inability to urinate, postoperative hemorrhage or clot retention, and urinary tract infection.)

Palliative care for patients diagnosed with terminal prostate cancer includes focal irradiation of symptomatic bone disease and what other care is needed?

B. Pain control (Palliative care includes adequate pain control ad local irradiation of symptomatic or unstable bone disease. Treatment therapies are not generally included in palliative care. If depression exists, it will be treated, but it is not considered a focus.)

Priapism (a prolonged painful erection not associated with sexual excitement) can occur at any age. In boys, ages 5-10 years, what are the most common causes of priapism?

B. Sickle cell disease or neoplasms

An age-related, nonmalignant, enlargement of the prostate gland.

Benign Prostatic Hyperplasia

Cryptorchidism, left untreated, is a high risk for testicular cancer and infertility. What are the treatment goals for boys with cryptorchidism?

C. Easier cancer detection

Which symptoms observed 3 days after a male child is diagnosed with mumps supports the diagnosis of mumps orchitis?

C. Painful enlargement of tests and fever.

Which statements are true regarding prostate cancers? Select all that apply.

C. Prognosis has improved because of PSA diagnostic screenings. D. African American males are at highest risk for developing the disease. E. Age is a risk factor of this cancer. (A recent increase in diagnosed cases is thought to reflect earlier diagnosis because of widespread use of PSA testing. The incidence of prostate cancer increased with age and is greater in the A.A. men of all ages. Prostate cancer is third to lung cancer and colon/rectal cancer as a cause of cancer related death to men. Ever man 50+ should have a digital rectal examination and PSA test done as part of his annual physical).

Wat treatment would be expected for a penile cancerous lesion that is freely movable and has no evidence of metastatic disease?

C. Sleeve resection

The parent of a male child who has undergone corrective surgery for cryptorchidism will be educated regarding which potent ion complication of the condition.

C. The need to monitor for early signs of testicular cancer. (A child with cryptorchidism or correction of it is at greater risk for testicular cancer and will need follow-up examinations as well as his parent to monitor for early signs.)

Erectile dysfunction, now recognized as a marker for ______ disease, is now considered a component of the _______ syndrome.

Cardiovascular, Metabolic

The consequences of ______ include infertility, malignancy, testicular torsion, and the possible psychological effects of an empty scrotum.

Cryptorchidism

Undescended Testes

Cryptorchidism

Although the cause of benign prostatic hyperplasia BPH is unknown, its incidence increased with age. In which ethnic group is BPH highest?

D. African American

What is the most common cause of relapsing urinary tract infections in men?

D. Chronic Prostatitis (Chronic prostatitis is the most common cause of relapsing urinary tract infections in men).

A predisposing factor to testicular cancer includes which of the following?

D. History of cryptorchidism

Which diagnostic test result best supports the diagnosis of noninflammatory prostatitis>

D. Normal leukocyte count (Symptoms of inflammatory and noninflammatory prostatitis are similar, but a normal leukocyte count (indicating no evidence of prostate inflammation) would be a key consideration to making a noninflammatory prostatitis diagnosis.)

Which of the following treatments would first be implemented for a confirmed diagnosis of erectile dysfunction?

D. Psychosocial counseling and oral medication therapy with slidenafil (The first line of treatment would be to treat the patient with counseling related to the self-esteem issues that may accompany ED and treatment with PDE-5 inhibitors, which are oral medication. Surgical placement of a prosthesis or implant would be a later option.)

Which course of treatment would be required for intravaginal testicular torsion?

D. Surgical detorsion procedure to be performed immediately. (A surgical detorsion is the required emergent treatment of this condition. An orchietomy may be needed at a later time if the testicle is deemed nonviable.)

Which of the following is thought to be a contributing factor to the development of benign prostatic hyperplasia (BPH)?

D. The actions of dihydrotestosterone. (DHT is thought to be the ultimate mediator of prostatic hyperplasia with estrogen serving to sensitize the prostatic tissue to the growth-producing effects of DHT. Another theory is the increased intraprostate levels of insulin-like growth factors).

_______ is commonly classified as psychogenic, organic, or mixed psychogenic and organic.

Erectile Dysfunction

What are some of the known causes of erectile dysfunction?

Neurogenic disorders, Parkinson disease, stroke, and cerebral trauma, often contribute to erectile dysfunction by decreasing libido or preventing the initiation of erection In the spinal card injury, the extent of neural impairment depends on the level, location, and extent of the lesion. Hormonal causes of erectile dysfunction include a decrease in androgen levels owing to both primary and secondary hypogonadism. Common risk factors for generalized penile arterial insufficiency include hypertension, hyperlipidemia, cigarette smoking, diabetes mellitus, and pelvic irradiation.

Erection is under the control of the ________ nervous system, and ejaculation and detumescence (penile relaxation) are under the ________ nervous system control.

Parasympathetic, Sympathetic

Tightening of the penile foreskin.

Phimosis

Involuntary, prolonged, abnormal, and painful erection.

Priapism

______ is caused by impaired blood flow in the corpora cavernosa of the penis.

Priapism

How do drugs like Viagra treat erectile dysfunction?

Sildenafil (Viagra) is a selective inhibitor of phosphodiesterase type 5 (PDE-5), the enzyme that inactivates cyclic guanosine monophosphate (cGMP). This acts by facilitating corporeal smooth muscle relation in response to sexual stimulation.

How does benign prostatic hyperplasia cause obstruction of the urethra?

The anatomical location of the prostate at the bladder neck contributes to the pathophysiology and symptomatology of benign prostatic hyperplasia (BPH). The two prostatic components to the obstructive properties of BPH and development of lower urinary tract symptoms are dynamic and static. The static component of BPH is related to an increase in prosaic size; it gives rise to symptoms such as weak urinary stream, post void dribbling, frequency of urination, and nocturne. The dynamic component of BPH is related to prostatic smooth muscle tone. Alpha-Adrenergic receptors are the main receptors for the smooth muscle component of the prostate.

How are testicular cancers staged?

The clinical staging for testicular cancer is as follows: stage I, tumor confined to testes, epididymis, or spermatic cord; stage II, tumor spread to retroperitoneal lymph nodes below the diaphragm; and stage III, metastases outside of the retroperitoneal nodes or above the diaphragm.