Chapter 90: Male Reproductive Disorders
how do you manage a continuous TURP or bladder irrigation?
- record the amount of irrigating solution instilled into the bladder and the total output - carefully monitor the TURP setup to make sure all tubes are open and that they are not twisted or kinked - make sure clients do not pull on catheters or change rates of flow of the solutions - often the surgeon orders that traction be placed on the penis, which kept taped securely in place on the hip or abdomen and is not allowed to hand down (traction facilitates drainage and prevents clotting, but may be uncomfortable) - may be necessary to irrigate the catheter manually. be sure the surgeon has written an order for manual irrigation. there is often a standing order - take special note if the client c/o a feeling of fullness, urgency, or bladder or flank pain, or if the drainage stops flowing from the tube. in any of these situations, shut off the continuous irrigation and notify the team leader or surgeon ASAP (client is at risk for hemorrhage)
risk factors for prostate cancer include?
-age - incidences increase after the age of 40 -race - african american men are 60% more likely to develop than Caucasian or hispanic men -family hx - chances increase if an immediate blood relative has prostate cancer -lifestyle - diet high in animal fats: saturated fats -obesity - -high testosterone levels - testosterone stimulates the growth of the gland -prostatic intraepithelial neoplasia (PIN) - gland cells look abnormal under the microscope but the man may not have any symptoms until around age 50 -genome changes - if genes BRCA 1 & BRCA 2 are present, the risk for cancer is increased;
risk factors of testicular cancer include?
-age 15-35 most common but can occur at any age -cryptorchidism -abnormal testicle development -caucasian race
when caring for a client with a continuous TURP bladder irrigation, when should you shut off the irrigation?
-if the client c/o bladder fullness, urinary urgency, or bladder or flank pain -if the drainage from the TURP tube stops -check to see if an order exists for a manual irrigation; irrigate tubing to check for blood clots
what are the steps on how to do a testicular exam on a client?
1. check one side of the scrotal sac for swelling then follow by checking the other side 2. locate the epididymis, a soft, rope or cord like structure on top and back of testicle, which feels like small bump on the upper or middle outer side of the testicle. Normal testicles also have blood vessels, supporting tissues and vessels to carry sperm 3. once the structure or feel of the epididymis is know, the client will be less likely to think that it is a tumor or abnormal lump of the testicle 4. examine each testicle. Place the index and middle finders under the testicle with the thumbs placed on top 5. with the thumb on top and the testicle between the thumbs and first two fingers, palpate the structures, one side at a time. Use a firm touch and gently roll the testicle between the tombs and fingers to feel for irregularities on the surface or texture of the testicle 6. feel for any evidence of a small lump or abnormality on both sides of the scrotum
about how long is an urethral catheter left in place after a radical prostatectomy & how to care for it?
2 weeks; the catheter helps put pressure on the vesicoureteral (bladder & ureter) incision to control bleeding; keep the catheter straight to avoid obstruction of urine flow
what is the percentage of men with varicoceles also with male factor infertility?
30-40
prostate cancer is not often noted in med under the age of _____ but by the age of ____, the chances of developing this adenocarcinoma significantly increases.
40 & 60
what medications can shrink the prostate by preventing hormonal changes that encourage prostate enlargement?
5-alpha reductase inhibitors- Finasteride (Proscar) and Dutasteride (Avodart), which may take up to 6 months to be effective.
What is a prostate-specific antigen (PSA)?
A blood test that detects a glycoproteins found only in the tissue of the prostate gland
What is premature ejaculation?
A consistent problem in which the client ejaculates before, during, or immediately after penetration
What is a prostate gland biopsy?
A needle excision of a prostate tissue and specimen for histologic exam; often performed to diagnose prostate cancer after a suspicious rectal exam.
What are some factors that can affect the PSA levels?
Age, African ethnic origin, prostate infection, and an individual's relative normal level.
Intraurethral Suppository to treat ED?
Alprostadil (MUSE)
Vasoactive Intracorporeal Pharmacotherapy to treat ED?
Alprostadil, Prostaglandin E, (Caverject) & Phentolamine HCl (Regitine)
What medication may be effective for priapism if used immediately?
Anticoagulants
What may relieve priapism?
Caudal or spinal anesthesia
How can you avoid falsely elevated PSA levels?
Collect the blood sample either before the digital prostate exam or at least 48 hrs after the exam
What surgical approaches are used for priapism?
Creation of a fistula (connection) between the glans penis and corpus spongiosum, and semipermanent diversion with a saphenous vein shunt
diagnostic testing for prostate cancer?
DRE & a PSA test
What is a Nocturnal penile tumescence (NPT) test?
Helps determine if a client is having nighttime erections; can often show the degree and duration of the erection and provide definitive clues to the cause of the condition.
All men with ED, except those who have a specific known cause for their ED, need an evaluation of what to determine causes and identify treatment options
Hormone level; nocturnal rigidity measurement; or duplex Doppler ultrasonography
When could your PSA be elevated?
If you have prostatitis (inflammation of the prostate gland), benign prostatic hyperplasia (BPH), and malignant prostatic tissue as well as metastatic prostate cancer.
What is a duplex Doppler ultrasonography?
Imaging of the cavernous arteries at the base of the penis before and after injection of a vasodilator into the corpora cavernosa of the penis
What may reverse priapism?
Injection of a solution of phenylephrine into the corpora cavernosa
Only about 5% of all men with ED are candidates for penile vascular surgery, which is?
Involves reconstruction of the arterial blood supply or removal of veins that drain blood from the penis too rapidly; because this procedure rarely produces a successful outcome, it is rarely performed.
Another type of prostatic biopsy is performed through endoscopy & how is that done?
It is inserted through the urethra to the prostate, where a small tissue sample is removed
what is the treatment involved with penile cancer?
Mohs surgery; circumcision if tumor is on foreksin; depending on the stage, cryosurgery or a penectomy
Transdermal agents to treat ED?
Nitroglycerin paste
The oral medications to treat ED are contraindicated for client who use? & may result in?
Nitroglycerin products; life-threatening hypotension
A combination of what is best used for early detection of prostate cancer?
PSA & digital rectal exam (DRE)
What is often identified as the cause in priapism?
Pelvic vascular thrombosis
Priapism can have many causes including?
Penile or spinal cord injury, tumor, and cerebrospinal syphilis; prolonged sexual activity, leukemia, sickle cell anemia, or other blood disorders
What 3 approaches can a prostate gland biopsy be performed?
Perineal, transrectal, or transurethral
The corpora cavernosa contain thick, dark, venous blood; the corpus spongiosum and glan are not involved during what?
Priapism
The client who receives vasodilating meds such as Viagra, Cialis, MUSE, Caverject may have a side effect of?
Priapism (prolonged, uncomfortable erection lasting 2-3 hrs or longer)
Another method for prostatic biopsy uses an ultrasound probe & how is that done?
Probe can be combined with a special biopsy needle that is activated by a rapidly firing spring; the biopsy needle obtains a tissue sample in a fraction of a second
What is priapism?
Refers to an abnormal and persistent penile erection without sexual stimulation; extremely painful and may last several hours or even days & must seek medical attention
What is erectile dysfunction, also called impotence?
Refers to the inability to achieve or maintain an erection sufficient to complete sexual intercourse
What medications are vasodilators taken in pill form that help the penis to fill with blood?
Sildenafil citrate (Viagra), Vardenafil (Levitra), & Tadalafil (Cialis)
Priapism may also be an undesirable result of therapy for ED, particularly with?
Sildenafil, Alprostadil, and injection therapy
What is testosterone partly responsible for?
Sperm reproduction and libido (sexual desire)
An erection is caused by?
Spinal reflex arcs activated by tactile stimuli and psychogenic factors (auditory, visual, and psychological stimulation)
what medication can be effective for ED & BPH?
Tadalafil (Cialis)
What hormone levels may be checked in cases of erectile dysfunction (sometimes called impotence) or sexual dysfunction?
Testosterone
Why might radiation therapy be used following removal of a cancerous prostate?
To destroy any remaining malignant cells
What is the goal of priapism during treatment?
To improve the venous drainage of the corpora cavernosa while preventing ischemia that may result in impotence
Why is bladder irrigation performed?
To maintain latency of the urethra after prostate surgery- Because the urethra passes through the prostate gland as it empties urine from the bladder
Priapism may be a side effect of some medications, including?
Trazadone, Chlorpromazine, Prazosin, Tolbutamide, certain antihypertensives, anticoagulants, and corticosteroids
The male reproductive system is closely linked to what system?
Urinary
What is secondary ED?
When the client has achieved erection and completed intercourse in the past
What is primary ED?
When the client has never achieved sufficient erection.
what is the treatment for epididymitis?
a C&S of any penile discharge; antibiotics and analgesics as ordered, provide scrotal support, and apply cold packs to the scrotum; antibiotic therapy usually continues for 3 months or longer if the infection is chronic;
what will most likely distinguish cancer from prostatitis?
a biopsy
before the prostatectomy, the client may have?
a catheter inserted for continuous urinary drainage to prevent accumulation of stagnant urine in the bladder; give him plenty of fluids, with proper diet and rest
what is radiation cystitis?
a common problem following radiation therapy; antispasmodics, analgesics, and increased fluid intake are forms of treatment
prostate cancer is almost always an adenocarcinoma, which is?
a gland cell cancer that is fairly common in men, especially african american men.
what medication can cause epididymitis?
a heart medication- Amiodarone (Pacerone)
chronic or untreated epididymitis can involve complications such as?
abscesses in the scrotum
prostatitis can be classified as?
acute bacterial, chronic bacterial, chronic abacterial (also known as chronic pelvic pain syndrome), and asymptomatic inflammatory
what are symptoms of torsion? & What can happen if left untreated for more than a few hours?
acute onset of sudden severe scrotal pain, vomiting, abdominal pain, and nausea; can cause testicular infarction and necrosis, therefore considered a surgical emergency
how often should men get their prostate checked?
after age 50 at least yearly
what are some preoperative nursing considerations for a client who is having a radical prostatectomy?
alert the client to the strong possibility of postoperative ED; encourage the client who wishes to have children to consider sperm banking before the surgery; review the types of available treatment options for ED and how they work; discuss the possibility that the client will have a suprapubic cystoscopy catheter and some sort of continuous bladder irrigation for about 2-3 days after surgery
what medications can be beneficial for BPH symptoms?
alpha blockers- Doxazosin (Cardura), Tamsulosin (Flomax), Alfuzosin (Uroxatral), Silodosin (Rapaflo), and Finasteride (Prosper)
what is varicocele?
an abnormal dilatation of the testicular veins in the scrotum, causing a reflux of blood down to the scrotum when standing or straining.
what is hydrocele?
an accumulation if fluid in the space between the membrane covering the testicle and the testicle itself; client is often asymptomatic
what is Peyronie disease?
an accumulation of plaques or scar tissue along the corpora cavernosa, causing a painful curvature of the penis when erect; the plaque or scar tissue formation is idiopathic and benign; very painful and sometimes impossible penetration
surgery may be necessary to drain an access or remove part or all of the epididymis, known as?
an epididymectomy
what is cryosurgery?
an incision is made in the perineum and a special tool is inserted to the area of the prostate to freeze the tissue; it is believed to kill the cancer
for boys and men who are not sexually active, the source of the problem with epidiymitis is usually related to?
an infection spread from the urinary tract, including urine, urethra, prostate gland, or seminal vesicles
what is proctitis?
an inflammation of the rectum and anus, with preoperative chemo; use of a low-residue diet and antidiarrheal meds may help alleviate symptoms
postoperative nursing considerations for prostate surgery?
anti embolism stockings, early ambulation, and incentive spirometry; encourage fluid intake and monitor I&O; give stool softeners, as ordered; help the client and his partner deal with any psychological and emotional problems
what medication is common to be used for painful bladder spasms following a prostate surgery?
antispasmodics
what is symptomatic treatment for a hydrocele?
applying cold packs, proving support for the scrotum, and providing emotion reassurance that the condition will resolve and will not affect future fertility; drain is often used if a plication is not performed
males of any age can develop epididymitis, but what is it most often caused by?
bacterial infections due to STDs such as gonorrhea, syphilis, or chlamydia; other causes include organisms such as staphylococci, streptococci, and escherichia coli
why is NSAIDs avoided for incisional pain relief after a prostate surgery?
because of its anticoagulation effects
what is varicocele more commonly seen on the left side?
because the left spermatic vein is longer than the right
where does prostate cancer usually metastasize to?
bones, lymph nodes, brain, and lungs
bacterium chlamydia can be the cause of what symptoms like epididymitis?
burning sensation and penile discharge
what may cause hydrocele?
by an infection (orchitis) or injury
how can hydrocele be treated?
by aspirating the fluid; rarely satisfactory in the adult
what can cause testicular torsion?
by bilateral and congenital absence of the lateral attachments of the testes and epididymis to the scrotum; it can follow an activity that puts a sudden pull on the cremasteric muscle; extreme cold
S&S of varicocele?
can cause pain in the testicle or pain radiating to the other side; swelling and a nagging dull pain in the scrotum; veins become dilated and tortuous and, on palpation, are often described as similar to a bag of worms
what cancer is rare, especially in circumcised men?
cancer of the penis
how does the medication for an intraurethral suppository works?
causes the tissue to vasodilate, pulling blood into the area, which causes an erection
what is prostatitis?
characterized by pain, swelling, and inflammation of the prostate gland; it can occur in men of any age but typically is seen in men younger than 50
with testicular cancer, what may cause sterility?
chemo and radiation
what are some symptoms of ABP?
chills, fever, myalgia (muscle pain), general malaise, scrotal and low back pain, perineal pain, and pain after ejaculation; client has a very tender, enlarged and asymmetrical prostate on DRE.
what is an urinary flow test?
client voids directly into a receptacle that measures the strength and amount of urine flow, which is typically abnormal with BPH
after a client has a TURP, what happens from there?
client will return with a bladder irrigation in place; the surgeon inserts a triple-lumen catheter (with 3 separate tubes or openings) immediately after the prostate is removed in the OR
what is the difference between continuous & intermittent irrigation of the bladder?
continuous washes out blood before it can form clots; intermittent washes out clots that plug the catheter
if hormonal therapy isn't the effective treatment for Cryptorchidism, what can be done?
corrective surgery (orchiopexy) is usually done between the ages of 5-7
what is a less invasive procedure used to remove prostatic cancer?
cryosurgery
what other symptoms may clients develop with prostate cancer?
decrease in force and size of urinary stream; urgency; frequency; nocturia; hesitancy (difficulty in starting the stream); dysuria (painful urination); dribbling; urine retention; hematuria; complete urinary retention; ED; pain in the lower back, chest, pelvis, or upper thighs
what is the main risk factor with undescended testicle (Cryptorchidism)?
developing testicular cancer
what is chronic bacterial prostatitis (CBP)?
develops after episodes of ABP are unsuccessfully treated with antibiotics; hallmark of it is a hx of relapsing UTI; recurring bouts and difficult-to-treat infections
usually no S&S of prostate cancer, but if signs happen to show what would it be?
difficulty voiding, which occurs owing to the position of the prostate gland surrounding the urethra and subsequent obstruction of urethral patency
PSA levels increase when the prostate is?
enlarged, or the prostate area has had recent urologic procedures, an infection, surgery, or prostate cancer.
what is the vast majority of penile cancer?
epidermoid or squamous cell carcinoma - usually begins on or under the foreskin
orchitis is common in clients with?
epididymitis
when the testicle along with the epididymis is inflamed, what is it called?
epididymo-orchitis
what are common urinary symptoms seen with ABP?
hematuria (blood in urine), and urgency on urination or obstructive symptoms such as nocturia (frequent voiding at night), hesitancy, or dribbling
what are some complications with TURP?
hemorrhage, urinary retention, stress incontinence, and ED
what type of treatment is used for Cryptorchidism?
hormonal therapy
When is evaluation & treatment recommended during premature ejaculation? & what does treatment include?
if the client believes the problem affects his ability to have intercourse; wearing condoms, performing a special squeeze technique, application of lidocaine gel, and medications such as serotonin reuptake inhibitors
when does pain management become a priority with prostate cancer?
if the client metastasizes
what are some nursing considerations when treating a client with penile cancer?
include his concerns for sexual activity and his ability to have children; coping strategies such as support from a partner or wife and groups that have mutually beneficial discussions are helpful; early treatment is essential; fear of his diagnosis may interfere with acceptance of this disorder
what is epididymitis?
inflammation of the epididymis, which is the coiled tube at the posterior of the testicle that stores and carries sperm; usually an acute infection, but if it last 6 weeks or longer, it can become a chronic problem
with epididymitis, if the scrotum enlarges greatly what can happen?
interfere with the client's ambulation; intercourse or ejaculation can be painful; affect fertility
what is orchiopexy?
involves suturing the testes to the scrotal sac to secure them
on examination, a cancerous prostate feels?
irregular and may have hard nodules
how is CBP diagnosed?
isolation of bacteria from the expressed secretions obtained from prostatic massage; client serum white blood cell count is elevated; urine culture is usually negative
what is something to remember when doing a testicular exam on a client?
it is normal to find that one testicle is somewhat larger than the other for one testicle to have lower that the other
S&S of penile carcinoma?
may be growth or lesion on the glans, foreskin, or shaft of the penis; the color of the penis may change, a reddish rash can be seen beneath the foreskin, and the penile skin can become thicker; blood may be seen at the tip of the penis or under the foreskin; unexplained pain of the penis, swollen lymph nodes in the groin, and irregular swelling at the end of the penis.
as testicular cancer grows, what occurs?
may feel a dull ache in the abdomen or groin, have pain in a testicle or the scrotum, or have enlargement or tenderness of the breasts; along with backache, pain in the abdomen, weakness, and weight loss
what is a post void residual volume test?
measures the client's ability to empty their bladder; normally after voiding, any remaining urine indicates an enlarged prostate
what are intraurethral suppositories?
medication: Alprostadil (MUSE); smaller than a grain of rice, which the client self-injects into the urethra. The pellet melts, and the medication is absorbed into the corpora cavernosa.
what may right-sided varicocele suggest?
obstruction of the intra-abdominal venous drainage, which could be caused by a tumor
if BPH is left untreated, what could happen?
occlude the flow of urine out of the bladder
what is testicular cancer?
occurs in the testicles, which are inside the scrotal sac - the testicles produce androgens (male sex hormones) such as testosterone; not uncommon for client to notice a lump or abnormal growth
how does the triple-lumen cath work after TURP?
one lumen inflates the balloon that holds the catheter in places, whereas the second lumen drains the bladder into a drainage bag; the third lumen is used to instill a bladder solution that irrigates the bladder
what is the treatment for Peyronie disease?
oral meds: Clostridium Histolyticum (Xiaflex), Vitamin E, and non steroidal anti-inflammatory drugs (NSAIDs); or the plaque or scar tissue may be removed by surgery
mumps after puberty may cause?
orchitis, resulting in sterility
what happens when the catheter becomes clogged?
over distention of the bladder may cause the client great discomfort; usually a pump or controller regulates the flow of irrigant
symptoms of orchitis?
pain and swelling in the scrotum and sometimes urethral urination
what are nursing considerations for the client with prostatitis?
pain control and warm compresses or sitz baths; remind the client to increase fluid intake to flush bacteria out of the bladder; stool softeners help prevent constipation
what is a penectomy?
partial or complete removal of the penis
men who have not been circumcised at birth can develop a condition known as? Injury can also cause this; Circumcision can relieve this condition
phimosis
what all is involved in diagnosing epididymitis?
physical exam including a check of the prostate gland, enlarged lymph nodes of the groin, and unilateral enlargement of the testicles; doc will need to know sexual hx and will obtain a C&S of any discharge; imaging tests include an ultrasound with color Doppler, which will indicate blood flow and possibly any testicular torsion
sometimes with hydrocele, the sac requires surgical removal which is called?
plication
what is ablative laser used for?
procedure involve the vaporization of the enlarged tissue, which increases urinary flow
what is enucleative laser used for?
procedure typically removes all of the prostate tissue and prevent regrowth of tissue.
what is a benign prostatic hyperplasia?
prostate gland enlargement is a common condition that occurs as men age; the gland begins to grow at adolescence, continuing to enlarge with advancing age; watch and wait for symptoms to appear
what is a digital rectal exam (DRE)?
provides basic knowledge about the size of the prostate; is done by inserting a gloved hand into the rectum and feeling the tissues of the rectal wall, which are adjacent to the prostate
with prostate cancer, what may be considered a palliative measure for the client with bony metastases, thus alleviating some pain?
radiation therapy
what 2 surgeries may be done for someone with testicular cancer?
radical inguinal orchiectomy (total removal of the testicle & retroperitoneal lymph node dissection ( removal of lymph nodes) - during the surgery it is possible that nerves that affect ejaculation can be damaged
depending on the disease's stage and the client's age and symptoms, what are some treatment options for prostate cancer?
radical prostatectomy, radioactive seed implantation, cryosurgery, radiation therapy, or hormone ablation therapy; treatment may lead to ED in the majority of clients; incontinence is less common
symptoms of epididymitis?
redness, pain, and unilateral scrotal swelling, dysuria, blood in the semen, enlarged lymph nodes in the groin, and pain in the lower abdomen and pelvic area.
what is a prostatectomy?
removal of the excess or abnormal prostate tissue- the surgeon can dissect the prostate through an incision through the bladder, a perineal incision, or an incision below the bladder
what is a radical prostatectomy?
removal of the prostate and seminal vesicles and part of the urethra; sometimes cures prostatic cancer that not metastasized; an open procedure because an abdominal incision is necessary.
what is a nerve-sparing radical prostatectomy (retropubic prostatectomy)?
removes the prostate through an incision below the umbilicus and about the symphysis pubis; causes less ED, incontinence, and bleeding than do other methods
what can hello with orchitis?
scrotal support; ice bag applied to the scrotum- heat is not used
what is orchitis?
scrotum enlarges; with pain and swelling
what are the 2 types of testicular tumors?
seminoma - not as aggressive; & nonseminoma - develop at an earlier age and spread quickly
what should you teach the client with proctitis?
signs of urinary retention and monitor urine output closely
what is the prostate gland?
size of a walnut and located directly below a man's bladder; it purpose is to produce the semen that nourishes and transports sperm
what should you monitor while a client is receiving radiation therapy?
skin condition - they are more susceptible to excoriation and yeast infections
what is radioactive seed implantation?
small radioactive seeds (about the size of a grain of rice) are implanted in the exact location of the cancer, thereby, reducing side effects and risks associated with other types of radiation therapy
the scrotal temperature is higher than normal because of the blood pooling in the area, so heat impairs?
spermatogenesis and sperm storage, resulting in a low sperm count and infertility
what is plication?
stitching of folds or tucks in the hydrocele wall to reduce its size, will usually prevent redevelopment of the hydrocele
complications of a radical prostatectomy?
stress incontinence, epididymitis, urethral stricture, fistula, and ED
what is the first stage of a suprapubic prostatectomy?
surgeon performs a cystotomy (incision into the bladder) to relieve urinary retention
what is a perineal prostatectomy?
surgeon removes gland tissue through an incision in the perineum, catheter drainage is through the perineal incision only; the will find sitting up to be difficult; fecal contamination of the incision may occur because of its location
What is a suprapubic prostatectomy?
surgeon usually performs the procedure if the client's gland is greatly enlarged (>100 g); performed in 2 different stages
what type of treatment do they use if testicular cancer is found early?
surgery
what are the surgical treatments for torsion?
surgical detorsion (untwisting) and bilateral orchiopexy (surgical fixation of the testes)
what is Mohs surgery?
surgical removal of the tumor and the marginal tissues (around the edges)
how does testicular cancer present to the client?
symptoms appear gradually; a painless mass or lump develops as the testis enlarges; sudden collection of fluid noted in the scrotum and a feeling of scrotal heaviness occurs;
what is Cryptorchidism?
testicle or testicles that have not descended to their normal position in the scrotum also called undescended testicles
what is the most common form of cancer in younger caucasian males between 15 and 35?
testicular cancer - grows rapidly and can often metastasize before diagnosis
after catheter removal, what usually happens?
the client is incontient until they are able to train their external urethral sphincter to do the work of both the internal and external sphincter; nurses need to assist in sphincter retraining by instructing the client in Kegel exercises
after the 2 stage suprapubic prostatectomy, what happens?
the client returns with two indwelling catheters in place, one in the urethra and the other in the suprapubic wound- these catheters are attached to separate drainage containers, allowing for more accurate output measurement - the urethral catheter is attached to a closed drainage system, and the wound catheter is attached to an irrigation apparatus
what is phimosis?
the foreskin becomes so tight that it will not retract over the glans penis;
what can also increase the risk of penile carcinoma?
the human papillomavirus, which has been implicate in cancer of the cervix
what is the second stage of a suprapubic prostatectomy?
the prostate tissue is removed
what do they do if the torsion has caused testicle necrosis?
the testicle must be removed (orchiectomy); then an orchiopexy is then performed on the unaffected side to prevent torsion of that testis
in TURP, how does the surgeon remove the prostate tissue?
through the urethra by means of a resectoscope, which has a cutting edge or electric wire that slices the prostate away bit by bit- no incision necessary- shorter recovery time
what is an urodynamic and pressure flow study?
to determine bladder pressure and the strength of the bladder muscles; this testing is done by inserting a catheter through the urethra into the bladder, followed by water or air and the the pressures are measured
after TURP procedure, what should the nurse pay attention to?
to the color of the draining urine; it will be bloody postoperatively but should steadily decrease;
What does TURP stand for? & what happens during it?
transurethral resection of the prostate; the surgeon removes most of the prostate gland; it requires a temporary urinary catheter to drain the bladder
what is testicular torsion?
twisting of the spermatic cord, resulting in an interruption in blood flow to the testicle; uncommon and occurs most often in adolescents and young men.
risk factors of epididymitis includes?
urethral instrumentation, an indwelling catheter, anal intercourse, brachytherapy for prostatic cancer, HIV/AIDs, and unprotected sex with more than one sexual partner.
what is hypospadias?
urethral meatus located on the underside of the penis
what is epispadias?
urethral meatus located on the upper surface of the penis
what is often helpful in determining the cause of acute and chronic prostatitis?
urinalysis- bacteria and numerous white blood cells are present
growth of the prostate is not harmful, but the symptoms it produces may have many consequences, initial symptoms may be?
urinary difficulties; urinary retention, difficulty voiding or emptying the bladder completely, and finds that he must void frequently, often during the night (nocturia)
what test is positive in acute bacterial prostatitis and negative in nonbacterial prostatitis?
urine C&S
symptoms of CBP?
usually asymptomatic, but may c/o back or perineal pain or other relatively minor symptoms; prostate is usually normal on palpation
how is penile cancer diagnosed?
usually made after exam of biopsy tissue; standard lab and imaging studies are done to come it and to rule out any other problems such as infection from STDs
what is acute bacterial prostatitis (ABP)?
usually results from an ascending urinary tract infection, such as with E. coli; symptoms develop quickly, showing flu-like symptoms
treatment for ABP?
wide-spectrum antibiotics, analgesics, and sits baths; urine culture and/or ultrasound may be done
if diagnosed at an early stage, can this type of cancer usually be cured?
yes