Porth's Patho: Disorders of Male Reproductive, Chapter 43

A client is admitted with secondary orchitis. Which assessment question is most relevant? -"Does cancer run in your family?" -"Have you ever had mumps?" -"Did you get the flu vaccination this fall?" -"Have you ever injured your testicles in sports?"

-"Have you ever had mumps?" Orchitis is an infection of the testes. It can be precipitated by a primary infection in the genitourinary tract by the mumps virus. Injuries, influenza, and cancer are not likely relevant to the etiology.

The nurse is teaching a client with hypertension about managing erectile dysfunction (ED). What information should the nurse share with the client? -"Taking your antihypertensive with ED drugs is dangerous." -"The cause of ED is usually psychogenic and not physical." -"Participating in regular exercise may help resolve the ED." -"Taking your nitrates as prescribed should reduce ED."

-"Participating in regular exercise may help resolve the ED." Evidence to date suggests that exercise is the only lifestyle modification that helps reduce ED. Some antihypertensive and lipid-lowering drugs may actually worsen ED. The cause of ED is likely a combination of psychogenic and physical in this client's case, because there is a relationship between cardiovascular diseases such as hypertension and ED. Nitrates, which are antianginal medications, should not be taken with ED drugs; antihypertensives, however, are not contraindicated.

Which chronic health issues increase a man's risk for developing erectile dysfunction? Select all that apply. -Diabetes mellitus -Asthma -Hyperlipidemia -Hypertension -Crohn disease

-Diabetes mellitus -Hyperlipidemia -Hypertension Common risk factors for generalized penile arterial insufficiency (erectile dysfunction) include hypertension, hyperlipidemia, cigarette smoking, diabetes mellitus, and pelvic irradiation. Asthma and Crohn disease are not associated with erectile dysfunction.

The causes of infertility can be in either the male or the female. Male tests for infertility require a specimen of ejaculate that is collected when? -After 3 weeks of abstinence -Any time -After 3 consecutive days of intercourse -After 3 days of abstinence

-After 3 days of abstinence The specimen is best collected by masturbation into a sterile container after 3 days of abstinence.

The nurse is reinforcing information given to the client who is asking about screening for prostrate cancer. Which of these will be nurse teach the client about the prostate-specific antigen (PSA) test? -An elevated score on a PSA test does not necessarily indicate the presence of cancer. -PSA levels decrease with age. -The PSA test is not used as a screening device for prostate cancer. -A positive PSA test indicates the presence of cancer.

An elevated score on a PSA test does not necessarily indicate the presence of cancer. A positive PSA test indicates only the possible presence of prostate cancer. It can also be positive in cases of BPH and prostatitis. In fact, every man who has an elevated PSA will not necessarily have prostate cancer. PSA levels normally increase with age.

When caring for the client with acute bacterial prostatitis, the nurse plans for which intervention? -Transurethral prostatectomy -Anti-neoplastic medications -Urethral catheter -Antibiotics

Antibiotics Acute prostatitis usually responds to appropriate anti-microbial therapy based on the sensitivity of the causative agents in the urethral discharge.

A client comes to the clinic and informs the nurse that he was playing soccer and was kicked in the scrotal area on the right side. The nurse observes that the scrotal skin on the right side is dark red. What should the nurse suspect this client may have? -Spermatocele -Hematocele -Hydrocele -Varicocele

Hematocele A hematocele is an accumulation of blood in the tunica vaginalis, which causes the scrotal skin to become dark red or purple. It may develop as a result of an abdominal surgical procedure, scrotal trauma, a bleeding disorder, or a testicular tumor. This client sustained an injury to the scrotal area that created the hematocele. A spermatocele is a painless, sperm-containing cyst that forms at the end of the epididymis. Spermatoceles are freely movable and transilluminate. A varicocele is characterized by varicosities of the pampiniform plexus, a network of veins supplying the testes. The left side of the scrotum is more commonly affected. A hydrocele forms when excess fluid collecting between the layers of the tunica vaginalis.

The nurse is assessing a client with a collection of blood in the tunica vaginalis of the scrotum. How does the nurse correctly document this in the medical record? -Varicocele -Hydrocele -Hematocele -Spermatocele

Hematocele Disorders of the scrotum and testes include collection of fluid (hydrocele), blood (hematocele), or sperm (spermatocele) in the tunica vaginalis; another disorder involves varicosities of the veins in the pampiniform venous plexus (varicocele).

Which diagnosis is most likely to require surgical correction? -Hypospadias -Orchitis -Erectile dysfunction -Spermatocele

Hypospadias Hypospadias is a congenital disorder of the penis resulting from embryologic defects in the development of the urethral groove and penile urethra; surgery is the treatment of choice for hypospadias. Orchitis, erectile dysfunction (ED), and spermatocele rarely require surgical intervention.

A 15-year-old male client reports severe pain in the inguinal area and nausea. What action does the nurse take first? -Request a prescription for antiemetic. -Assess the client's abdomen. -Request a prescription for analgesia. -Inspect the client's genitalia.

Inspect the client's genitalia. The age of the client combined with where the pain is located should prompt the nurse to immediately inspect the testicles to observe for swelling and tenderness supporting intravaginal testicular torsion. This is a surgical emergency and early recognition and treatment are necessary if the testicle is to be saved. Other actions such as treating pain and nausea can be done once assessment for torsion is done. Assessing for other causes such as signs of appendicitis (rebound tenderness) may be indicated but are not as time-sensitive as ruling out testicular torsion.

The nurse is reviewing the laboratory results of a client who has non-inflammatory prostatitis. The nurse would expect the results to include: -Pain radiating down the inner thighs -Increased PSA level -Positive urine culture for bacteria -Normal leukocyte count

Normal leukocyte count Men with non-inflammatory prostatitis have symptoms resembling those of nonbacterial prostatitis but have negative urine culture results and no evidence of prostatic inflammation (i.e., normal leukocyte count). A normal leukocyte count indicates no evidence of prostatic inflammation and is a key factor to consider when making a non-inflammatory prostatitis diagnosis. PSA and bacterial culture are not used in considering either of these diagnoses.

A 42-year-old man reports testicular tenderness. He is concerned also because he found a mass that moves around within the scrotal sack. Upon examination, the physician determines that the mass is near the end of the epididymis, lights up uniformly when illuminated, and is above the testes. Which condition does this client most likely have? -Hydrocele -Spermatocele

Spermatocele A spermatocele is a painless, sperm-containing cyst that forms at the end of the epididymis, is above the testes, is freely moveable, and transilluminates. A hematocele is an accumulation of blood in the tunica vaginalis, which causes the scrotal skin to become dark red or purple. A hydrocele forms when excess fluid collects between the layers of the tunica vaginalis. A varicocele is characterized by varicosities of the pampiniform plexus, a network of veins supplying the testes.

After seeking care due to recent history of testicular enlargement and scrotal pain, a 22-year-old college student has been diagnosed with testicular cancer. Which statement by the client indicates the need for further teaching? -"I guess there's some solace in the fact that this cancer wasn't a result of an unhealthy lifestyle." -"I have to admit that the prospect of losing a testicle is a bit overwhelming." -"I really hope the cancer hasn't spread anywhere, because I've read that it's a possibility." -"I can't shake this feeling like I've received a death sentence."

"I can't shake this feeling like I've received a death sentence." Testicular cancer has the potential for metastasis, but outcomes are positive for most clients and survival rates are high. With appropriate treatment, the prognosis for men with testicular cancer is excellent. Orchiectomy remains the standard treatment, and the pathogenesis of testicular cancer is not thought to be related to lifestyle factors.

The parents of a baby born with hypospadias ask the nurse if the baby can be circumcised. Which response by the nurse is most accurate? -"The circumcision will not be done now; the foreskin is needed for surgical repair." -"The condition can be treated with topical medication; circumcision is not needed." -"The circumcision will be done when the child reaches puberty." -"The circumcision can be performed now."

-"The circumcision will not be done now; the foreskin is needed for surgical repair." Surgery is the treatment of choice for hypospadias. Circumcision is avoided because the foreskin is used for surgical repair. Factors that influence the timing of surgical repair include anesthetic risk, penile size, and the psychological effects of the surgery on the child.

The nurse is providing teaching about benign prostatic hyperplasia to a client who would like medication to avoid surgery. Which drug category is primarily prescribed to reduce prostate size by blocking the effects of androgens? -5 alpha-reductase inhibitors -Alpha 1-adrenergic blocking agents -Beta-adrenergic blockers (beta-blockers) -Herbal medicines

-5 alpha-reductase inhibitors 5-alpha-reductase inhibitors reduce prostate size by blocking the effects of androgens on the prostate. The effects of herbal agents may improved peak urine flow rates, but the durability of these effects is unproven. The long-term toxicity of these agents remain unclear as well as concern for variations in standardization of herbal products. Beta-adrenergic blockers are prescribed for high blood pressure. Alpha 1-adrenergic blocking agents relax smooth muscle to relieve prostatic obstruction and increase urine flow.

The nurse is providing an education program to a group of men over the age of 18 years. An important topic the nurse is discussing relates to balanitis and its prevention. Which man does the nurse recognize is at high risk for this disorder? Select all that apply. -A man that is on medication for hypertension -A man with diabetes -A man that is immunosuppressed -A man with poor hygiene -A man that has been circumcised

-A man with diabetes -A man that is immunosuppressed -A man with poor hygiene Balanitis is an acute or chronic inflammation of the glans penis, which generally occurs in 11% of adult males and 3% of boys. Males with poor hygiene, immunosuppression, or diabetes are more prone to balanitis. Males taking medications for hypertension and males that have been circumcised are at no greater risk for balanitis.

An adult male reports painful urination, rectal pain, fever/chills, general malaise and myalgia. Vital signs are: temperature, 101.7°F (38.7°C); blood pressure, 105/74 mm Hg; pulse, 98 bpm; respiration, 22 breaths/min. What condition should the health care provider suspect? -Acute bacterial prostatitis -Epididymitis -Benign prostatic hyperplasia -Orchitis

-Acute bacterial prostatitis The manifestations of acute bacterial prostatitis include fever and chills, malaise, myalgia, arthralgia, frequent and urgent urination, dysuria, and urethral discharge. Dull, aching pain often is present in the perineum, rectum, or sacrococcygeal region. Benign prostatic hyperplasia is an enlargement of the prostate and gives signs and symptoms of weak urinary stream, postvoid dribbling, frequency of urination, and nocturia. Epididymitis is characterized by unilateral pain and swelling, accompanied by erythema and edema of the overlying scrotal skin. Orchitis is associated with enlarged testis, tenderness, scrotal skin redness, edema of the scrotum, and induration of the testes.

An adolescent male comes to the urgent care clinic. Upon assessment, the following is noted: history of circumcision, erythema of the glans, and prepuce with a malodorous discharge. Based on symptoms, the probable diagnosis would be: -Balanitis xerotica obliterans -Acute superficial balanoposthitis -Acute phimosis -Penile carcinoma

-Acute superficial balanoposthitis The symptoms for this client are suggestive of acute superficial balanoposthitis. It occurs in males who have phimosis or a large redundant prepuce. Balanitis xerotica occurs in uncircumcised males.

The nurse is caring for a client recently diagnosed with testicular cancer. The nurse evaluates the medical record for which of these diagnostic tests, typically altered in this type of malignancy? -Urinalysis -D-Dimer test -White blood cells -Alpha fetoprotein test

-Alpha fetoprotein test Two tumor markers are useful in evaluating the tumor response to therapy: alpha-fetoprotein, a glycoprotein that is normally present in fetal serum in large amounts, and HCG, a hormone that is normally produced by the placenta in pregnant women.

Benign prostatic hyperplasia (BPH) and prostatic adenocarcinomas present differently. The nurse is aware of which difference? -BPH is commonly located in the periurethral zone of the prostate, while prostate cancers are commonly located in the peripheral zones of the prostate. -BPH is commonly located in the peripheral zones of the prostate, and prostate cancers are commonly located in the periurethral zone of the prostate. -BPH and prostate cancers are commonly discrete lesions in the periurethral region of the prostate. -BPH and prostate cancers are commonly multicentric and located in the peripheral zones of the prostate.

-BPH is commonly located in the periurethral zone of the prostate, while prostate cancers are commonly located in the peripheral zones of the prostate. BPH is characterized by the formation of large, discrete lesions in the periurethral region of the prostate rather than the peripheral zones, which commonly are affected by prostate cancer.

A 30-year-old male client is being treated for testicular cancer. The nurse monitors what hormone levels as indicators of response to treatment? Select all that apply. -Dihydrotestosterone -Luteinizing hormone (LH) -Beta-human chorionic gonadotropin -Alpha-fetoprotein -Testosterone

-Beta-human chorionic gonadotropin -Alpha-fetoprotein Measuring tumor markers produced by malignant cells provides information about characteristics of certain tumors. In the case of testicular germ cell tumors, the hormones alpha-fetoprotein and beta-human chorionic gonadotropin both serve as markers that can indicate degree of cancer activity. These hormones are normally released during embryonic development of the testes, and their reappearance in the adult suggests activity of undifferentiated cells in a testicular germ cell tumor. Androgens such as dihydrotestosterone and testosterone are considered promoting hormones in certain forms of prostate cancer but are not used as testicular cancer markers. Luteinizing hormone promotes ovulation in females and testosterone secretion in males and is not used as a tumor marker for testicular cancer.

Based on the group that statistically has the greatest risk, the health care provider should assess which ethnic group for prostate cancer? -Black -Japanese -Native American/First Nation -White

-Black The incidence of prostate cancer is highest among blacks and lowest in Japanese.

A client on the urology floor who has BPH asks the nurse how the pharmacologic agent A client on the urology floor who has BPH asks the nurse how the pharmacologic agent finasteride will help decrease the size of his prostate. Which principle explains the mechanism of action? -Promoting relaxation of the urinary sphincter -Blocking effects of androgens on the prostate -Decreasing urine output and the need to void -Relaxation of the muscles surrounding the urethra

-Blocking effects of androgens on the prostate Dihydrotestosterone (DHT), an androgen and growth factor, contributes to the development of BPH by increasing the proliferation of prostatic stromal cells and decreasing the death of the epithelial cells. The 5-reductase inhibitors such as finasteride block this effect and reduce prostate size.

The nurse in the urology office recognizes screening men at risk for prostate cancer includes which diagnostic measures? -Blood level of prostate-specific antigen (PSA) and digital rectal exam -Prostate biopsy and tissue cytology -Pelvic ultrasound and x-ray of kidneys, ureter, and bladder -Alpha fetoprotein and human chorionic gonadotropin (HCG) serum blood levels

-Blood level of prostate-specific antigen (PSA) and digital rectal exam The tests currently available to screen for prostate cancer include digital rectal examination, PSA testing, and transrectal ultrasonography. Prostate biopsy and tissue cytology are not screening measures but tests to confirm the cancer. Pelvic ultrasound and x-ray of kidneys, ureter, and bladder are used for detection of kidney stones. Alpha fetoprotein and HCG serum blood levels are used to predict an increased risk for subsequent miscarriage in women.

A client complains of not being able to experience satisfactory sexual intercourse. The nurse knows that erectile dysfunction is now recognized as a marker for: -Arthritis -Cardiovascular disease -Diabetes -Balanitis

-Cardiovascular disease Erectile dysfunction is defined as the inability to achieve and maintain an erection sufficient to permit satisfactory sexual intercourse. Erectile dysfunction is now recognized as a marker for cardiovascular disease and is now considered a component of the metabolic syndrome.

Epididymitis can be sexually transmitted, or it can be caused by a variety of other reasons, including abnormalities in the genitourinary tract. What are the most common causes of epididymitis in young men without underlying genitourinary disease? -Chlamydia trachomatis and Neisseria gonorrhoeae -Candida albicans and Escherichia coli -Chlamydia trachomatis and Candida albicans -Escherichia coli and Neisseria gonorrhoeae

-Chlamydia trachomatis and Neisseria gonorrhoeae Sexually transmitted acute epididymitis occurs mainly in young men without underlying genitourinary disease and is most commonly caused by Chlamydia trachomatis and Neisseria gonorrhoeae. Candida albicans and Escherichia coli are not the most common causes of epididymitis in young men without underlying genitourinary disease.

What is the most common cause of recurrent urinary tract infections in males? -Cryptorchidism -Chronic bacterial prostatitis -Benign prostatic hyperplasia (BPH) -Peyronie disease

-Chronic bacterial prostatitis Chronic bacterial prostatitis is the most common cause of relapsing urinary tract infections in males. Relapsing urinary tract infections are not generally associated with the other options.

Which risk factor is associated with erectile dysfunction (ED) and considered preventable? -Benign prostatic hyperplasia -Cigarette smoking -Multiple sclerosis -Cryptorchidism

-Cigarette smoking Common risk factors for generalized penile arterial insufficiency include hypertension, hyperlipidemia, cigarette smoking, diabetes mellitus, and pelvic irradiation. Cigarette smoking induces vasoconstriction and penile venous leakage because of its effects on cavernous smooth muscle. Cryptorchidism is a major risk factor for testicular cancer. Benign prostate hyperplasia (BPH) is a risk factor for ejaculatory pathway obstruction rather than erectile difficulties. Multiple sclerosis is one of many neurologic causes of ED.

The nurse is caring for a client with cancer of the penis. The nurse recognizes which factor reduces the risk of this type of cancer? -Surgical correction of cryptorchidism -Exposure to sunlight -Abstinence from sexual intercourse -Circumcision

-Circumcision While the cause of penile cancer is unknown, suggested risk factors include poor genital hygiene, human papillomavirus (HPV) infection, ultraviolet radiation exposure, increasing age, and immunodeficiency states. Circumcision confers protection, making cancer of the penis is extremely rare in men circumcised at birth.

When caring for a group of clients, the nurse recognizes which of these individuals has increased risk for balanitis? -Client with a sexually transmitted infection -Client with a congenital genitourinary disorder -Individual with a thyroid disorder -Individual with epispadias

-Client with a sexually transmitted infection Balanitis refers to local inflammation of the glans penis that may result from trauma, irritation, or infection caused by a wide array of organisms, most commonly Candida albicans.

When caring for a group of clients, the nurse recognizes which of these individuals has increased risk for balanitis? -Individual with epispadias -Individual with a thyroid disorder -Client with a congenital genitourinary disorder -Client with a sexually transmitted infection

-Client with a sexually transmitted infection Balanitis refers to local inflammation of the glans penis that may result from trauma, irritation, or infection caused by a wide array of organisms, most commonly Candida albicans.

The nurse is teaching a male client about testicular cancer. Which risk factor does the nurse discuss as a major one for testicular cancer? -Hypospadias -Cryptorchidism -A high-fat diet -Sexually transmitted infections

-Cryptorchidism Although the cause of testicular cancer is unknown, the strongest association has been with cryptorchidism or undescended testes.

Which assessment is most likely to reveal a potential exacerbation in a 70-year-old client's diagnosis of benign prostatic hyperplasia (BPH)? -Blood test for white blood cells and differential -Sperm morphology testing -Urine testing for microalbuminuria -Digital rectal examination

-Digital rectal examination The diagnosis of BPH is based on history, physical examination, digital rectal examination, urinalysis, blood tests for serum creatinine and prostate-specific antigen (PSA), and urine flow rate. The digital rectal examination is used to examine the external surface and size of the prostate. An enlarged prostate found during a digital rectal examination does not always correlate with the degree of urinary obstruction. Some men can have greatly enlarged prostate glands with no urinary obstruction, but others may have severe symptoms without a palpable enlargement of the prostate. Proteinuria, increased WBCs, and changes in sperm morphology are not associated with BPH.

A client asks the nurse what can cause, or contributes to the development of, benign prostatic hyperplasia (BPH). The best response would be: -Decreased amounts of intraprostatic levels of insulin-like growth factor that results in the overgrowth of the prostate gland. -Dihydrotestosterone (DHT) proliferates the growth of prostatic stromal cells, leading to a reduction in the death of the epithelial cells. -Decreased amounts of estrogen lead to the enlargement of the cells within the walls of the prostate gland. -The repeated actions of bladder retractions place increased pressure on the prostate gland causing hypertrophy of the gland.

-Dihydrotestosterone (DHT) proliferates the growth of prostatic stromal cells, leading to a reduction in the death of the epithelial cells. It is thought that dihydrotestosterone (DHT)-induced growth factors contribute to the development of BPH by increasing the proliferation of prostatic stromal cells and decreasing the death of epithelial cells.

Which disorder of the male genitourinary system creates the most urgent need for prompt and aggressive surgical treatment? -Intravaginal testicular torsion -Benign prostatic hyperplasia (BPH) -Spermatocele -Erectile dysfunction

-Intravaginal testicular torsion Although all of the noted health problems warrant monitoring and possible treatment, intravaginal testicular torsion is an emergency that requires prompt surgery to save the torsed testicle.

A client asks the nurse what can cause, or contributes to the development of, benign prostatic hyperplasia (BPH). The best response would be: -The repeated actions of bladder retractions place increased pressure on the prostate gland causing hypertrophy of the gland. -Decreased amounts of estrogen lead to the enlargement of the cells within the walls of the prostate gland. -Dihydrotestosterone (DHT) proliferates the growth of prostatic stromal cells, leading to a reduction in the death of the epithelial cells. -Decreased amounts of intraprostatic levels of insulin-like growth factor that results in the overgrowth of the prostate gland.

-Dihydrotestosterone (DHT) proliferates the growth of prostatic stromal cells, leading to a reduction in the death of the epithelial cells. It is thought that dihydrotestosterone (DHT)-induced growth factors contribute to the development of BPH by increasing the proliferation of prostatic stromal cells and decreasing the death of epithelial cells.

The nurse is caring for a client with cancer of the scrotum. When performing a health history, which of these does the nurse explore as a risk for this type of malignancy? -Multiple sexual partners -Childhood illness with mumps -History of inguinal hernia -Exposure to tar and soot

-Exposure to tar and soot Cancer of the scrotum was the first cancer directly linked to a specific occupational exposure: tar, soot, and oils are implicated. Poor hygiene, chronic inflammation, and exposure to PUVA or HPV also has been associated with the disease. The mean age of presentation with the disease is 60 years, often preceded by 20 to 30 years of chronic irritation.

When performing a rectal examination of an older adult male client, the nurse practitioner recognizes that the prostate of a client who has prostate cancer is often described in which way? -Cobblestone-like -Hard and irregular -Asymmetrical and hard -Enlarged and rubbery

-Hard and irregular Enlargement of the prostate due to BPH usually produces a large, palpable prostate with a smooth, rubbery surface. Hardened areas of the prostate gland suggest cancer and should be sampled for biopsy.

Select the factor that would increase a male's risk for the development of testicular cancer. -Occupational exposure to soot -Improper hygiene practices -History of cryptorchidism -Exposure to ultraviolet A radiation

-History of cryptorchidism History of cryptorchidism is the greatest risk for developing testicular cancer. Additional predisposing factors include genetic factors and disorders of testicular development. The remaining options are risk factors for scrotum cancer.

The mother of a 5-year-old boy brings him into the clinic because there is a firm feeling and swelling around one of his testes. What would the suspected diagnosis be? -Cryptorchidism -Peyronie disease -Hydrocele -Priapism

-Hydrocele Hydroceles are palpated as cystic masses that may attain massive proportions. If there is enough fluid, the mass may be mistaken for a solid tumor. Transillumination of the scrotum (i.e., shining a light through the scrotum for the purposes of visualizing its internal structures) or ultrasonography can help to determine whether the mass is solid or cystic and whether the testicle is normal.

The nurse in the urology clinic is reviewing the chart of a client with erectile dysfunction. Which factor in the client's history does the nurse recognize is a hormone-based condition that may contribute to erectile dysfunction? -Anxiety -Hyperthyroidism -Spinal cord injury -Hypogonadism

-Hypogonadism Hormonal causes of erectile dysfunction include a decrease in androgen levels related to primary or secondary hypogonadism; this may be caused by aging (andropause) or hyperprolactinemia.

The nurse is performing a newborn assessment on a 2-day-old male infant. Assessment reveals the presence of the urethral opening on the ventral side of the penis. The nurse would document this finding as being: -Epispadias -Hypospadias -Balanitis -Phimosis

-Hypospadias In hypospadias, the termination of the urethra is on the ventral or underside surface of the penis. The etiology is unknown. Surgery is the treatment of choice and circumcision is avoided. Epispadias is a condition in which the urethral opening is on the dorsal or upper surface of the penis and is a less common condition. Phimosis refers to a tightening of the prepuce or penile foreskin that prevents its retraction over the glans. Balanitis is an acute or chronic inflammation of the glans penis, which generally occurs in 11% of adult males and 3% of boys.

A client calls the clinic and informs the nurse that he has sustained an erection for 3 hours and that it is extremely painful. The client has a history of sickle cell disease and this has not happened to him in the past. Which instruction should the nurse give to the client? -The client should not be concerned; this often happens in male clients. -There are no long-term effects of this occurrence. -If the client does not seek medical attention, impotence may result. -The client is having an increase in blood flow to the penis.

-If the client does not seek medical attention, impotence may result. Priapism is a true urologic emergency because the prolonged erection can result in ischemia and fibrosis of the erectile tissue with significant risk of subsequent impotence. It is caused by impaired blood flow in the corpora cavernosa of the penis.

An adult male has been diagnosed with mumps orchitis. The nurse should educate the client regarding which complication associated with mumps orchitis? -Hematocele formation -Impaired spermatogenesis -Penile atrophy -Erectile dysfunction

-Impaired spermatogenesis The residual effects seen after the acute phase of mumps orchitis include hyalinization of the seminiferous tubules and atrophy of the testes, along with impaired spermatogenesis that has the potential to result in sterility. Spermatogenesis is irreversibly impaired in approximately 30% of testes damaged by mumps orchitis. Penile atrophy, hematuria, and hematocele are not among the signs, symptoms, and sequelae of mumps orchitis.

A client has developed priapism. For which outcome is this client at risk? -Cancer of the penis -Swelling of the testicles -Premature ejaculation -Impotence

-Impotence Priapism is an involuntary, prolonged (>4 hours), abnormal, and painful erection that continues beyond, or is unrelated to, sexual stimulation. The prolonged erection can result in ischemia and fibrosis of the erectile tissue with significant risk of subsequent impotence. The other results will not occur.

What late complications of a transurethral prostatectomy (TURP) will the nurse address with the client as a part of discharge teaching? -Increased hemorrhage -Inability to urinate -Incontinence -Increased clotting

-Incontinence Late complications of a TURP include erectile or sexual dysfunction, incontinence, and bladder neck constriction. Immediate complications of TURP include the inability to urinate, postoperative hemorrhage or clot retention, and urinary tract infection.

The nurse is caring for a client who has just given birth to a premature neonate with cryptorchidism. What information does the nurse provide to the client? -This will not be a concern until your son reaches puberty. -A specialist will examine your baby before you are discharged. -It is likely the testes will descend by the age of 2 months. -It is normal for a premature baby to have cryptorchidism.

-It is likely the testes will descend by the age of 2 months. While about 30% of premature infants will have cryptorchidism, it is not considered a normal finding. In this population, more than 80% will have the testes descend into the scrotum by 2 months of age with no intervention. Until the age of 6 months, no treatment or referral to a specialist is needed, as close to 100% of infants' testes will have descended by this age. Due to the increased risk for infertility and malignancy, corrective surgical therapy is recommended and should be done prior to 1 year of age to minimize these risks.

If not treated urgently, testicular torsion can result in which complication? -Inguinal herniation -Cancer of the scrotum -Loss of testicular perfusion -Dartos muscle atrophy

-Loss of testicular perfusion With testicular torsion, the testis rotates about the distal spermatic cord, obstructs perfusion through the testicular arteries and spermatic veins, and obstructs nerve conduction. The dartos muscle separates the two testes and responds to changes in temperature by contracting when cold and relaxing when warm. Most squamous cell cancers of the scrotum occur after 60 years of age and are linked to poor hygiene, chronic inflammation, exposure to ultraviolet A radiation, or human papillomavirus (HPV). After descent of the testes, the inguinal canal normally closes almost completely; failure of this canal to close predisposes to the development of an inguinal hernia later in life.

A client requests a prescription for sildenafil to assist him with achieving and maintaining an erection. Which type of medication would contraindicate the use of sildenafil? -Antihistamine -Nitrate -Beta-blocker -Angiotensin-converting enzyme (ACE) inhibitor

-Nitrate The concomitant use of phosphodiesterase type 5 (PDE5) inhibitors and nitrates is absolutely contraindicated because of the risk of profound hypotension. Angiotensin-converting enzyme inhibitors, beta-blockers, and antihistamines do not fall into the category of contraindicated medications.

A 27-year-old male developed mumps and was ill for several days. The client suddenly developed a fever and painful enlargement of the testes approximately 4 days after recovering. The nurse should suspect that the client has developed: -Testicular torsion -Testicular cancer -Hydrocele -Orchitis

-Orchitis Orchitis is an infection of the testes and can be precipitated by a primary infection in the genitourinary tract, or the infection can be spread to the testes through the bloodstream or the lymphatics. The onset of mumps orchitis is sudden; it usually occurs approximately 3 to 4 days after the onset of the parotitis and its characterized by fever, painful enlargement of the testes, and small hemorrhages into the tunica albuginea.

The nurse on the urology unit teaches the nursing student that which test assists in detecting a recurrence of prostate cancer after prostatectomy? -PSA level -Human chorionic gonadotropin (HCG) level -White blood cell count -Alpha fetoprotein serum level

-PSA level A rising PSA (prostate-specific antigen) after treatment is consistent with progressive disease and is used to detect recurrence after total prostatectomy. Because the prostate is the source of PSA, levels should drop to zero after surgery.

A client is concerned about having mumps orchitis and asks the nurse about the symptoms. What is the nurse's best response? -Abnormal increase in sexual drive -Painful enlargement of the testes with fever 3 days after infection -Painful urination with the presence of urethral discharge -Purplish or red-colored scrotum after an abdominal procedure

-Painful enlargement of the testes with fever 3 days after infection Onset of mumps orchitis is sudden—approximately 3 to 4 days after the onset of the infection. Symptoms include fever, painful enlargement of the testes, and small hemorrhages into the tunica albuginea. Urinary symptoms are absent. Sexual drive is not increased. Androgenic hormone function is usually maintained in these cases.

The parents of a newborn boy have decided against circumcision. The nurse emphasizes that, as the child grows, the mother must properly cleanse the area beneath the foreskin and to return the foreskin to the original position to prevent: -Paraphimosis -Epispadias -Balanitis -Cryptorchidism

-Paraphimosis In paraphimosis, the foreskin is so tight and constricted that it cannot cover the glans. A tight foreskin can constrict the blood supply to the glans and lead to ischemia and necrosis.

The nurse inserts a Foley catheter in an uncircumcised male client for the treatment of urinary retention and does not place the foreskin back over the glans penis. Several hours later, the client complains of severe pain at the catheter site and, when assessed, the nurse is unable to retract the foreskin. Which problem does the nurse know has occurred? -Phimosis -Balanitis -Hypospadias -Paraphimosis

-Paraphimosis In paraphimosis, the foreskin is so tight and constricted that it cannot cover the glans. A tight foreskin can constrict the blood supply to the glans and lead to ischemia and necrosis. Many cases of paraphimosis result from the foreskin being retracted for an extended period, as in the case of catheterized uncircumcised males. Phimosis refers to a tightening of the prepuce or penile foreskin that prevents its retraction over the glans. Hypospadias is when the urethral opening is on the ventral side of the penis. Balanitis is an acute or chronic inflammation of the glans penis.

A nurse is providing teaching to the parents of a child who has undergone corrective surgery for cryptorchidism. The most important information for the nurse to provide is: -Parents should be taught that their child needs frequent follow-up visits. -Parents must understand that their child is at increased risk for sterility. -Teaching should include methods to prevent recurrence of this problem. -Explanations that medication therapy needs to be administered until puberty.

-Parents should be taught that their child needs frequent follow-up visits. Treatment of men with undescended testis should include lifelong follow-up, considering the sequelae of testicular cancer and infertility. Parents need to be aware of the potential issues of infertility and increased risk of testicular cancer. On reaching puberty, boys should be instructed in the necessity of testicular self-examination.

A 75-year-old man presents at the clinic complaining of pain during intercourse and an upward bowing of his penis during erection. The client's history mentions an inflammation of the penis that was treated 3 months ago. The physician's physical examination of the client notes beads of scar tissue along the dorsal midline of the penile shaft. What would be the suspected diagnosis of this client? -Peyronie disease -Balanitis -Paraphimosis disease -Cavernosa disease

-Peyronie disease Peyronie disease involves a localized and progressive fibrosis of unknown origin that affects the tunica albuginea (i.e., the tough, fibrous sheath that surrounds the corpora cavernosa) of the penis. The disorder is characterized initially by an inflammatory process that results in dense fibrous plaque formation. The plaque usually is on the dorsal midline of the shaft, causing upward bowing of the shaft during erection.

A 12-year-old boy with pain in the tip of his penis and a red, swollen, tender foreskin is uncircumcised because of religious reasons. Which medical diagnosis is likely responsible for this child's manifestations? -Peyronie disease -Paraphimosis -Phimosis -Balanitis

-Phimosis Phimosis refers to a tightening of the prepuce or penile foreskin that prevents its retraction over the glans. In paraphimosis, the foreskin is so tight and constricted that it cannot cover the glans. Balanitis is an acute or chronic inflammation of the glans penis. Peyronie disease involves a localized and progressive fibrosis of unknown origin that affects the tunica albuginea.

The provider is assessing a client with a history of erectile dysfunction (ED) who is requesting a prescription for treatment. When assessing for additional information related to causes of ED, which information should the provider solicit from the client? -Presence of arterial occlusive disease -Ability to void -Frequency of sexual intercourse -Number of children the client has fathered

-Presence of arterial occlusive disease Vascular disease may impair blood flow to the pudendal arteries or their tributaries, resulting in loss of blood volume and subsequent poor distention of the vascular spaces of erectile tissue. Other preventable risk factors include obesity, physical inactivity, high cholesterol levels, high blood pressure, and smoking.

A client in the urology clinic asks the nurse how the doctor will determine if his prostate lesion is due to benign prostatic hyperplasia (BPH) or prostate cancer. Which response should the nurse convey? -The diagnosis can be made from the clinical manifestations. -A blood test called the PSA will be used. -Your family history will direct the doctor to the diagnosis. -Presence of cancers are determined through a biopsy.

-Presence of cancers are determined through a biopsy. The diagnosis of prostate cancer is based on history and physical examination; confirmation of the presence of cancer cells is obtained through biopsy.

The nurse is caring for a client with sickle cell crisis. For which of these urologic complications does the nurse observe? -Benign prostatic hyperplasia -Priapism -Acute prostatitis -Erectile dysfunction

-Priapism Priapism is an abnormal, painful, sustained erection that can lead to ischemic damage of penile structures. It can occur at any age and is one of the possible complications of sickle cell disease.

A 52-year-old male diagnosed with erectile dysfunction (ED) asks the nurse what will be implemented as a first option for treatment. The best response would be: -Intravenous administration of a PDE-5 inhibitor -Catheterization and increased fluids to increase vascular flow -Psychosexual counseling and PDE-5 inhibitor medications -Surgical placement of a penile prosthesis

-Psychosexual counseling and PDE-5 inhibitor medications Treatment methods include psychosexual counseling, androgen replacement therapy, oral and intravenous drug therapy, vacuum restriction devices, and surgery. Commonly prescribed drugs for ED are the selective inhibitors of phosphodiesterase-type 5 (PDE-5). The PDE-5 inhibitors are taken orally. Surgery would not be the initial therapy, and increasing fluids does not increase blood flow to the penis.

A client presents with priapism. The nurse interviews the client about which potential risk factors? Select all that apply. -Recent sexual activity -Recent intake of alcohol -Orthostatic hypotension -Hematologic disorders -History of erectile dysfunction

-Recent intake of alcohol -Hematologic disorders -History of erectile dysfunction The nurse asks about hematologic disorders, because sickle cell anemia, leukemia, and thrombocytopenia are all risk factors for priapism. Intake of alcohol or use of medication such as PDE5 inhibitors to treat erectile dysfunction should also be investigated as contributing to the priapism. Recent sexual activity is not relevant to the state of priapism, because this condition is defined as unwanted erection not associated with sexual arousal. Having low blood pressure would not contribute to priapism.

The nurse is caring for a client with acute superficial balanoposthitis. The nurse assesses for which of these signs or symptoms consistent with the diagnosis? -Redness of the glans penis and malodorous discharge -Painful erection lasting more than 4 hours -Penile distortion of the erect penis -Pus or bacteria in the urine

-Redness of the glans penis and malodorous discharge Acute superficial balanoposthitis is characterized by erythema of the glans and prepuce. An malodorous discharge may be present.

A 22-year-old male client presents with an enlarged firm testis and scrotal edema and is suspected to have orchitis. The nurse includes what actions in the plan of care? Select all that apply. -Restriction of client's activity -Application of cold packs -Collection of urethral cultures -Elevation of the scrotum -STAT antibiotic therapy

-Restriction of client's activity -Application of cold packs -Collection of urethral cultures -Elevation of the scrotum Orchitis is an inflammation of the testes often following a viral infection, especially mumps infections. Urethral cultures, urinalysis, and urine culture should be obtained. Supportive treatment includes bed rest, hot or cold packs for analgesia, and scrotal elevation. Antibiotic therapy is not part of the treatment of orchitis.

A client is admitted into the emergency department with a sustained erection lasting 4 hours. Which initial treatments does the nurse anticipate administering? Select all that apply. -Sedation -Surgical shunt -Analgesics -Insertion of a urinary catheter -Hydrating measures

-Sedation -Analgesics -Hydrating measures Initial treatment measures for priapism would include analgesics, sedation, and hydration. Urinary retention may necessitate catheterization, but this client has not stated that he has urinary retention so this is not indicated at this time. Other local measures include ice packs and cold saline enemas, aspiration, and irrigation of the corpus cavernosum with plain or heparinized saline, or instillation of alpha adrenergic drugs. If less aggressive treatment does not produce detumescence, a temporary surgical shunt may be established between the corpus cavernosum and the corpus spongiosum.

For males between 5 and 10 years of age, which cause of priapism is most common? -Renal failure -Sickle cell anemia -Spinal cord injury -Accidental trauma

-Sickle cell anemia Priapism is due to impaired blood flow in the corpora cavernosa of the penis. Priapism can occur at any age. Sickle cell disease or neoplasms are the most common cause of priapism in males between 5 and 10 years of age. Accidental trauma is not a cause of priapism. Subtypes of priapism include ischemic (veno-occlusive, low flow) and abnormal cavernous blood gases. Secondary causes include hematologic conditions such as leukemia, sickle cell disease, and thrombocytopenia; neurologic conditions such as stroke, spinal cord injury, and other central nervous system lesions; and renal failure.

Priapism (a prolonged painful erection not associated with sexual excitement) can occur at any age. In boys, ages 5 to 10, what are the most common causes of priapism? -Hypospadias or neoplasms -Hemophilia or sickle cell disease -Sickle cell disease or neoplasms -Neoplasms or hemophilia

-Sickle cell disease or neoplasms Priapism can occur at any age, in the newborn as well as other age groups. Sickle cell disease or neoplasms are the most common cause in boys between 5 and 10 years of age. Hemophilia and hypospadias are not linked to priapism in any age group.

Squamous cell cancer of the penis is characterized by which clinical manifestation? -Smegma accumulation in uncircumcised male with poor hygiene -Painless cyst on the inner surface of the prepuce -Erectile dysfunction with prolonged erection -Herpes ulcerations on the penile shaft

-Smegma accumulation in uncircumcised male with poor hygiene The cause of penile cancer is unknown. Invasive squamous cell carcinoma of the penis usually begins as a small lump or ulcer on the glans or inner surface of the prepuce. Several risk factors have been suggested, including poor hygiene, human papillomavirus infections (rather than herpes simplex virus infections), ultraviolet radiation exposure, and immunodeficiency states. There is an association between penile cancer and poor genital hygiene and phimosis. Circumcision confers protection, and hence cancer of the penis is extremely rare in men circumcised at birth. It is thought that circumcision is associated with better genital hygiene, which, in turn, reduces exposure to carcinogens that may accumulate in smegma and decreases the likelihood of potentially oncogenic strains of HPV. Erectile dysfunction can be the result of depression, androgen level imbalance, systemic medications, or arterial insufficiency that are unrelated to squamous cell tissue changes.

Which factor in the evaluation and treatment of benign prostatic hyperplasia (BPH) is considered to be the single most important one? -Subjective symptoms reported by the client -Frequency of erectile dysfunction -Testosterone level management -Prostate cancer prevention measures

-Subjective symptoms reported by the client It is now thought that the single most important factor in the evaluation and treatment of BPH is the man's own personal experiences related to the disorder. The American Urological Association Symptom Index consists of seven questions about symptoms regarding incomplete emptying, frequency, intermittency, urgency, weak stream, straining, and nocturia. Erectile dysfunction may develop secondary to the androgen hormone imbalances associated with BPH. Both androgens (testosterone and dihydrotestosterone) and estrogens appear to contribute to the development of BPH.

The nurse has just completed the admission assessment of a client diagnosed with invasive penile cancer. The most likely plan of treatment will be: -Surgical removal of the affected area -Radiation treatment to the affected area -Laser treatment to the affected area -Application of fluorouracil cream

-Surgical removal of the affected area The mainstay of treatment for invasive cancer is surgery. Fluorouracil cream or laser treatments are both conservative treatments. Radiation may be considered a palliative treatment.

In the neonatal and pediatric population, there can be many physiologic problems with the male genitourinary system. What is the most common acute scrotal disorder in the pediatric population? -Testicular torsion -Hypospadias -Balanitis -Paraphimosis

-Testicular torsion The most common acute scrotal disorder in the pediatric population is testicular torsion.

The nurse in the newborn nursery is caring for a neonate with epispadias. Why does the nurse makes a point of assessing the baby's abdomen? -Undescended testes may be palpated in the lower abdomen of children born with epispadias. -The bowel frequently protrudes through the umbilical ring in children born with epispadias. -Hernias commonly occur in children with epispadias. -The bladder may be found outside the abdominal wall in children with epispadias.

-The bladder may be found outside the abdominal wall in children with epispadias. Epispadias, the opening of the urethra on the dorsal surface of the penis, may occur as a separate entity. It often is associated with exstrophy of the bladder, a condition in which the abdominal wall fails to cover the bladder.

The nurse is caring for a client with significant benign prostatic hyperplasia (BPH) and hydronephrosis who is fearful of having corrective surgery. Which information is important for the nurse to convey? -If not treated promptly, this condition may become cancerous. -The obstruction is causing urine to flow backward and cause kidney dysfunction. -Medications which shrink prostate tissue will begin to work in a week or so. -Herbal preparations can be helpful and are free from side effects.

-The obstruction is causing urine to flow backward and cause kidney dysfunction. Enlargement of the prostate causes obstruction to urinary outflow which may cause infection, damage to the bladder wall, cause hydroureter or hydronephrosis. This back-pressure on the urinary system may cause renal failure.

The pediatric nurse is teaching the mother of a newborn with hypospadias about this disorder. Which of these does the nurse convey? -The foreskin of the penis is unable to be fully retracted. -Medication will be given to correct this problem. -Undescended testes are frequently associated with hypospadias. -The opening of the urethra is found on the underside of the penis.

-The opening of the urethra is found on the underside of the penis. In hypospadias, which affects approximately 1 in 350 male infants, the termination of the urethra is on the ventral or underside surface of the penis.

The nurse is caring for an infant with an undescended testis. Which of these does the nurse teach the parents is the appropriate treatment? -Treatment is not necessary as it resolves spontaneously. -A surgical procedure to remove the testicle is needed. -The surgical placement of the testis in the scrotum is needed. -A procedure to implant an artificial organ is needed.

-The surgical placement of the testis in the scrotum is needed. The treatment goals for boys with cryptorchidism include measures to enhance future fertility potential, placement of the gonad in a favorable place for cancer detection (orchiopexy), and improved cosmetic appearance.

The nurse is teaching the client about pharmacologic treatment for benign prostatic hyperplasia (BPH). Which explanation of the action of these alpha adrenergic blocking medications is best? -They prevent urinary frequency and infections. -They shrink prostate tissue almost back to normal size. -They promote erectile function when that is the primary symptom. -They relax the smooth muscle to relieve prostatic obstruction.

-They relax the smooth muscle to relieve prostatic obstruction. The presence of adrenergic receptors in prostatic smooth muscle has prompted the use of alpha-adrenergic blocking drugs (e.g., doxazosin, terazosin) to relieve prostatic obstruction and increase urine flow.

Which factor places a male client at risk for balanitis? -Uncircumcised penis -Chronic prostatitis -Androgen deficiency -Multiple sexual partners

-Uncircumcised penis Balanitis is either a chronic or acute, sclerosing, atrophic process of the glans penis that can occur in uncircumcised men. As such, the uncircumcised state supersedes the influence of sexual behavior, prostatitis, or hormonal effects.

A client asks, "What caused my acute prostatitis?" Which response by the nurse explains the most common cause of acute prostatitis? -Mucous gland overgrowth -Urethral infection with Escherichia coli -Acute pyelonephritis -Prostate hyperplasia

-Urethral infection with Escherichia coli The most likely etiology of acute bacterial prostatitis is an ascending gram-negative E. coli urethral infection or reflux of infected urine into the prostatic ducts, rather than a descending bacterial infection from the kidneys (pyelonephritis). Benign prostatic hyperplasia (BPH) is an age-related, nonmalignant enlargement of the prostate gland caused by overgrowth of the prostate mucosal glands.

A client asks, "What caused my acute prostatitis?" Which response by the nurse explains the most common cause of acute prostatitis? -Prostate hyperplasia -Mucous gland overgrowth -Acute pyelonephritis -Urethral infection with Escherichia coli

-Urethral infection with Escherichia coli The most likely etiology of acute bacterial prostatitis is an ascending gram-negative E. coli urethral infection or reflux of infected urine into the prostatic ducts, rather than a descending bacterial infection from the kidneys (pyelonephritis). Benign prostatic hyperplasia (BPH) is an age-related, nonmalignant enlargement of the prostate gland caused by overgrowth of the prostate mucosal glands.

Which complication is associated with prostatic hyperplasia? -Scrotal edema -Hypospadias -Urine retention -Testicular cancer

-Urine retention Benign prostatic hyperplasia (BPH) is a common disorder in men older than 40; because the prostate encircles the urethra, BPH exerts its effect through obstruction of urinary outflow from the bladder. Hypospadias is a congenital condition in which the termination of the urethra is on the ventral surface of the penis. Scrotal edema is often the result of testicular disease or inflammation rather than prostate enlargement. Often the first sign of testicular cancer is a slight enlargement of the testicle that may be accompanied by some degree of discomfort.

A client is suspected to have small varicoceles in his left scrotum. Which assessment technique may help accentuate small varicosities? -Turning to the left side -Rectal exam -McRoberts maneuver -Valsalva maneuver

-Valsalva maneuver The Valsalva maneuver may be used to accentuate small varicosities. If the varicocele is present, retrograde blood flow to the scrotum can be detected by Doppler ultrasonography. Other diagnostic aids include radioisotope scanning and spermatic venography.

A client is admitted with a prolonged and painful erection that has lasted longer than 4 hours. The nurse knows that this is a true urologic emergency, and that the cause is: -cardiovascular disease. -impaired blood flow in the corpora cavernosa of the penis. -poor hygiene. -chronic inflammation of the glans penis.

-impaired blood flow in the corpora cavernosa of the penis. Priapism is an involuntary, prolonged (>4 hours), 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 with significant risk of subsequent impotence. Priapism is caused by impaired blood flow in the corpora cavernosa of the penis.

Palliative care for clients diagnosed with terminal prostate cancer includes focal irradiation of symptomatic bone disease and: -chemotherapy. -pain control. -radiation therapy. -counseling for depression control.

-pain control. Palliative care includes adequate pain control and focal 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.

During clinical skills lab, a student walks away from the "client" the student just catheterized. The faculty assesses the student's ability to clean up after the procedure and finds the student has not replaced the client's foreskin over the glans. Which problem will the faculty review with this student? -that tight foreskin can lead to ischemia at the penile tip -how to remove excess betadine from the penile tip -advantages of the foreskin in adult males -proper sterile technique

-that tight foreskin can lead to ischemia at the penile tip A tight foreskin can constrict the blood supply to the glans and lead to ischemia and necrosis. Many cases of paraphimosis result from the foreskin being retracted for an extended period, as in the case of catheterized uncircumcised males. No information is presented as to whether sterile technique is a problem during insertions. Betadine is frequently used to cleanse the tip of the penis just prior to catheterization. By adulthood, an uncircumcised male should have received education on how to care for the foreskin to keep it clean and retractable. If not, the nurse should provide this information to the client.

The nurse is caring for a client diagnosed with benign prostatic hyperplasia (BPH). The nurse teaches the client about what medications commonly used to treat BPH and its complications? Select all that apply. -αlpha-1 adrenergic antagonists (e.g., tamsulosin) -aromatase inhibitors (e.g., aminoglutethimide) -5-alpha-reductase inhibitors (e.g., finasteride) -phosphodiesterase-5 inhibitors (e.g., tadalafil) -bisphosphonates (e.g., pamidronate)

-αlpha-1 adrenergic antagonists (e.g., tamsulosin) -5-alpha-reductase inhibitors (e.g., finasteride) -phosphodiesterase-5 inhibitors (e.g., tadalafil) The 5-alpha-reductase inhibitors such as finasteride treat BPH by reducing prostate size via blocking the effect of androgens. Drugs of the alpha-adrenergic antagonist class block the receptors in the prostatic smooth muscle to relieve prostatic obstruction and increase urine flow. The phosphodiesterase-5 inhibitors class of medications reduce lower urinary tract symptoms by relaxing smooth muscle. Research has indicated combining two classes of medications can better control the symptoms of BPH. Both aromatase inhibitors and bisphosphonates are used in later stage prostate cancer and not in BPH.

A male client reports frequent urination, difficulty starting to urinate, and dribbling after he has finished urinating. Which diagnosis correlates with this client's manifestations? -Urinary tract infection -Androgen deficiency -Bladder cancer -Benign prostatic hyperplasia (BPH)

Benign prostatic hyperplasia (BPH) Symptoms of BPH include urinary hesitancy, diminished force of stream, retention, and postvoid dribbling. BPH is very common in men age 40 years or older.

The community health nurse is conducting a men's health class. Which of these does the nurse relate as the major role of the prostate? -It increases sperm motility. -It has no purpose or function in modern time. -It increases acidity of seminal fluid. -It protects the urethra.

It increases sperm motility. The prostate surrounds the urethra. It produces a thin, milky, alkaline secretion that aids sperm motility by helping to maintain an optimum pH.

Which treatment intervention is recommended for infants who have a severe case of hypospadias? -surgical repair -splitting of the foreskin -application of topical steroids -immediate circumcision

surgical repair Surgical repair for normal sexual and urinary function to prevent psychological sequelae of having malformed genitalia is the most common treatment of hypospadias in the more severe cases. Circumcision is the treatment of choice for symptomatic phimosis. Splitting of the foreskin to allow for swelling and more blood flow is a radical procedure for prolonged erection. Application of topical steroids to suppress the overactive immune system is the treatment for balanoposthitis.