Medical-Surgical Nursing: Concepts & Practice 3rd edition Chapter 39 Care of Men with Reproductive Disorders Copyright © 2017, Elsevier Inc. All rights reserved.

Male Reproductive System Structures and functions Sperm production Effects of aging

Structures of the Male Reproductive System See Figure 39-1 on p. 923. From Lewis SL, Heitkemper MM, Dirksen SR, Bucher L: Medical-surgical nursing: assessment and management of clinical problems, ed. 9, St. Louis, 2014, Mosby.

Fertility Older adult considerations Contraception Reversible contraception Permanent contraception (vasectomy) Nursing management

Treatment Options for Erectile Dysfunction Medications taken about 1 hour before intercourse Complementary and alternative therapies Sexual therapy Penile implants Negative pressure (vacuum constrictive devices) See Table 39-2 on p. 929.

Health Screening and Assessments Testicular self-examination Diagnostic tests Tests for general state of health Serum acid phosphatase Tumor protein marker studies

Disorders of the Male Reproductive System Erectile dysfunction Premature ejaculation Retrograde ejaculation Infertility Hydrocele Varicocele Testicular torsion Priapism Peyronie’s disease

Scrotal Masses See Figure 39-4 on p. 930. From Lewis SL, Heitkemper MM, Dirksen SR, Bucher L: Medical-surgical nursing: assessment and management of clinical problems, ed. 9, St. Louis, 2014, Mosby.

Diagnostic Tests for the Male Reproductive System Digital rectal examination (DRE) Semen analysis Testicular self-examination (TSE) Prostate-specific antigen (PSA) level Transrectal ultrasound Urography Uroflowmetry See Table 39-1 on p. 926.

Diagnostic Tests for the Male Reproductive System (Cont.) Prostate tissue analysis (biopsy) Cystoscopy Urethral smears Luteinizing hormone (LH) level Prolactin level Follicle-stimulating hormone (FSH) level Testosterone level See Table 39-1 on p. 923.

Benign Prostatic Hyperplasia Etiology and pathophysiology Signs and symptoms Diagnosis DRE Pressure flow studies Postvoiding ultrasound or catheterization Treatment

Treatment of Benign Prostatic Hyperplasia Drug therapy Herbal therapy Surgery Nursing management Preoperative care Postoperative care

Surgical Interventions for Male Urogenital Problems Transurethral microwave thermotherapy (TUMT) Transurethral needle ablation (TUNA) High-intensity focused ultrasound (HIFU) Open prostatectomy Suprapubic prostatectomy Retropubic prostatectomy Perineal prostatectomy See Table 39-3 on p. 933.

Surgical Interventions for Male Urogenital Problems (Cont.) Transurethral resection of the prostate (TURP) Transurethral incision of the prostate (TUIP) Laser prostatectomy Transurethral electrovaporization of the prostate (TUVP) Transurethral photoselective vaporization of the prostate (PVP) Urethral stent Laparoscopic radical prostatectomy See Table 39-3 on p. 933.

Two Approaches to Prostatectomy See Figure 39-6 on p. 932. From Lewis SL, Heitkemper MM, Dirksen SR, Bucher L: Medical-surgical nursing: assessment and management of clinical problems, ed. 9, St. Louis, 2014, Mosby.

Two Approaches to Prostatectomy (Cont.) See Figure 39-6 on p. 932. From Lewis SL, Heitkemper MM, Dirksen SR, Bucher L: Medical-surgical nursing: assessment and management of clinical problems, ed. 9, St. Louis, 2014, Mosby.

Continuous Bladder Irrigation (CBI) System See Figure 39-7 on p. 934. From Black JM, Hawks JH: Medical-surgical nursing: clinical management for positive outcomes, ed. 8, Philadelphia, 2009, Saunders.

Inflammations and Infections of the Male Reproductive Tract Epididymitis Orchitis Prostatitis Type I: acute bacterial prostatitis Type II: chronic bacterial prostatitis Type III: nonbacterial prostatitis or chronic pelvic pain syndrome

Cancer of the Male Reproductive Tract Cancer of the penis Testicular cancer Prostate cancer Clinical symptoms PSA screening test Treatment and nursing care