1. Nursing Management: Male Reproductive Problems Chapter 55 Overview Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

2. Problems of the Prostate Gland Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 2 Fig. 55-1. Areas of the male reproductive system in which problems are likely to develop.

3. Benign Prostatic Hyperplasia Etiology and Pathophysiology Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 3

4. Benign Prostatic Hyperplasia Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 4 Fig. 55-2. Benign prostatic hyperplasia. The enlarged prostate compresses the urethra.

5. Benign Prostatic Hyperplasia Clinical Manifestations Complications Diagnostic Studies Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 5

6. Benign Prostatic Hyperplasia Collaborative Care Drug therapy 5  -reductase inhibitors  -adrenergic receptor blockers Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 6

7. Benign Prostatic Hyperplasia Collaborative Care, continued Minimally invasive therapy Transurethral microwave thermotherapy Transurethral needle ablation of prostate Laser prostatectomy Intraprostatic urethral stents Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 7

8. Benign Prostatic Hyperplasia Collaborative Care, continued Invasive therapy Transurethral resection of prostate Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 8

9. Benign Prostatic Hyperplasia Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 9 Fig. 55-3. Transurethral resection of the prostate.

10. Benign Prostatic Hyperplasia Collaborative Care Invasive therapy, continued Transurethral incision of prostate Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 10

11. Nursing Management: Benign Prostatic Hyperplasia Nursing Assessment Nursing Diagnoses Planning Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 11

12. Nursing Management: Benign Prostatic Hyperplasia Nursing Implementation Health promotion Acute intervention Preoperative care Postoperative care Ambulatory and home care Evaluation Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 12

13. Prostate Cancer Etiology and Pathophysiology Clinical Manifestations and Complications Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 13

14. Prostate Cancer Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 14 Fig. 55-4. Metastasis of prostate cancer to the pelvis and lumbar spine.

15. Prostate Cancer Diagnostic Studies Collaborative Care Conservative therapy Surgical therapy Radical prostatectomy Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 15

16. Prostate Cancer Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 16 Fig. 55-5. Common approaches used to perform a prostatectomy. A, Retropubic approach involves a midline abdominal incision. B, Perineal approach involves an incision between the scrotum and anus.

17. Prostate Cancer Collaborative Care Surgical therapy, continued Nerve-sparing procedure Cryotherapy Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 17

18. Prostate Cancer Collaborative Care, continued Radiation therapy External beam radiation Brachytherapy Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 18

19. Prostate Cancer Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 19 Fig. 55-6. A, Prostate brachytherapy. Implantation of seeds with a needle guided by ultrasound and a template grid. B, Radioactive seeds.

20. Prostate Cancer Collaborative Care, continued Drug therapy Hormonal therapy Luteinizing-hormone–releasing hormone (LHRH) agonists and antagonists Androgen receptor blockers Estrogen Orchiectomy Chemotherapy Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 20

21. Culturally Competent Care: Prostate Cancer Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 21

22. Nursing Management: Prostate Cancer Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health promotion Acute intervention Ambulatory and home care Evaluation Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 22

23. Prostatitis Etiology and Pathophysiology Clinical Manifestations and Complications Diagnostic Studies Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 23

24. Nursing and Collaborative Management: Prostatitis Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 24

25. Problems of the Penis Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 25

26. Congenital Problems Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 26

27. Problems of Prepuce Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 27 Fig. 55-7. A, Phimosis. Unable to retract the foreskin due to secondary lesions on the prepuce. B, Paraphimosis. Ulcer with edema from foreskin remaining contracted over the prepuce.

28. Problems of Erectile Mechanism Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 28

29. Cancer of Penis Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 29

30. Problems of the Scrotum and Testes Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 30

31. Inflammatory and Infectious Problems Skin Problems Epididymitis Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 31

32. Inflammatory and Infectious Problems Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 32 Fig. 55-8. Scrotal masses.

33. Inflammatory and Infectious Problems Orchitis Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 33

34. Congenital Problems Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 34

35. Acquired Problems Hydrocele Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 35

36. Acquired Problems Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 36 Fig. 55-9. Hydrocele.

37. Acquired Problems Spermatocele Varicocele Testicular Torsion Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 37

38. Testicular Cancer Etiology and Pathophysiology Clinical Manifestations and Complications Diagnostic Studies Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 38

39. Nursing and Collaborative Management: Testicular Cancer Testicular Self-Examination Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 39

40. Nursing and Collaborative Management: Testicular Cancer Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 40 Fig. 55-10. Testicular self-examination.

41. Nursing and Collaborative Management: Testicular Cancer Collaborative Care Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 41

42. Sexual Functioning Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 42

43. Vasectomy Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 43 Fig. 55-11. Vasectomy procedure. The vas deferens is ligated or resected for the purpose of sterilization.

44. Erectile Dysfunction Etiology and Pathophysiology Clinical Manifestations and Complications Diagnostic Studies Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 44

45. Erectile Dysfunction Collaborative Care Oral drug therapy Vacuum constriction device Intraurethral devices Penile implants Sexual counseling Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 45

46. Nursing Management: Erectile Dysfunction Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 46

47. Andropause Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 47 Table 55-12. Clinical Manifestations of Andropause.

48. Infertility Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 48