1. Chapter 17 Reproductive System Diseases and Disorders

2. Anatomy and Physiology
Female external structures
Vulva
Labia majora and labia minora
Clitoris
Vestibule and vestibular glands
Hymen
Vaginal orifice

3. Anatomy and Physiology
Female internal structures
Ovaries
Fallopian tubes
Uterus
Cervix
Vagina
Hormones: estrogen and progesterone

4. Anatomy and Physiology
Male external organs
Scrotum and penis

5. Anatomy and Physiology
Male internal organs
Testes
Epididymis
Vas deferens
Urethra
Seminal vesicles
Bulbouretheral and prostate glands

6. Common Signs and Symptoms
Female
Abdominal and pelvic pain
Fever and malaise
Abnormal vaginal discharge
Burning and/or itching of the genitals

7. Common Signs and Symptoms
Female
Pain during sexual intercourse
Any change in breast tissue
Abnormal discharge from the nipple

8. Common Signs and Symptoms
Male
Urinary disorders including frequency, dysuria, nocturia, and incontinence
Pain in the pelvis, groin, or reproductive organs
Lesions on external genitals

9. Common Signs and Symptoms
Male
Swelling or abnormal enlargement of the reproductive organs
Abnormal penile discharge
Burning and/or itching of the genitals

10. Diagnostic Tests Female Bimanual examination Hysterosalpingogram
Papanicolaou smear of cervix
Cervical biopsy
Cone biopsy

11. Diagnostic Tests Female Dilatation and Curettage Laparoscopy
Mammography
Blood tests

12. Diagnostic Tests Male Digital rectal examination Cystoscopy Biopsy
Laboratory tests including PSA

13. Premenstrual Syndrome
Symotoms prior to menses
Symptoms begin mid-cycle
Headache and nausea
Back and joint pain
Edema and bloating
Weight gain

14. Premenstrual Syndrome
Symptoms begin mid-cycle
Breast tenderness
Sleep disturbances
Irritability
Mood swings
Depression

15. Premenstrual Syndrome
Treatment
Individualized
Dietary changes
Avoid caffeine, chocolate, nicotine, salt, sugar, and alcohol

16. Menstrual Abnormalities
Amenorrhea
Dysmenorrhea
Menorrhagia
Metrorrhagia

17. Endometriosis
Abnormal growth of endometrial tissue outside of the uterus
Common sites of implantation include ovaries, fallopian tubes, abdominal wall, and intestines

18. Endometriosis Symptoms Dysmenorrhea
Low back, vaginal, and pelvic cramping
Heavy menses and dyspareunia

19. Endometriosis Treatment Hormones
Remission with pregnancy, nursing, and menopause
Panhysterectomy

20. Pelvic Inflammatory Disease
Inflammation of some or all of the pelvic reproductive organs
May include cervicitis, salpingitis, endometritis, oophoritis
Most commonly caused by STDs

21. Pelvic Inflammatory Disease
Symptoms
Fever
Chills
Pain in pelvic area
Leukorrhea
Treatment: antibiotics, analgesics, and rest

22. Ovarian Cyst Commonly benign fluid-filled sacs on or near the ovary
Two types
Physiologic
Neoplastic

23. Ovarian Cyst Symptoms Treatment depends on type and size
Low back pain
Pelvic pain
Dyspareunia
Nausea and vomiting
Treatment depends on type and size
May resolve by itself or require laparoscopy

24. Fibroid Tumor Also known as leiomyomas
Benign tumors of smooth uterine muscle
Symptoms
Abnormal uterine bleeding
Excessive menstrual bleeding and pain

25. Fibroid Tumor Treatment depends on woman’s age and desire for children
Surgical removal of fibroids or hysterectomy
Uterine embolization
Hormone therapy

26. Vaginitis Inflammation of vagina Symptoms Burning and itching
Swelling of vagina and external genitalia

27. Vaginitis Common type of vaginitis Candida: fungus or yeast
Trichomonas: parasite
Atrophic: post-menopausal

28. Toxic Shock Syndrome
Found almost exclusively in menstruating women using tampons
Organism: staphylococcus aureus
Symptoms: high fever, vomiting, diarrhea, and dropping blood pressure
Treatment: IV fluids, antibiotics

29. Toxic Shock Syndrome Symptoms Treatment: IV fluids, antibiotics
High fever
Vomiting
Diarrhea
Decreasing blood pressure
Treatment: IV fluids, antibiotics

30. Menopause Natural halting of menstruation
Occurs between ages 45 and 55

31. Menopause Common symptoms Treatment: hormone therapy, exercise
Hot flashes and night sweats
Vaginal dryness
Depression
Sleep disorders
Decreased libido
Treatment: hormone therapy, exercise

32. Uterine Prolapse Uterus protrudes into vagina Symptoms
Heaviness in pelvis
Urinary stress
Dysuria
Low back pain
Treatment: hysterectomy

33. Cystocele Herniation of urinary bladder through anterior vaginal wall
Symptoms: pelvic pressure, urinary urgency, frequency, and incontinence
Treatment: depends on degree of herniation

34. Rectocele Herniation of rectum through posterior vaginal wall
Symptoms: discomfort, constipation, fecal incontinence
Treatment: surgical repair

35. Cervical Cancer Fifth leading cause of cancer-related death in females
Symptoms: abnormal cervical bleeding
Treatment: surgical removal of tumor

36. Uterine Cancer Develops in endometrium and spreads to uterine wall
Symptoms: abnormal bleeding in menopausal women
Treatment: surgical removal of uterus and ovaries with radiation

37. Ovarian Cancer Quite common and often fatal
Symptoms: pressure on the bladder, abdominal or pelvic pain, general feeling of ill health
Treatment: complete hysterectomy, radiation, and chemotherapy

38. Fibrocystic Disease
Most common breast disorder of premenopausal females between the ages of 30 and 55
Cysts are linked to estrogen levels

39. Fibrocystic Disease To decrease breast pain: Reduce caffeine and salt
Use of mild diuretics
Use of mild analgesics the week prior to menstruation is recommended

40. Mastitis Inflammation of breast tissue Symptoms Redness Heat Swelling
Pain and often bloody nipple discharge

41. Mastitis Treatment Antibiotics Application of heat Analgesics
Firm supporting bra to decrease discomfort

42. Breast Cancer Adenocarcinoma of the breast ducts
Most common breast neoplasm (affects one out of nine females)
Risk factors
Age 40 and over
Family member affected with breast cancer

43. Breast Cancer Risk factors Onset of menses before age 13
Menses continuing after age 50
Nullipara
First child after age 30
Obesity
Chronic breast disease

44. Breast Cancer Symptoms Treatment Non-tender lump of varying size
Occurs most often in upper outer quadrant of breast often with dimpling
Treatment
Mastectomy, chemotherapy, and/or radiation

45. Ectopic Pregnancy
Fertilized ovum attaches to tissue outside the uterus, usually in fallopian tubes
Symptoms
Acute pelvic pain
Vaginal bleeding
Positive pregnancy test

46. Ectopic Pregnancy Treatment Prompt surgery to terminate pregnancy
Every effort is taken to preserve ovary and tube if future pregnancy is desired

47. Spontaneous Abortion “Miscarriage”
Natural termination of pregnancy before fetus is viable
Symptoms
Vaginal bleeding
Cramping and pelvic pain

48. Spontaneous Abortion Once it starts, progression is difficult to stop
D & C may be necessary to remove any tissue remaining in the uterus

49. Morning Sickness Associated with first trimester of pregnancy
Symptoms: nausea and vomiting
Treatment
Not necessary unless vomiting
Light meals several times a day

50. Morning Sickness Treatment Dry food before drinking Avoid fatty foods
Rest after meals

51. Hyperemesis Gravidarum
Excessive vomiting during pregnancy
Treatment includes IV fluids and withholding all foods and oral fluids
Usually subsides by second pregnancy

52. Toxemia Usually appears during 3rd trimester Symptoms Hypertension
Sudden weight gain
Proteinuria
Edema in face, hands, and feet

53. Toxemia Treatment Frequent monitoring of blood pressure
Weight and urine protein

54. Abruptio Placentae Separation of placenta from uterus
Degrees of symptoms
Partial separation may be asymptomatic
Complete separation may cause severe abdominal pain and vaginal bleeding
Shock and decrease in fetal heart tones

55. Abruptio Placentae Treatment
Prompt delivery either vaginally or by c-section
Blood replacement may also be necessary

56. Placenta Previa
Abnormal positioning of placenta in lower uterus near or over cervical os
Symptoms: painless, bright red vaginal bleeding during third trimester

57. Placenta Previa
Treatment-vaginal delivery is asymptomatic or if bleeding is not severe; emergency c-section if maternal bleeding or fetal anoxia

58. Placenta Previa Treatment
Vaginal delivery is asymptomatic if bleeding is not severe
Emergency c-section if maternal bleeding or fetal anoxia

59. Prostatitis Inflammation of prostate gland Symptoms
Dysuria
Pyuria
Fever and low back pain
Treatment: antibiotics, warm sitz baths, increased fluid intake, analgesics

60. Benign Prostatic Hyperplasia
Enlargement of prostate gland due to normal cells overgrowing and enlarging
Common in men over age 60

61. Benign Prostatic Hyperplasia
Symptoms
Nocturia
Inability to start urination
Weak urinary stream
Inability to empty stream

62. Benign Prostatic Hyperplasia
Treatment
Prostatic massage
Sitz bath
Catheterizations
Regular sexual intercourse
Surgery

63. Prostatic Carcinoma Neoplasm of prostate gland affecting men over 50
Second most common cause of cancer-related deaths in men

64. Prostatic Carcinoma Symptoms are similar to BPH Treatment
Depends on age and physical condition of individual
Degree of metastasis

65. Epididymitis Inflammation of epididymis Symptoms
Swollen, hard, and painful epididymis
Often accompanied by severe scrotal pain and swelling

66. Epididymitis Treatment Rest Analgesics Use of a scrotal support
Avoidance of alcohol, spicy foods, and sexual stimulation

67. Orchitis
Inflammation of one or both testes due to viral or bacterial infection
Symptoms: swelling, pain, tenderness of one or both testes, fever, malaise
Treatment: dependent on cause

68. Testicular Tumor Commonly affect young men age 20-35
Most common type of cancer in this group
Symptoms: painless mass felt in testicle
Treatment: orchiectomy, chemotherapy, and radiation

69. Cryptorchidism Undescended testicle Premature birth is common cause
Treatment: surgery

70. Genital Herpes Viral infection
1 in 6 individuals in United States is infected
Not curable
Periods of remission and exacerbation

71. Genital Herpes Symptoms Treatment is symptomatic
Blister-like lesions causing dysuria
Severe itching
Treatment is symptomatic
Antiviral medications
Sitz baths
Ice therapy and analgesics

72. Gonorrhea “Clap” Symptoms Purulent discharge from penis and vagina
Dysuria
Urinary frequency in males and females
Female - cervicitis
Genital itching and burning pain

73. Gonorrhea Treatment Antibiotics including Penicillin Tetracycline
Ceftiaxone

74. Syphilis Treatment: Penicillin or Tetracycline is very effective
Three stages
Primary - appearance of painless chancre
Secondary - chancre heals
Period of rest lasting 6 weeks to 1 year

75. Syphilis Secondary - rash appears Tertiary
Bacteria invade organs throughout body causing gumma
Curable with antibiotics during this stage but effects of lesions are irreversible

76. Chlamydia Known as “silent” STD - Bacterial Symptoms
Drainage with burning and itching
Urination due to urethritis and epididymitis
Treatment: antibiotics

77. Trichomoniasis Caused by protozoan Symptoms
Male - urethritis, epididymitis, and prostatitis
Female - green frothy vaginal discharge, itching and burning of genital area

78. Trichomoniasis
Treatment
Antiparasitic medications such as Flagyl

79. Genital Warts Viral infection Symptoms Treatment
Possible tenderness in affected area
Treatment
Chemical or surgical removal
Cervical cancer related to genital warts

80. Dyspareunia Pain or discomfort with sexual intercourse
May affect men and women
Treatment is dependent on cause

81. Premature Ejaculation
Expulsion of seminal fluid during foreplay, prior to complete erection, or immediately after sexual intercourse
Common in young males
Treatment is based on cause

82. Infertility
Inability of couple to achieve pregnancy after one year of unprotected sex

83. Infertility Causes Presence of STD Hormonal disorders
Abnormality of reproductive organs
Endometriosis
Scarring or blockage of fallopian tubes
Vaginal antibodies that kill sperm

84. Infertility Treatment Based on cause Surgery Medication therapy
Hormone imbalance

85. Hydiatidiform Mole Grape-like cysts in uterus that mimic pregnancy
Treatment: D & C
At higher risk to develop choriocarcinoma requiring frequent follow-up examinations