Male Reproductive System: Benign Prostatic Hyperplasia, Prostate Cancer, Erectile Dysfunction, Prostatitis, Peyronie's Disease, Priapism, Cryptorchidism, Hydrocele, and Varicocele

What is Benign Prostatic Hyperplasia?

it is an enlargement of prostate gland leading to disruption of urine outflow from bladder to urethra

What are some risk factors for Benign Prostatic Hyperplasia?

• aging

• obesity

• lack of physical activity

• alcohol use

• erectile dysfunction

• smoking

• diabetes

• first-degree relative family history

What are some signs and symptoms of Benign Prostatic Hyperplasia?

• difficulty starting a urine stream

• decreased/weaker flow of urine

• urinary frequency  

• nocturia

• urination urgency

• dysuria

• bladder pain

• incontinence

• dribbling at end of urination

What are some labs and diagnostic tests for Benign Prostatic Hyperplasia?

• digital rectal exam

• prostate-specific antigen level

• serum creatinine

• rectal ultrasound

• postvoid residual by ultrasound 

• transrectal ultrasound

What is a surgical intervention for Benign Prostatic Hyperplasia?

transurethral resection of the prostate

What are some nursing actions and interventions for Benign Prostatic Hyperplasia?

• administer tamsulosin (flomax) when ordered

• watch urine output

• if pt. has transurethral resection of the prostate, assess for bladder spasms

• if pt. has transurethral resection of the prostate, do manual, intermittent irrigation

• use aseptic technique when taking care of pt.’s post op for TURP

What are some patient teachings for Benign Prostatic Hyperplasia?

• tell pt. tamsulosin (flomax) can cause hypotension

• tell pt. to take tamsulosin (flomax) before bed or first thing in the morning

• teach pt. to try to urinate every 2-3 hours

What are some signs and symptoms of Prostate Cancer?

• pain in lumbosacral area radiating down hips or legs 

• tumor can spread to pelvic lymph nodes, bones, bladder, lungs, and liver

What are some complications of Radical prostatectomy for Prostate Cancer?

• hemorrhage

• seroma

• lymphocele

• urinary retention

• infection

• wound dehiscence

• venous thromboembolism

What are some labs and diagnostic tests for Prostate Cancer?

• PSA screening (every 2 years)

• digital rectal exam

• transrectal ultrasound procedure

• MRI 

• ultrasound fusion biopsy

What is a surgical intervention for Prostate Cancer?

radical prostatectomy

What are some patient teachings for Prostate Cancer?

• tell pt. that finasteride and dutasteride may reduce the chance of getting prostate cancer

• tell pt. there is a life expectancy of less than 10 years

• tell pt. early recognition and treatment are important to control tumor growth, prevent metastasis, and preserve quality of life

• teach pt. kegel exercises

What is erectile dysfunction?

it is the inability to attain or maintain an erection

What is a surgical intervention for erectile dysfunction?

penile implants

What are some nursing actions and interventions for patients with erectile dysfunction?

• refer pt. to sex therapist if psychological 

• administer phosphodiesterase type 5 inhibitors sildenafil (viagra), tadalafil (cialis), vardenafil (levitra) 

• administer vasoactive medications when ordered

What are some patient teachings for erectile dysfunction?

• tell pt. to not take erectile dysfunction medications with nitrates 

• tell pt. side effects of erectile dysfunction medications are heart attack, leg/back pain, dyspepsia, flushing, nasal congestion 

• tell pt. they can have a vacuum erection device, intraurethral device, intracavernosal injections

What are some signs and symptoms of Acute Bacterial Prostatitis?

• fever, chills

• back & perineal pain

• dysuria, frequency, urgency, cloudy urine

• acute urinary retention

What are some signs and symptoms of Chronic Prostatitis?

• backache

• perineal and pelvic pain

• ejaculatory pain

• enlarged prostate

• tender prostate

What are some complications of Prostatitis?

• epididymitis

• cystitis

• sexual dysfunction

• prostate abscess

What are some labs and diagnostic tests for Prostatitis?

• blood cultures

• PSA

• TRUS

• MRI

What are some nursing actions and interventions for Prostatitis?

• administer alpha-adrenergic blockers when ordered

• administer antibiotics

What are some patient teachings for Prostatitis?

• tell pt. they need to take antibiotic for 4 weeks for acute bacterial prostatitis

• tell pt. they need to take antibiotics for 8-12 weeks or long-term for chronic bacterial prostatitis

• tell pt. they can take warm sitz baths

What is Peyronie’s Disease?

it is plaque formation in the corpora cavernosa of the pencils causing inelasticity and curvature during erection

What can cause Peyronie’s Disease?

• trauma to penis

• dupatine contracture

What are some patient teachings for Peyronie’s Disease?

• tell pt. they can take collagenase clostridium histolyticum (xiaflex)

• tell pt. they can take intralesional vaerpamil

What is Priapism?

 it is a painful erection for more than 4 hours

• medical emergency

What are some complications of Priapism?

• penile tissue necrosis

• hydronephrosis

What are some nursing actions and interventions for Priapism?

• administer injectable ED medications when ordered

• administer PDE5 inhibitors when ordered

• administer corpora cavernosa when ordered

What is Cryptorchidism?

it is undescended testes

What is a complication of Cryptorchidism?

testicular cancer

What is Hydrocele?

it is nontender, fluid-filled mass from altered lymphatic drainage of the sacrum and swelling of the tunica vaginalis that surrounds the testes

What is a diagnostic test for Hydrocele?

transillumination

What is Varicocele?

it is the dilation of the veins that drain the testes

What are some signs and symptoms of Varicocele?

• wormlike feel (sack of worms) that is often on the left side

• 40-50% of men are infertile

What is a patient teaching for Varicocele?

tell pt. they can get a injection of sclerosing agent or surgical repair