• Enlargment of prostate gland>↑ # of cells
• Non-malignant disorder ass. w aging
• usually in men over 55
• Can cause kidney infection if urine backed up

• Difficulty urinating/starting a stream
• urinary retention
• Feeling the urge all the time
• dribbling
• residual urine                     (DUFDRN)
• Nocturia

• Watchful waiting
• limiting fluids in eventing
• drug therapy
• surgery

• Proscar>
  •  androgenic hormone
  •   SE= loss of libido, impotence
• Terazosin(Hytrin)
  • alpha adrenergic blocker
  • SE= hypotension, dizziness, urinary frequency, incontinence

• approaches
  • TURP>transurethral resection
  • Suprapubic
  • perineal
  • Retropubic

peri-op nursing care for BPH surgery

• Pre-op catheter
• Usual post-op care
• Three way catheter for irragation(urine may be bloody)
• B&O suppositories, relaxes muscles for (bladder spasms)

TURP

• Transurethral resection of the prostate
• Part of prostate removed w/cuttintg insturement  @ end of endoscope

• midline abmn. incision int bladder
• Suprapubic catheter (cystostomy tube) & foley catheter inserted

• Abdmn. incision but bladder not entered

• incision made between scrotum & anus

• Prostate gland & its capsule,seminal vesicles, lymphnodes removed through retropubic/perineal incision.
• for clients with prostatic cancer

What is PID?

• Pelvic inflammatory disease( outside uterus)
• May be fallopian tubes,ovaries, pelvic peritoneum, perlvic vascular system

• Gonococcus bacteria MOST COMMON
• Gram- bacteria(staph/strep)
• bacteria enter through vagina

• N&V, chills, fever
• If chronic>menstrual disturbance, backache, pelvic heaviness
• Purulent vaginal drainage               (NIPS)
• severe lower abdn./pelvic pain

• antibiotics
• bedrest
• sometimes hospitalization

• Adenocarcinoma
• 3rd most common caused of cancer man death
• over 50 can develop_high risk if 70
• more frequent in african americans
• a diet high in fat and low in fruit is a risk

• Obstruction of urine flow
  • frequencey
  • nocturia
  • dysuria
  • urinary retention
• blood in urine

• DRE-digital rectal exam
  • + for enlarged, nodular prostate
• Positive PSA: Over 4mg/ml suspicious, over 10 is malignancy
• Biopsy to confirm

• Depends on age, SE, other health conditions, stages and grades of cancer
• prostatecomy
• bilateral orchiectomy
• radiation
• hormone therapy
• Chemo>if spread outside prostate

gleason grade for prostate cancer

• 1-5
• 1=almost normal
• 5= very abnormal

• Curative if cancer not spread outside gland
• side effects: possible impotence, incontinence, genital/lower extremity edema
• Expect pinkish drainage/small clots from catheter post op>NOTIFY dr. if large amounts

• less invasive
• removes no lymph nodes
• may cause nerve damage

• removing testicles
• removes source of androgen that stimulates cancer growth

• alone or with other treatments
• SE: impotence, diarrhea,unrinary frequency
• External:beam focuses on prostate from outside
• Internal:temporary/perm. placement of radioactive pellets inside prostate(dime size)

• androgen suppresion
  •  sometimes to shrink prostate prior to surgery/radiation
  • lowers testosterone levels(high voice)
  • not curative, may slow growth

• 18-40 year age group 
• leading cause of death from cancer for men 25-34 yrs.

• Undescended testes into scrotal sac
• testes remain in inguinal canal/abmn.cavity
• (testes have to be cooler than body or wont produc sperm)

Complications of cryptorchidism

• Steritity(wont produce sperm)
• 20-40% gr8er risk for testicular cancer

• androgen therapy(2-3wks)>see if descend
• orchiopexy- surgery-secures testes w/scrotum
• NRsng manage-teach monthly testicular self-exams

• Situated in original, natural, existing place of position???CANCER??

• anually after 40 yrs. of age

• Opening between bladder and vagina allowing urine to leak in vagina

• Ureterovaginal fistula- opening between urethra/fagina
• Rectovaginal fistula-opening between rectum and vagina

• Surgical repair aftrer inflammation/edema dissapear(may take mo.'s of treatment)
• high rate of
  • hemorrhage(1st 24 hr.)
  • infection
• if repair not possible-symptomatic care
  • reduce infection risk
  • manage skin exoriation

• 95% discoverd by women
• mammography-noninvasive
• MRI-if lesion seen
• Biopsy-needle aspiration

• inflammation of vagina
• Symptoms> abnorm. vagina discharge, itching, burning, redness, swelling, 
• from
  • STDs> trichomonas
  • Candida alicans 2° to depressed immune system or antibiotic treatment

• Inflammation of cervix
• chronic inflammation can lead to cancer
• from
  • infection after childbirth
  • gonorrhea/other microbes
  • decreased estrogen
  • trauma

• leukorrhea(white/yellow discharge)
• spotting/bleeding
• painful intercourse

• Diagnosed by pelvic exam or lab smears
• treatment:
  • Antibiotics/antifungals
  • electrocautery
  • conization/removal of diseased part

• endometrial tissue found outside uterus in ovaries, pelvis, abdomen
• possible family link
• Increased incidence from STD's

• Endometrial cells respond to circulating hormones>can bleed in2 surrounding areas>cause scare tissue
• Scarring around fallopian tubes can  cause sterility

• suppressoin of ovulation
• laproscopic laser to remove tissue/adhesions
• hysterectomy

• Caused difficulty in childbirth

• Uterine displacement
• utereus bent backward @ acute angle

• Uterus diplacement
• uterus bent forward @ acute angle

• Prostate specific antigen
• elevated if BPH
• If prostate cancer: positive: over 4mg/mL suspicious>over 10 indicates malignancy

• Palpable lumps in testes
• occasions breast tenderness     (POLO)
• low back pain>later stages
• often no s/s found in other examinations

• sexually active women(HPV)
• Chronic cervicitis
• cigarette smoking

• Vague lower abmn. discomfort initially
• urine frequency/urgency  
•  (later:)
•  severe pain      (VUSGWA)
• Gi symptoms
• weight loss
• ascites

• Papanicolaou test
• determines presence of abnorma/cancer cells

• Dialation & curettage
• To find reason for abnormal uterine bleeding

• entire breast tissue and SOME lymphnodes removed

• entire breast tissue and ADDITIONAL lymphnodes removed

• Entire breast tissue, EVEN MORE lymph nodes, Chest wall muscle, some skin removed

• Know what phsysian/patient discussed
• emotional support
• fear of dying
• "Reach for recovery"
• Recconstructive surgery

• Lymphedema
  • slows circulation of lymph fluid

• can take 1wk-1mo.
• combined manual lymphatic drainage,
• ptnt. self massage,
• exercise
• wearing of compression garment
• ptnt. must provide continuing treatment so does not return.

• Female over 50
• family history
• Radiation exposure as child
• previous cancer(colon, endrometrial,breast)
• chronic ETOH consumption
• More hormones over lifetime 
  • obesity
  • early menst., late menopause
  • not having children or having after 30
• White women get more, black women likely to die from it

• Herpes simplex Type 2

S/S of herpes genatalis

• Multiple vesicles on
  • penis, prepuce,buttox.thighs,introitus, cervix
  • they burn/itch befor coming fluid filled blisters
  • rupture 1-3 days become> painful,redenned ulcers & scab over
• Inguinal lymph node swelling
• flulike symptoms
• headache

• infection caused by bacterium: neisseria gonorrhoeae
• STD
• microorganism invade area depending on nature of sexual contact
• can spread through out the body

• appear 2-6 days after infection
• purulent discharge
• pain on urination      (APP)

• Symptoms appear IN 2-6 days
• white/yellow vaginal discharge
• intermenstrual bleeding form cervicitis
• painful urination

• painful BM"s
• purulent rectal discharge

• Sore throat

• skin rash
• painful joints         (SPF)
• fever

Chlamydia and *drug of choice* to treat

• Microorganism lives inside cells it infects
• DRUG CHOICE:antimicrobials
  • doxy cycline(Vibramycin)
  • tetracyclines
  • erythromycin(E-MYACiN)      ???????????
  • clarithromycin(biaxin)
  • azithromycin(zithormax)

• Risk for bleeding related to inadequate hemostasis "???

dysuria

• lack of power:weakness
• inability of man to achieve/maintain penile erection

• accumulation of serous fluid in peritoneal cavity