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Disorders of the Prostate gland (ERECTILE DYSFUCTION (ASSESSMENT AND…
Disorders of the Prostate gland
PROSTATITIS
SYMPTOMS
perineal discomfort,
burning, urgency, frequency,
pain with or after ejaculation
nocturia
CAUSES
inflammation of the prostate gland caused by infectious agent
ASSESSMENT
collect prostatic fluid
PATHOPHSIOLOGY
Infection and inflammation of the prostate gland results in oedema,
Of importance is the pressure exerted on the urethra which will cause symptoms related to micturition
Chronic inflammation may cause an increase in prostate size,
may result in obstruction of the urinary flow
MEDICAL MANAGEMENT
A broadspectrum antibiotic agent is given for 10 to 14 days
analgesic agents, antispasmodic medications and bladder sedatives and stool softeners
NURSING MANAGEMENT
administration of prescribed antibiotics
provision of comfort measures, including prescribed analgesic agents and sitz baths
Patient needs to be instructed about the importance of continuing antibiotic therapy.
HEALTH EDUCATION
instructs the patient to complete the prescribed course of antibiotics
Foods and liquids increase prostatic secretions , should be avoided.
sexual arousal and intercourse should be avoided.
Medical follow-up is necessary for at least 6 months to 1 year
BENIGN PROSTATIC HYPERPLASIA
CAUSES
The exact cause of benign prostatic hyperplasia is not known
SYMPTOMS
A prostate gland that is large, rubbery, and nontender.
incomplete emptying of the bladder and urinary retention
RISK FACTORS
Alcohol
ASSESSMENT AND DIAGNOSIS
Patient History-taking
Lifestyle in relation to sexual practices,
delay in passing urine when there is an urge
nocturia, incomplete emptying and urinary leakage
Physical examination include Abdominal palpation
Urinalysis, urine culture
A blood test for full blood count, clotting factors
Kidney function, and a prostate-specific antigen
PATHOPHYSIOLOGY
The hypertrophied prostate results in an obstruction in the urethra and incomplete emptying of the bladder
In many patients older than 50 years, the prostate gland enlarges and obstructing the outflow of urine
SURGICAL INTERVENTION
Any one out of Five methods of prostatectomy may be used
Transurethral resection of the prostate (TURP)
Retropubic prostatectomy
Perineal prostatectomy.
Laparoscopic radical prostatectomy
MEDICAL MANAGEMENT
Medical management
watchful waiting,(TUIP), balloon dilation.
Alpha-blockers, 5-alpha-reductase inhibitors, transurethral
Non-surgical invasive treatment.
HEALTH EDUCATION
Avoid or stop drinking alcohol
PROSTATIC CANCER
CAUSES
is a malignant tumour of the prostate It is generally slow-growing and progressive
The cause of prostatic cancer are unkwon
RISK FACTORS
age, over 50 years
Family history of prostate cancer
A diet high in fat
PATHOPHYSIOLOGY
Prostate cancer is an androgen- dependent adenoma carcinoma.
It can spread by Direct extension to nearby structures
And Via the blood stream
ASSESSMENT AND DIAGNOSIS
DRE Cancerous lesion in the prostate may be palpated in the rectum
Transrectal ultrasonography (TRUS/TUS). Used to detect non-palpable prostatic tumours.
Radiological studies
Blood tests
Pelvic node dissection.
MEDICAL MANAGEMENT
Treatment is based on the stage of the disease and the patient’s age and symptoms
SURGICAL MANAGEMENT
A radical prostatectomy
NURSING MANAGEMENT
Improved pattern of urinary elimination
Maintain optimal nutritional status
Relief of pain
Improved physical mobility
ERECTILE DYSFUCTION
CAUSES
Erectile dysfunction has both psychogenic and organic causes
Psychogenic causes include anxiety, fatigue, depression.
Organic causes include diabetes, testosterone deficiency.
SYMPTOMS
Decreased frequency of erections
Inability to achieve a firm erection
RISK FACTORS
Men older than 65 years of age
ASSESSMENT AND DIAGNOSTIC FINDINGS
Requires a sexual and medical history
Analysis of presenting symptoms
Detailed assessment of all medications, alcohol, and drugs used;
Nocturnal penile tumescence tests
PATHOPHYSIOLOGY
Sensual stimulation, release of the LH, which cause constriction
Anything that interferes with this process can cause erectile dysfunction.
Inability of the brain to respond to sexual stimuli can interrupt the signals to PNS
MEDICAL MANAGEMENT
Adrenergic blocking medication may be used
Intracavernosal vasodilating drugs
Sildenafil (Viagra) used
SURGICAL MANAGEMENT
Revascularisation
NURSING MANAGEMENT
Nurse must find, implement, and integrate their sexual beliefs and behaviors into a healthy.
HEALTH EDUCATION
how to administer oral medications and injections..
Nurse implement, and integrate their sexual beliefs and behaviors into a healthy.
PROSTATECTOMY
1Transurethral resection
surgeon removes the prostate piecemeal by cutting and coagulating tissues
2 Perineal prostatectomy
Perineal prostatectomy involves removing the gland through an incision in the perineum
3 Retropubic prostatectomy
The surgeon makes a low abdominal incision and approaches the prostate gland between the pubic arch and the bladder without entering the bladder.
4 Laparoscopic radical prostatectomy
provides better visualization of the surgical site and surrounding areas
5 Suprapubic prostatectomy
Suprapubic prostatectomy is one method of removing the gland through an abdominal incision