MALE REPRODUCTIVE PROBLEMS 2021 With Notes

Health Problems of the Male
Reproductive System
PENILE PROBLEMS
Hypospadias
is a condition in which
the Urethral opening
located behind glans
penis or anywhere
along ventral surface
of penile shaft.
• Objectives of surgical correction:
• Enable child to void in standing position and
direct stream voluntarily in usual manner
• Improve physical appearance of genitalia
• Produce a sexually adequate organ
PENILE PROBLEMS
Epispadias
A condition in which the meatal
opening is located on dorsal
surface of penis
• Surgical correction, usually including penile

and urethral lengthening and bladder neck
reconstruction (if necessary)
Nursing Care Management
• Every male newborn should be examined
carefully for signs of hypospadias/epispadias.
• In male infants who remain uncircumcised,
verify that the newborn’s meatal opening is
present on the glans penis.
• Prepare the parents or the child who are old
enough to understand what is occurring,
possible surgical procedure or the expected
outcome.
• Repair may require some type of urinary
diversion to promote optimum healing and to
maintain the position and the patency of the
newly formed urethra.
• Teach the significant others how to care
for/secure the indwelling catheter or stent and
irrigation technique.
• Avoid tub bath until stent has been removed
to prevent infection.
• An antibacterial ointment may be applied for
infection control.
• Encourage the child to increase oral fluid
intake and avoid straddle toys, sand boxes,
swimming, and rough activities until allowed
by the surgeon
PENILE PROBLEMS
Phimosis
Narrowing or
stenosis of
preputial opening
of foreskin that
prevents
retraction of the
foreskin over the
glans penis
Management
• Mild cases: manual
retraction of
foreskin and proper
cleansing of area
• Severe cases:
circumcision or
vertical division and
transverse suturing
of foreskin
Nursing Care Management
• Proper hygiene of the phimotic foreskin
• The foreskin should not be forcibly retracted,
since it may create scarring that can prevent
future retraction or paraphimosis where the
retracted foreskin cannot be replaced in its
normal position over the glans.

HYDROCELE
• fluid in scrotum (tunica vaginalis)

• can be the result of cancer, trauma (such as a
hernia), or orchitis
• usually not painful
HYDROCELE
• Diagnosis
– Transillumination
– Sonography
HYDROCELE
• Needle aspiration
• Surgical repair if
indicated if
spontaneous
resolution not
accomplished in 1 year:
hydrocelectomy
Nursing Care Management:
• Preoperative preparation of the infant and
appropriate explanation to the parents of the
child’s expected postoperative status.
• Postoperatively the wound is kept clean and
dry
• Change diaper as soon as it is damped.
• Instruct the parent to provide sponge bath 2
to 5 days and to change the diapers frequently
• Older adults are cautioned to perform
strenuous activity for about 3 weeks.
TESTICULAR TUMORS
• Uncommon condition
but are usually malignant
when found in
adolescence.
• most common solid
tumor in males 15 to 34
years of age.
TESTICULAR TUMORS
Clinical Manifestations:
– heavy, hard, painless mass
– does not transilluminate unless accompanied by

a hydrocele
– involved testicle hangs lower

TESTICULAR TUMORS
Diagnostics:
– UTZ
– Direct Bx
TESTICULAR TUMORS
Treatment and Nursing care:
– Surgical removal of the
affected testicle & the
adjacent lymph nodes if
they are affected.
– Chemotherapy
– Radiotherapy
– Provision of careful
explanations of the various
procedures
TESTICULAR TUMORS
TESTICULAR SELF-EXAMINATION
VARICOCELE
• elongation, dilation, and
tortuosity of the veins of the
spermatic cord superior to the
testicle
• incidence increases
dramatically at the onset of
puberty
• found most often on the left
side
VARICOCELE
• wormlike mass, situated above the
testicle
• discomfort during sexual stimulation
• left testicle is usually smaller than
the right
• decreasing testicular size
• Decreasing levels of
dihydrotestosterone in seminal
plasma
VARICOCELE
Diagnostic Procedure
• Doppler ultrasound – dilatation of the vessels
of the pampiniform plexus
VARICOCELE
Treatment and Nsg. Care:
• Varicocelectomy
• Provision of careful
explanations of infertility
evaluation
EPIDIDYMITIS
• an inflammatory reaction of the
epididymis as a result of an
infection, a chemical irritant, or a
nonspecific cause
• causative factors (males <35y/o):

Chlamydia trachomatis & Neisseria
gonorrheae
EPIDIDYMITIS
• slow onset of unilateral scrotal pain, redness, &
swelling
• urethral discharge
• dysuria
• fever
• pyuria
EPIDIDYMITIS
Treatment and Nursing Care:
• Mild presentation of symptoms
may mimic testicular torsion,
which requires immediate
surgical intervention
• scrotal support
• bed rest
• analgesics
• antibiotic therapy
TESTICULAR TORSION
• a condition in which the tunica

vaginalis, which normally
encases the testicle, fails to do
so and the testis hangs free
from its vascular structures
TESTICULAR TORSION
• can result in partial or
complete venous occlusion
with rotation around this
vascular axis.
• peak onset at 13 years of age
• most common cause of

testicular loss in young males
TESTICULAR TORSION
• n/v
• abdominal pain
• testicular swelling
• testicular pain
• Scrotum (red, warm, edematous,
and appears to be immobile or
fixed)
• absence of cremasteric reflex
TESTICULAR TORSION
Diagnostics
• Doppler ultrasound – avascular testicle
TESTICULAR TORSION
• Nurses should be alert to the
possibility of testicular torsion in
adolescents who complain of
scrotal pain
• School nurses are likely to
encounter such injuries and
should refer the adolescent for
medical evaluation immediately
GYNECOMASTIA
• Some degree of bilateral or
unilateral breast enlargement
occurs frequently in young
boys during puberty
• the adolescent should be
evaluated for rare adrenal or
gonadal tumors, liver disease,
or Klinefelter syndrome
GYNECOMASTIA
• can also be drug induced:
– CCBs
– oral Ketoconazoles
– Marijuana
GYNECOMASTIA
• plastic surgery
• The nurse should assure the
adolescent and his parents that
this situation is benign and
temporary
• The adolescent may benefit from
the knowledge that it occurs in
more than 50% of his peers

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MALE REPRODUCTIVE PROBLEMS 2021 With Notes

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Health Problems of the Male

• Surgical correction, usually including penile

• fluid in scrotum (tunica vaginalis)

– does not transilluminate unless accompanied by

– involved testicle hangs lower

• causative factors (males <35y/o):

• a condition in which the tunica

• peak onset at 13 years of age

• most common cause of

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