Male Reproductive Problems
BENIGN PROSTATIC HYPERPLASIA (BPH)
Benign prostatic hyperplasia (BPH) is prostate gland enlargement due to increased
epithelial cells and stromal tissue.
BPH results from endocrine changes associated with the aging process.
The compression of the urethra leads to clinical symptoms including decrease in caliber
and force of the urinary stream, difficulty in initiating voiding, intermittency and
Conservative and initial treatment is “watchful waiting” when there are no symptoms or
only mild ones. Drug therapy may also be used.
Invasive treatment of symptomatic BPH involves prostate resection or ablation.
Prostate cancer is the most common cancer among men, excluding skin cancer.
Risk factors include family history, age, and ethnicity.
Symptoms of prostate cancer are similar to those for BPH, including dysuria, hesitancy,
dribbling, frequency, and urgency.
Elevated levels of prostate-specific antigen (PSA) indicate prostatic pathology, although
not necessarily prostate cancer.
The conservative approach to management is “watchful waiting.”
Invasive therapies include radical prostatectomy and cryosurgery. Treatment may also
include drugs, hormones, chemotherapy, and radiation.
The nursing role is to encourage patients, in consultation with health care providers, to
have annual prostate screening (PSA and digital rectal examination) starting at age 50 or
younger if risk factors present.
The term prostatitis describes a group of inflammatory and noninflammatory conditions
affecting the prostate gland.
It includes acute bacterial prostatitis, chronic bacterial prostatitis, chronic
prostatitis/chronic pelvic pain syndrome, and asymptomatic inflammatory prostatitis.
Antibiotics are used for acute and chronic bacterial prostatitis. EPIDIDYMITIS
Epididymitis is an acute, painful inflammatory process of the epididymis secondary to
an infectious process, trauma, or urinary reflux down the vas deferens.
Antibiotic use is important for both partners if transmission was through sexual contact.
Conservative treatment consists of bed rest with elevation of scrotum, use of ice packs,
STRUCTURES AND FUNCTIONS
The human nervous system is a highly specialized system responsible for the control and
integration of the body’s many activities.
The nervous system can be divided into the central nervous system (CNS) and parts of
the peripheral nervous system (PNS).
o The central nervous system consists of the brain and spinal cord.
o The peripheral nervous system consists of the cranial and spinal nerves and the
autonomic nervous system (ANS).
The nervous system is made up of two types of cells: neurons and neuroglia.
o The neurons of the nervous system come in many different shapes and sizes, but
they all share common characteristics: (1) excitability, or the ability to generate a
nerve impulse; (2) conductivity, or the ability to transmit the impulse to other
portions of the cell; and (3) the ability to influence other neurons, muscle cells,
and glandular cells by transmitting nerve impulses to them.
o Neuroglia, or glial cells, provide support, nourishment, and protection to neurons.
Nerve impulses originate within a neuron as an action potential that moves along the
body of the cell (axon) until it reaches the end of the nerve fiber. From there, it is
transmitted across the junction between nerve cells by a chemical interaction and then,
the impulse will move across the next neuron as an action potential.
o A synapse is the structural and functional junction between two neurons. It is the
point at which the nerve impulse is transmitted from one neuron to another or
from neuron to glands or muscles.
o A neurotransmitter is a chemical agent involved in the transmission of an
impulse across the synaptic cleft.
CENTRAL NERVOUS SYSTEM
The major structural components of the CNS are the spinal cord and brain. Spinal Cord
The spinal cord is continuous with the brainstem and exits from the cranial cavity through
the foramen magnum. A cross section of the spinal cord reveals gray matter that is
centrally located and is surrounded by white matter.
Specific ascending and descending pathways in the white matter can be identified.
o In general, the ascending tracts carry specific sensory information to higher levels
of the CNS.
o Descending tracts carry impulses that are responsible for muscle movement.
Lower motor neurons are the final common pathway through which descending motor
tracts influence skeletal muscle, the effector organ for movement. The cell bodies of
these cells are located in spinal cord and the axons innervate the skeletal muscles.
The brain consists of the cerebral hemispheres, cerebellum, and brainstem.
The cerebrum is composed of the right and left hemispheres. Both hemispheres can be
further divided into four major lobes.
o The frontal lobe controls higher cognitive function, memory retention, voluntary
eye movements, voluntary motor movement, and expressive speech.
o The temporal lobe contains Wernicke’s area, which is responsible for receptive
speech and for integration of somatic, visual, and auditory data.
o The parietal lobe is composed of the sensory cortex, controlling and interpreting
o Processing of sight take place in the occipital lobe.
The basal ganglia, thalamus, hypothalamus, and limbic system are also located in the
The brainstem includes the midbrain, pons, and medulla. The vital centers concerned
with respiratory, vasomotor, and cardiac function are located in the medulla.
The brainstem contains the centers for s