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Problem getting or keeping an erection and can happen at any age

Causes Stress Illness Fatigue Alcohol/drugs Prescription meds

Pathophysiology Interference with Circulation – blood supply entering penis Nerve supply – receptors and neurotransmitters Hormone balance testosterone Limbic system – emotions and sexual desire

Treatment Counseling Intracorporeal medication Medication change Hormone therapy Yohimbine Viagra Devices Surgery Implants Vascular surgery (younger men only)

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Cutting of vas deferens provides permanent birth control Effective about 6 weeks following surgery

Patient should be encouraged to continue using another form of birth control for 3 months after surgery.

Can also have a vasectomy reversal- the surgeon reconnects the vas deferens. More successful soon after the vasectomy.

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Risk factors: Peaks age 15-34 Cryptorchidism Family history DES use by mother Caucasian High socioeconomic status

Signs & Symptoms: Painless lump Swelling

Diagnosis Ultrasound Chest x-ray examination Blood for tumor markers Biopsy

Treatment Surgery Radiation Chemotherapy

Nursing Care Teach TSE Provide emotional support Discuss sperm bank deposit Offer cancer support group

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Orchitis –  Rare inflammation or infection of testes

Patient has swollen extremely tender testicles, red scrotal skin and fever

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Epididymitis – Inflammation or infection of epididymis that can be caused by bacteria ,viruses etc.

Treated with antibiotics

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Varicocele – Scrotal veins become dilated, feels like “bag of worms”

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Hydrocele – Fluid collection in scrotal sac

Does not generally cause pain.

No treatment necessary

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Cryptorchidism – (Undescended testes)
Condition in which an infant boy is born with one or both of his testicles no in the scrotum

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Phimosis Tightening of foreskin, doesn’t allow retraction

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Priapism Painful erection lasting 4-6 hours Medical emergency

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Gives the penis a curved or crooked look when erect

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Very slowly and often do not cause a major threat to health or life Rare in early stages Later stages Urinary obstruction Hematuria Urinary retention Bone pain Anemia Weakness Weight loss

Treatment Testosterone-suppressing medications TURP or open prostatectomy

Radiation therapy

Saw Palmetto

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Benign Prostatic Hyperplasia

�  Benign overgrowth of prostate

�  Eventually obstructs urethra

�  Occurs in 75% of men over 70

�  Saw palmetto may slow down growth

�  S/Sx: decreased stream, difficulty urinating, dribbling

�  Rx: TURP

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Prostatectomy for an Enlarged Prostate with Urologist Dr. Michael White