Genital-Urinary System
Male Reproductive System
Behavioral Objectives
By the end of this lecture the student will be able to:
• Review the anatomy and physiology of the genito-urinary systems
• Describe the physical assessment of the GU systems
• Discuss the application of the nursing process as it relates to patients with
disorders of the GU system
• Describe etiology, pathophysiology, clinical manifestations, nursing
management and patient education for the following GU disorders:
–
–
–
–
Prostatitis,
Orchitis
Prostaic hypertrophy
Prostatic neoplasms
• Discuss the nursing interventions in pre and post-operative care of
patients undergoing the following GU system surgeries:
– Prostatectomy
Introduction
–
–
Several organs are
both urinary tract and
reproductive system
Disease of male
reproductive system
are usually treated by
an urologist.
Anatomy & Physiology
• Brunner and
Suddarth’s Medical
Surgical Nursing
– Volume 2
– Ch. 49
– pg 1739 - 1776
Testes
•
Descend into
peritoneum in the last
month of fetal life,
–
–
–
–
•
Paired
Ovoid
Smooth
Firm – not soft
Encased in the scrotum
–
i temp
Spermatogenesis
•
What is
Spermatogenesis?
– Formation of Sperm
• Spermatozoa
– Immature sperm
• Collecting tubules
– Transmit the
spermatozoa in the
epididymis
Testes
•
Testes have two
functions
• Formation of
spermatozoa
• Secretion of
the male sex
hormone testosterone
Vas deferens (ductus deferens)
•
Tube
–
–
upward  abd.
cavity
downward  base
of the bladder
Seminal vesicles
•
•
•
It acts as a reservoir for
testicular secretions
The tract is continued
called the ejaculatory
duct –
Passes through the
prostate gland and
enters into the urethra
Accessory glands
•
Prostate gland
– Location:
•
•
below the neck of the
bladder
Surrounds the urethra
– Function:
•
Secrets chemicals to
help spermatozoa
Accessory glands
•
Cowper’s gland /
bulbourethral gland
– Location
•
Below the prostate
– Function
•
Lubrication for sperm
Penis
•
Dual function
– Copulation
– Urination
• Urethra
– Tube carries urine &
semen
– Opens at the tip of
the glans
Penis
•
The glans
– Covered penile skin –
foreskin
– Retracted to expose
the glans.
• Circumcision
– Foreskin removal
Physical Assessment
•
Brunner and
Suddarth’s Medical
Surgical nursing pg
1742-1744
Health History
Evaluate urinary & sexual function
•
Frequency
•
Force of stream,
•
“double” or “Triple” voiding
•
Dysuria
•
Hematuria
•
Hematospermia
–
•
Medications
–
–
–
•
Diuretics
Psychotropic agents
Anti-hypertensives
Diagnosis
–
–
•
blood in the ejaculate semen/sperm
DM
HTN
Smoking
Physical Assessment
Digital Rectal
Examination (DRE)
–
–
–
> 40 yrs
Annually
Prostate gland
•
Size, shape and
consistency
Physical Assessment
Testicular exam
• Monthly (self)
• Abnormalities &
masses
Physical Assessment
Prostate Specific Antigen
•
h PSA level is = ?prostate
Cancer?
•
h PSA  Prostate
pathology screen
–
–
–
–
BPH
Prostatitis
Foley catheter
DRE does not cause
Increase in PSA
Small group questions:
1. Describe the path a spermatozoa takes from formation to
ejection
2. What are the male sex hormones and where are they
formed?
3. What type of doctor would a man see if he is having sexual
dysfunction?
4. While assessing the testes what would be normal findings?
4. What are the male accessory glands and what are
their purposes?
5. Describe the purpose of a DRE, Testicular exam and
PSA screen. How often should men have these
screens done?