1. REPRODUCTIVE SYSTEM PRESENTED BY GROUP 5

3. ducts: epididymis, vas deferens, urethra

4. accessory glands: seminal vesicles, prostate glands, Cowper’s gland

5. supporting structures: scrotum, penis External Structures: Penis - comprised of 3 columns of erectile tissues(2 corpus cavernosa on the sides of the shaft; 1 corpus spongiosum around the urethra). Consists of the Shaft and the Glans Penis. Shaft - contains the urethra which is the passageway for urine and semen Glans - is highly sensitive (well supplied with sensory receptors) and is located at the dismal end of the penis. At the tip of the glans is the opening to the urethra, called urethral meatus. It is covered by a fold of skin, Prepuce/foreskin that is often removed during circumcision. Scrotum - rugated skin-covered muscular pouch/sac suspended from the perineum. It contains the testes, epididymis and the lower portion of the spermatic cord.

6. Penis a.Conduit for urine form bladder b. Male organ for sexual intercourse 2. Scrotum a.House testes and maintains their temperature at a level cooler than the body thus promoting normal sperm formation 3. Testes a.Endocrine glands that secrete the primary male hormone, testosterone 4. Seminiferous Tubules a.Location of spermatogenesis (within the testes) 5. Epididymis a. Storage for some spermb. Final sperm maturationc. Where sperm develops the ability to be motile. 6. Vas Deferens a. Storage of spermsb. Conduction of sperm form epididymis to urethra 7. Seminal Vesicle, Prostate, Bulbourethral gland a. Secretion of seminal fluids that carry sperm and provide for:- Nourishment of sperm- Protection of sperm from hostile acidic environment of vagina- Enhancement of motility of sperm- Washing of all sperm from urethra 8.Urethra a.hollow tube leading from the base of bladder, passing through the prostate gland, continues to the outside through the shaft and glans penis. 9.Cowper’s glands a.They secrete an alkaline fluid that helps counteract the acid secretion of the urethra and ensures safe passage of spermatozoa.

13. DISEASES OF THE REPRODUCTIVE SYSTEM

17. Paraphimosis

18. Faccidity of the penile shaft proximal to the areas of paraphimosis

22. preputialpain

23. urinary obstruction

24. edema of the distal foreskin

25. tenderness

26. erythema of the glands

27. uncircumcised or improperly circumcised penis

28. poor hygiene

29. irritation

30. red, swollen foreskin

31. pain upon urination

33. Asses, for bloody urine (hematuria)

34. Observe for foreign bodies surrounding glans penis

35. Palpate for tenderness

36. Check urinary patency

37. Inspect for red, swollen foreskin, irritation and pain upon urination

38. Position patient in Provide privacy thru draping

41. Acute pain related to surgery.

42. Fear related to perceived threat of the surgical procedure and separation from support system.

43. Deficient knowledge of the preoperative aspects of circumcision and post-operative self care.

45. Surgeons may perform preputioplasty with the aim of increasing the diameter of the preputial ring but without excising the prepuce (foreskin).

46. Circumcision is typically performed under gen. anesthesia. Foreskin is pulled back as far as it will go. It slit along its upper surface and then all around so that it can be removed. The raw edges of the inner and outer layers are stitched and a dressing is applied. rings without incision of foreskin

48. Emphasize the importance of seeking halthcare provider.

49. Proper hygiene

51. Advice patient to take a bath everyday for proper hygiene

52. Discourage patient to retract his foreskin to avoid irritation and infection

54. Antibiotics for infection

55. Encourage to undergo circumcision

57. Encourage patient to regain the highest level of function and independence possible.

59. Medium hypospadia -(10% of the cases) the meatus is located on the medium part of the penis, which often has a slight curvature.

60. Posterior hypospadia - (20% of the cases) these are the most severe types: the meatus is located at the base of the penis or in the scrotum of in the perineal scrotum. The penile curvature is considerable.Hypospadias: pathophysiology and etiologic theories Hypospadias is a congenital defect of the male urethra and phallus. Most boys with hypospadias have no other signs of under-masculinization or congenital malformations. The incidence appears to be increasing in the developed world. Evidence suggests that the etiology of hypospadias is multifactorial and that environmental conditions may have a role in the increasing incidence.

62. Opening of urethra may be seen near head of penis, midshaft or beneath the scrotum.

63. Downward curve in the penis (chordee).

64. Hooded appearance of penis.

65. Abnormal spraying during urination.

66. Undescended testicle (cryptocrhidism).

69. Remove jewelry and metal objects

71. Bladderspasms

72. Fistulaformation

73. Recurrentchordee

74. Urethralstenosis

75. Undescended testicles

77. Sexual reason

79. Duckett’s technique

80. Snodgrass’s technique

82. Healthy lifestyle

83. Generic counseling, health teaching about the illness.

84. Immunization against infectious diseases.

86. Encourage patient to perform self examination

87. Advise patient to use a mirror to check inaccessible places, scrotum ventral side of the penis

90. Provide adequate rest

91. Ambulate to perform self care activities w/c may restore normal activity of patient and to improve self esteem.

92. EPISPADIA is a rare congetinal malformation of male urogenital apparatus that consist of a defect of the dorsal wall of the urethra. The extent of defecvt can vary from a child glandural defect to complete defects as are observed in bladder exstrophy, diastasis of the pubic bones, or both occurs more commonly in males than in females. Etiology Unlike hypospadias, epispadias can be explain by defective migration of the paired primordia of the genital tubercle that fuse on the midline to form the genital tubercle at the fifth week of embryologic development. Pathophysiology In males, epispadias causes impotentiacoeundi, which results from the dorsal curvature of the penile shaft, and in impotentia generandi,which results from the incomplete urethra. Also reported are frequent ascending infections to the prostate r bladder and kidneys and psychological problems related to deformity if epispadia is distal to the bladder neck, urinary continence may be not be present.

94. Widened penis

95. Enlarged pubic bone

96. Urinary incontinence

97. Urinary tract infections

100. Remove jewelry and metal objects

101. Question regarding pregnancy or possibility of pregnancy.

103. Bleeding, infection, wound separation, flap necrosis, and edema.

104. Post-op complications

105. Urethrocutaneous fistula with urinary leakage from the new urethra and urethral stricture.

107. Healthy lifestyle/ genital hygiene

108. Immunization against infectious disease

110. Encourage Px to perform self examination

111. Advise Px to seek medical assistance if unusual assessment may not after self examination.

112. Advise Px to wash his genital carefully to prevent infection.

114. Unexplained birth defect

115. Intrauterine growth retardation

116. Hormonal Abnormalities

117. Low birth weight

118. Environmental chemicals

119. Other generic defectsPathophysiology A prevalent but still unsubstantiated theory links undescended testes to development of the a fibromuscular band that connects the testes to the scrotal floor this band probably helps pull the testes into the scrotum by shortening as the fetus grow. May result from inadequate testosterone levels or a defect in the testes or the gubernaculum. Because the testes are maintained at a higher temperature by being within the body spermatogenesis is impaired, leading to reduced fertility.

121. Missing testicle in male newborn.

122. Undescended testicle.

126. Testicular atrophy due to devascularization during dissection of the cord occurs in approximately 5% of patients.

127. Accidental division of the vas deferens occurs in 1-2% of patients.

128. Epididymoorchitis.

130. Men who have a hydrocele experience swelling of the testicles.

131. Hydroceles may be a sign of a more serious condition

135. Scrotal swelling and feeling of heaviness due to fluid accumulation.

136. Inguinal hernia.

137. Testicular enlargement due to fluid accumulation.

138. Fluid collection, with either flaccid or tense mass due to patency between the scrotal sac and the peritonial cavity.

139. Pain due to acute epididymal infection or testicular torsion.

141. The resulting ischemia can cause testicular atrophy and subsequent impairment of fertility.

142. Hemorrhage into the hydrocele can result from testicular trauma.

144. Postoperative wound infections occur in 2% of patients undergoing surgery for hydrocele.

145. Post-operative hemorrhagic hydrocele is not uncommon, but it usually resolves spontaneously.

147. Anxiety

148. Body image disturbance

151. Infertility

152. A painless testicle lump, scrotal swelling, or bulge within the scrotum, more common on the left side

153. Lump will disappear when sufferer is in horizontal (laying down) position due to lack of gravitational pull on the blood

154. Pain

155. Discomfort

158. Low sperm count

159. Male Infertility

160. Hydrocele

162. Provide info about disease process prognosis and treatment.

164. Use supporter.

165. Teach patient of perineal care.

167. Prepare for surgery.

170. Hormonal Factors

171. Diet

172. Chemical carcinogens

173. VirusesPathophysiology Prostate tumors are usually adenocaricinomas that begin in the peripehery of the posterior lobe of the gland, whereas BPH occurs centrally and the gland is large by the time it restricts urination. The tumor may appear as normal prostatic tissue, which delays diagnosis. Typically, such lesions grow slowly and remain confined to the prostatic capsule, and if they occur late in life, the client may die of other causes. Sometimes, however, the tumor grows rapidly and metastasis has occurred by the time a diagnosis is made. When prostate cancer metastasizes (spreads), it does so mainly through direct extension to the bladder neck and seminal vesibles. Other spread occurs through lymphatic and hematogenous routes. Obturator and iliac nodes are commonly positive. With advanced disease, metastasis to the bone is common, as is spread to the lungs and liver.

175. Increased urination at night.

176. Difficulty starting and maintaining a steady stream of urine.

177. Blood in the urine

179. Client signed a consent.

180. Some urologists require a preoperative bleeding profile and complete blood count.

181. Note last Oral intake of aspirin products and nonsteroidal anti-inflammatory agents

183. Instruct patient to avoid any strenuous activity for the rest of the day.

184. Watch out for Hematuria and some bloody streaks in the stool are expected for 24 to 48 hrs. after surgery.

186. pain

187. difficulty urinating (urinary incontinence)

189. Urinary Retention related to the obstruction.

190. Fluid Volume Deficit Due to Postoperative Hemorrhage.

192. Eastrogens from fermented soybeans and other plant sources (called phytoestrogens) may also help prevent prostate cancer.

193. Green Tea maybe protective

194. Intake of Vit. E and Omega 3 fatty acids.

195. Frequent Ejaculation (more than 5 times per week)

197. Radical perimeal prostatectomy

200. Emphasize seeing healthcare provider

201. Provide info about disease process prognosis and treatment.

203. Frequent ejaculation

205. Tell patient to use cholesterol lowering drugs

206. Teach patient about the surgey.

207. Prepare for surgery.

208. Prostatectomy- Surgical removal of the prostate

209. TURP (transurethral resection of the prostate)

210. Orchiectomy

211. Cryosurgery

212. Radiation therapy(Radiotherapy)

213. OVARIAN CANCER Ovarian cancer is a cancerous growth arising from an ovary. Most commonly forms in the living of the ovary (resulting in epithelial ovarian cancer) or in the egg cells (resulting in a germ cell tumor). ETIOLOGY Ovarian cancers are histologically diverse. At least 80% originate in the epithelium; 75% of these cancers are serous cystadenocarcinoma, and the rest include mucinous, endometriod, transitional cell, clear cell, unclassified carcinomas, and Brenner tumor. PATHOPHYSIOLOGY Where epithelial ovarian cancer arise from cells derived from the ovarian surface epithelium and/or the peritoneal mesothelium is unclear; however, more than 70% of women present with tumor involving multiple peritoneal surfaces, suggesting the presence of metachronous peritoneal t tumors. In particular, primary peritoneal carcinoma appears to be one of the famililian ovarian cancer phenotypes.

215. Bloating

216. Indigestion

217. Increase waist size

218. Leg pain

219. Pelvic pain

220. Abdominal mass

223. Place the patient on NPO for at least 6 hours.

224. Explain the procedure to the patient.

225. Position the patient according to the organ to be visualize.

227. Instruct the patient not to eat anything after midnight before the test.

228. If indicated, prepare the patient with laxative to clean out the intestinal tract.

229. Ask if there are known allergies to iodine or contrast dye. A contrast medium may be given intravenously to provide better visualization of body parts.

230. Explain the procedure to the patient.

231. Position the patient according to the organ to be visualize.

232. Monitor dye reaction.

235. Ensure patient is properly position in front of the x-ray board.

236. If the image is taken instruct patient to release his/her breath.

238. Progressive function loss of various organs

239. Ascites (fluid in the abdomen)

241. Imbalance Nutrition less than the body requirements related to anorexia cachexia or malabsorption.

242. Anticipatory grieving related to loss

243. Acute Fatigue related to cancer therapy.

244. Malabsorption related to chemotherapy and radiation theraphy.

247. Counsel the community to participate in cancer prevention programs

249. Advise patient to reduce intake of dietary fat because a high fat diet increases the risk for cancer.

250. Encourage patient to stop smoking cigarettes if he/she is smoking because cigarettes and cigars are carcinogens.

252. Administer intravenous therapy as prescribed to alleviate fluid and electrolyte imbalances in patients with advanced ovarian cancer.

254. Assist the patient in identifying strategies for coping with them.

255. Collaborate with dietitians to help paients plan meals that will bw acceptable and meet nutritional requirements

257. Uterine fibroids (also referred to as myoma, leiomyoma, leiomyomata, and fibromyoma) are benign (non-cancerous) tumours that grow within the muscle tissue of the uterus.

258. Uterine fibroids are the single most common indication for hysterectomyEPIDEMIOLOGY AND ETIOLOGY It has been estimated that 20% to 25% of women over 30 years of age develop uterine fibroid tumors (myomas). Uterine myomas occur more often in black women and in women who have never been pregnant. They rarely become malignant. Because their growth is stimulated by ovarian hormones, fibroid tumors of the uterus tend to disappear spontaneously with the advent of menopause. PATHOPHYSIOLOGY The cause of uterine myomas is unknown. They do not appear to be transmitted genetically. Because uterine myomas regress after menopause, it has been suggested that they are stimulated by estrogen. The sizes of myomas are variable. Most are found in the body of the uterus (corporeal), but some occur in the cervix or may involve the broad ligament. Subserous growths may extend outward into the folds of the broad ligament, cresting as intraligamentary tumors that burrow outward to from retroperitoneal masses. Intramural growths may cause in change in the contour of the uterus if they are small. When the growths are larger, they may produce an actual uterine enlargement. Submucous tumors may impinge on the uterine enlargement. Submucous tumors may impinge on the blood vessels of the larger, they may impinge on the opposite uterine wall and distort the cavity of the uterus. In some instances, submucous tumors develop pedicles and may protrude through the vagina or cervix resulting in infection or ulcerations.

260. Pain in the back of the legs

261. Pain during or pressure

262. Pain during sexual intercourse

263. Pressure on the bladder which leads to a constant need to urinate, incontinence, or inability to empty the bladder

264. Pressure on the bowel which can lead to constipation and/or bloating

267. Assess patient for cervical or endometrial carcinoma or acute pelvic inflammation because this procedure is contra-indicated with such condition.

268. Provide patients privacy

272. Sudden severe pain in lower abdomen

273. Premature labor and delivery during pregnancy

274. Abnormal fetal position

275. Separation of placenta from the uterine wall

276. Impairing of uterine lining

277. Blocking the fallopian tube

278. Distorting the shapes of the uterine cavity

280. Acute pain related to surgery

281. Anxiety related to fear that will undergo surgery, anxiety are common.

282. Deficient knowledge of the perioperative aspect of hysterectomy and post- operative elf care.

285. Hysterectomy – surgical removal of uterus.

286. Laparoscopic or HysteroscopicMyomectomy – removal of a fibroids through a laparoscope inserted through a small abdominal incision.

287. Uterine artery embolization – polyvinyl alcohol beads are injected into the blood vessels that supply the fibroids which block the flow of blood and causing necrosis.

290. Group 5 members: Balgos, Cecile Cortel, George Ivan Dasig, Ken Hensley Dela Cruz, Jesce Progio, Genesis

291. The End