1. REPRODUCTIVE SYSTEM DISORDER WELCOME

5. it is the tightness of the prepuce (foreskin) of the penis that prevents the retraction of the foreskin over the glans. What is PHIMOSIS ?

6. CAUSES Congenital phimosis Acquired phimosis RISK FACTORS Sex-Male only Age-occur at any age; a higher incidence is seen in infancy and adolescence Repeated catheterization CLINICAL MANIFESTATIONS Pain Penile swelling Penile inflammation Penile discharge/ Purulent discharge Urination difficulties Pain on urination Erythema Tenderness

14. What is HYPOSPADIA ? is a congenital malformation of the male sex organs: The urethra does not open through the glans of the penis, but somewhere through the underside of the penis shaft or even at the base of the penis.

15. TYPES ANTERIOR HYPOSPADIA (70% of the cases) MEDIUM HYPOSPADIA (10% of the cases) POSTERIOR HYPOSPADIA (20% of the cases) CAUSES CONGENITAL >Hormonal imbalance >Deficiency during a certain critical period before the baby is born >Genetic factors >Environmental factors CLINICAL MANIFESTATIONS Urethral opening in the shaft of the penis Urinary obstruction Absence of prepuce DIAGNOSIS Physical examination X-rays to provide pictures of the urinary tract

19. What is EPISPADIA ? It is a congenital anomaly characterized by a variable defect in the dorsal urethra. * It is often part of the condition termed epispadias-exstrophy of the bladder.

23. Distal epispadias. Outlining of local flaps from the glans to reconstruct the distal urethra. Reconstruction of distal penile urethra using local flaps (arrows). Vertical island flap drawn on the ventral aspect of the penis. Island flap transferred dorsally and anastomosed to the urethra. Island flap sutured into a tube to reconstruct the missing portion of the urethra. Urethral reconstruction is completed.

40. Here is a large hydrocele of the testis

41. Enlarged left hemiscrotum Puncture: serohemorrhagic liquid exposure of the vaginal cavity. Skin suture and declivis drainage of hemiscrotum.

45. Varicocele Ligation Varicocele Embolization

61. Predisposing Factor Precipitating Factor Age ( 30 y. o. and above) Genetics Race (black American) Sex (female) Anatomy hormonal therapy stress in uterine (multiple contraction) nullipara Transformation or abnormal growth of myocytes Growth of Formation of fibroids (asymptomatic) Enlarged fibroids/myomas in the uterus Acute pain pelvic pressure constipation urinary retention infertility/abortion abnormal bleeding fibroid presses other organs erosion of weak fibroids obstruction hysterectomy Fibroids shrink during Menopausal stage myomectomy Able to conceive Unable to conceive Twisting of fibroid stalk

71. REFERENCE: INTERNET http://www.healthscout.com/ency/68/360/main.html http://emedicine.medscape.com/article/777539-overview http://www2.hu-berlin.de/sexology/ECE3/html http://www.wrongdiagnosis.com http://www.steadyhealth.com/ http://www.medindia.net/ http://www.urethralsurgery.com http://www.medcyclopaedia.com/ http://www.healthline.com BOOK Medical-Surgical Nursing by Black et.al. 6th edition.

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