NURSING ASSESSMENT – HISTORY AND PHYSICAL ASSESSMENT OF MALE REPRODUCTIVE SYSTEM… . ANILKUMAR BRMSC .N

Introduction

Mae sexulaity is a complex phenomenon that is strongly influenced by personal, cultural and social factors.

Assessment of male reproductive function begins with an evaluation of urinary function and symptoms.

This assessment includes a focus an sexual function as well as manifestations of sexual dysfunction.

The patient is asked about his usual state of health and any recent change in general, physical and sexual activity.

Any symptoms or changes in function are explored fully and described in detail.

These symptoms, collectively referred to as prostatism, may include those associated with an obstruction caused by an enlarged prostate gland, increased urinary frequency, decreased force of urinary stream, double or triple voiding.

The patient also assessed for dysuria, hematuria and hematospermia (blood in the ejaculation)

Assessment of sexual function and dysfunction is an essential part of every health history. The extent of history depends on the patient presenting symptoms and the presence of factors that may affect the sexual function. Chronic illness (DM, HTN, Multiple sclerosis, stroke & cardiac disease.)

use of medications that affects the sexual function (,anti hypertensive, antipsychotics, OTC etc)

also collect history regarding stress and alcohol, and smoking.

Assessment of male reproductive function

PAST HEALTH HISTORY In the past health history should include information about major illness, hospitalization, and surgeries and also inquire about any infectious involving the reproductive system.

Common reproductive illness that affects reproductive function are mumps and rubella.

In health history the nurse should ask if male patient have had mumps, have been immunized with mumps vaccine, or have any indicatios of sterility.

The nurse also question the client regarding the patient current health status and presence of any acute or chronic conditions.

Medications : A list of all prescription and OTC medications that the patient should be documented including reason for medications the dosage and duration of using.

PHYSICAL ASSESSMENT

DRE (Digital rectal examination)

Testicular examination (TSE) Testicular self examination

DIAGNOSIS EJACULATION

Prostate – specific antigen test (PSA)

Ultrasonagraphy Prostate fluid and tissue analysis

Test of male sexual function

DRE (Digital rectal examination)

The DRE is recommended as part of the regular health check up for every men older than 40 years of age.

THE DRE enables the examiner to assess the size, shape, and consistency of the prostate gland.

Tenderness of the prostate gland on palpation and the presence and consistency of any nodules are noted.

Testicular examination

The male genitalia are inspected for abnormalities and for palpated for masses.

The scrotum is palpated carefully for nodules, masses or Inflammation.

Examination of the scrotum can reveal such disorder as hydrocele, hernia or tumour of the testis.

The penis is inspected and palpated for ulcerations, nodules, inflammation and discharge.

Diagnostic evaluation

PROSTATE – SPECIFIC ANTIGEN TEST (PSA). • The prostate gland produces substances

known as “prostate specific antigen (PSA). • It can be measured in a blood specimen

and levels increase with prostate cancer (A number of other conditions example. BPH. TURP, acute urinary retention, acute prostatitis)

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PSA levels are measue in Nano grams per milliliter ( ng/ml) normal 0.2 to 4.0 ng/ml. Valves more than 4.0 is considered elevate.

Ultrasonagraphy

TRUS (Trans rectal ultrasound) may performed in patients with abnormalities detected by DRE and in those with elevated PSA levels.

Prostate fluid or tissue analysis

Specimens of prostate fluid or tissue may be obtained for culture if disease or Inflammation of the prostate gland is suspected

Test for male sexual function

If the patient can not engage in sexual intercourse to his satisfaction, a detailed history is obtained, additional test, in lncluding psychological evaluations are also part of tests, including psychological evaluations are part of the diagnostic workup and are usually conducted by special team.