Disorder of the Male Reproductive organ Prostatitis.pptx

Disorder of the Male Reproductive organ Prostatitis Medical Surgical Nursing Bsc nursing 4th semester

1. DISORDERS OF THE PROSTRATE Deepshikha Kakoty, NEIGRIHMS Dept of Medical Surgical Nursing

2. PROSTRATITIS: I nflammation of the prostate gland, caused by infectious agents or other conditions including urethral stricture, prostatic hyperplasia. Overall prevalence in men is 5 , Higher risk age 20-50 & 70 . Most common urologic disorder in men < 50 years.

3. CLASSIFICATION OF PROSTATITIS ▶ A c ute B a ct e rial Prostratis ( Category 1) ▶ Chr o n i c B a cterial Prostratis (Category 2 ) ▶ Chronic pelvic pain syndrome CPPS ( Category 3) ▶ Asy m pt o m atic I n f la m m atory p r os t atitis ( Category 4)

4. ▶ Both Acute and Chronic Bacterial prostatitis, generally result from organisms reaching the prostate gland by one of the following routes: Ascending from the urethra (upward) Descending from the bladder (downwards) and invasion via the blood stream or the lymphatic channels. Common organisms : Escherichia coli , Klebsiella , Pseudomonas , Enterobacter , Neisseria gonorrhoea and group D streptococci . Chronic Bacterial P rostatitis in volves recurrent episodes of infection , produces localizd discomfort but no systemic illness. ▶ CPPS is a new term that describes the syndrome with prostate and urinary pain in the absence of a n objective evidence of a bacterial infection of the prostrate, may be associated with STDs. Asymptomatic I nflammatory P rostatitis is usually diagnosed in individuals who have no symptom, but are found to have an inflammatory process in the prostate.

5. R/F: Cat 1: caused by GI or Sexually Transmitted Bacteria. Most pts experience systemic illness that may require hosp. Possible R/F : recent epididymitis, unprotected penetrative anal sex, urethral stricture or meatal stenosis, recent catheterization or cystoscopy. Cat 2: uncommon (<10 %), Gram negative GI organisms most common. Possible R/F : poor relation of pelvic floor muscles during urination, causing turbulence & movement of bacteria from urethra to prostratic ducts. Cat 3: 90 % with non acute manifestations, etiology unknown. Cat 4 : pathologic diagnosis.

6. CLINICAL MANIFESTATION ▶ Peri n e a l d i sco m f o rt ▶ Bur n i n g, u r gency and f r equency ▶ Pain with ej a culation ▶ Prostatodynia (pain in the prostate gland) ▶ S u d d en f e ve r , chills and perine a l, rect a l and low back pain in a c u t e bacterial prostatitis Urinary Symptoms:

7. DIAGNOSTIC EVALUATION ▶ H /t and P/E ▶ Culture of the prostate fluid or tissue / histological examination of the tissue ▶ Urine an a lysis and culture ▶ CBC ▶ MRI a n d tra n sa b dominal ultras o u n d

8. MEDICAL MANAGEMENT ▶ Antibiotics commonly used for acute or chronic bacterial prostatitis antibiotics therapy involves for up to 4 weeks . DOC: Fluroquinolone. ▶ P t is encouraged to remain on bed rest to alleviate symptoms . ▶ Comfort is provided with analgesics to relieve pain, anti spasmodic medications and bladder sedatives , sitz bath and stool softeners.

9. ▶ Chronic bacterial prostatitis is difficult to treat because most antibiotics diffuse poorly from the plasma into the prostatic fluid . ▶ Rx includes floroquinolones (Cipro) , Trimethoprim-Sulfamethoxazole (bactrum) ▶ Other treatment modalities include : Regular Prostratic Massage, Anti spasmodic, sitz bath and stool softeners. Cat 3 Prostratitis : Alpha adrenergic blockers to promote relaxation of the bladder and prostate , NSAIDS, hot sitz bath, regular sexual ejaculation. Sugery if medical Rx does not improve manifestation that effects the pt’s quality of life. (TURP)

10. COMPLICATIONS ▶ Swelling of the prostate gland ▶ Urinary retention ▶ Epididymitis ▶ Bactermia and pyelonephritis

11. ▶ Hyper t h e r m ia r/t infe c t i ous p roce s s a s evidenc e d b y feve r , discomfort ▶ Acute p a in r /t prostatic in f la m ma t ion as evidenc e d by pain, difficulty in urine and in ejaculation . ▶ Chronic pain r /t chronic pros t at i t i s, chronic pelv i c syndro m e . ▶ Deficient knowledge r /t disease cause, clinical manifestation and treatment NURSING DIAGNOSIS

12. Instruct pt to take antibiotics as prescribed. C omfort measures: sitz baths (10 to 20 mins) several times daily. Continued use of stool softeners and not sitting for long periods. Pelvic Muscle Relaxation technique. Constipation to be avoided by adequate fluid & dietary fibre intake. To a void sexual a rousal and inter c o u rs e dur i ng p e r i od of a c ute inflammation . F ollow – up s . HEALTH EDUCATION

13. Read on ‘Pelvic Muscle Relaxation Exercises’