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NURS 531 Advanced Pharmacotherapeutics Exam 4 Study Guide

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Male Reproductive Disorders Congenital Anomalies Hypospadias ● Pathophysiology: Urethral opening is on the ventral (underside) surface of the penis. ● Cause: Incomplete fusion of urethral folds during embryogenesis (weeks 8–20). ● Manifestations: Abnormal urine stream, difficulty with voiding, possible fertility issues later. Epispadias ● Pathophysiology: Urethral opening on the dorsal (upper) surface of the penis. ● Cause: Defective closure of genital tubercle during development. ● Manifestations: Urinary incontinence, abnormal stream, often associated with bladder exstrophy. Cryptorchidism ● Pathophysiology: Failure of one or both testes to descend into the scrotum. ● Etiology: Hormonal abnormalities (low testosterone), mechanical obstruction, prematurity. ● Manifestations: Empty scrotum, infertility risk, ↑ risk of testicular cancer. Penile and Scrotal Disorders Disorder Etiology Pathogenesis Clinical ManifestationsPriapism Sickle cell disease, trauma, medications (PDE-5 inhibitors, antidepressants) Prolonged, painful erection due to trapped blood in corpora cavernosa Painful erection >4 hrs, ischemia → fibrosis Phimosis Congenital or infection-related scarring Tight foreskin cannot be retracted Pain, infection, hygiene problems Paraphimosis Retracted foreskin trapped behind glans Venous congestion → edema Pain, swelling, possible ischemia of glans Peyronie Disease Unknown (fibrosis from trauma suspected) Fibrous plaque formation in tunica albuginea Painful erections, curvature, erectile dysfunction Erectile Dysfunction Vascular (atherosclerosis), neurogenic, psychogenic, hormonal Impaired blood flow or nerve supply Inability to maintain erection Hydrocele Congenital (patent processus vaginalis) or acquired (infection, tumor) Fluid accumulation between tunica vaginalis layers Scrotal swelling, transillumination positive Spermatocele Dilation of epididymal duct Cystic accumulation of sperm Painless scrotal mass Testicular Torsion Congenital high attachment or trauma Twisting of spermatic cord → ischemia Sudden scrotal pain, swelling, emergency Male Infertility Varicocele, infection, hormonal, obstruction ↓ sperm number/function Inability to conceive Epididymitis Bacterial infection (often Chlamydia, Gonorrhea, E. coli) Inflammation of epididymis Scrotal pain, swelling, dysuria Prostatitis Bacterial or chronic nonbacterial inflammation Edema, inflammation, obstruction Pelvic pain, dysuria, fever (acute), recurrent UTIs (chronic)

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