Reproductive disorders

Reproductive disorders

1. Female disorders

   • Pelvic Inflammatory Disease
     • Infection caused by gonorrhea & chlamydia
     • Affects vagina, fallopian tubes and cervix; sometimes ovaries
     • Symptoms: pelvic pain, vaginal discharge, pain on urination
       • Can lead to infertility; scarring of fallopian tubes
         • Treated with antibiotics and sexual abstinence
         • Can cause ectopic pregnancy
     • Educate about safe sex
     • Check for STIs
   • Endometriosis
     • Endometrium grows outside of uterus
       • Metaplasia, allergies, family history, obesity
     • Causes pain, infertility, irregular menstrual cycle
       • High risk of recurrence
     • Laparoscopic surgery to remove ectopic tissues, hormonal drugs
       • Educate patient about coping mechanisms, social workers/ counsellors (infertility)
       • Pain management
   • Menopause
     • Gradual reduction in production of hormones with atrophy of ovaries
       • Hot flushes, night sweats,
     • Diagnosed after 12 months without a period
     • Symptom relief, HRT - OESTROGEN
       • Healthy life style, exercise
       • Risk of osteoporosis
   • Ectopic pregnancy
     • Sometimes due to endometriosis
       • Increased likelihood of recurrence
     • Foetus can implant in abdominal cavity or fallopian tubes
       • Blocked or no peristalsis of fallopian tubes
         • If the fallopian tube ruptures, pt. can haemorrhage - shock
           • Emergency surgery to remove foetus from tube, or salpingectomy
     • Acute pain 6- 8 weeks after menses, dysmenorrhoea or amenorrhoea, malaise, syncope
   • Hysterectomy
     • Surgical removal of uterus - may include cervix
       • Reason - cancer, fibroids, adenomyosis, prolapse
         • Abdominal cramps, vaginal discharge, heavy/ irregular bleeding, pain (back, pelvis), difficulty having sex
     • Nursing: observe elimination patterns (urine & faeces), pain relief, referral to psych services, assist with mobility
       • No sex for 6 weeks

2. Male disorders

   • Testicular torsion
     • Twisting of spermatic cord, can obstruct blood supply
       • Sudden onset of pain, painful urination, nausea & vomiting
     • Abnormal positioning, swelling of scrotum
     • Pain management, emergency surgery
     • Risk factors: age (12 - 16), previous history, family history
     • Causes: trauma - kicks, wrestling
   • TURP - Transurethral Resection of prostate
     • Enlargement of prostate, blockage of urine flow
       • Surgical procedure to remove obstructive tissue of prostate
         • Usually an overnight stay in hospital; GA or spinal
           • Pain assessment & management
           • Infection control
         • Bleeding should cease in 4 weeks
         • Retrograde ejaculation, infertility, incontinence, erectile dysfunction
           • Nursing education & pyschological support
         • Continuous Bladder irrigation
   • Benign Prostatic Hyperplasia
     • Enlargement of prostate without cancer
     • Obstructs flow of urine through urethra
     • Cause: unknown, probably male sex hormone depletion
       • Risk factors: diabetes, heart disease (beta blockers) obesity
     • Urinary symptoms (frequency, urgency), sexual dysfunction, renal calculi, narrowed urethra,
       • Manage pain, reassurance after TURP &/or drug therapy (HRT)

3. Vasectomy & tubal ligations

   • Vasectomy = cut the vas deferens to prevent pregnancy, will not affect sexual function
     • Chronic pain, infection, haematoma
     • Ice pack, analgesia
     • Hygiene cares, skin assessment
     • Education to avoid sex for 1 week, avoid heavy lifting
     • Falls risk assessment - post-op & pain
   • Tubal ligation - for women to avoid pregnancy
     • Cut & tie fallopian tubes
       • Risk of pain & infection
       • Risk of damage to surrounding organs
     • PV loss, weakness, dizziness