20 Mar Discussion: Disorders of the Reproductive Systems
Discussion: Disorders of the Reproductive Systems
While the male and female reproductive systems are unique to each sex, they share a common function—reproduction. Disorders of this system range from delayed development to structural and functional abnormalities. Since many reproductive disorders not only result in physiological consequences but also psychological consequences such as embarrassment, guilt, or profound disappointment, patients are often hesitant to seek treatment. Advanced practice nurses need to educate patients on disorders and help relieve associated stigmas. During patient evaluations, patients must feel comfortable answering questions so that you, as a key health care provider, will be able to diagnose and recommend treatment options. As you begin this Discussion, consider reproductive disorders that you would commonly see in the clinical setting.
To Prepare
• Review Chapter 22 and Chapter 23 in the Hammer and McPhee text, as well as Chapter 33 and 34 in the Huether and McCance text.
THE ASSIGNMENT TO COMPLETE. (PLS PROVIDE SUBHEADINGS). THANKS.
In a 1-2-page paper, respond to your colleagues’ postings on “BENIGN PROSTATE HYPERPLASIA (BPH) AND PROSTATE CANCER” below in the following ways:
• Share insights on how behavior as a factor impacts the pathophysiology of the disorder your colleague selected.
• Offer alternative diagnoses and prescription of treatment options for the disorder of “BENIGN PROSTATE HYPERPLASIA (BPH) AND PROSTATE CANCER”
• Support your paper with 1 or more credible outside sources, in addition to 2 course resources within the last 5yrs. (SEE ATTACHED LEARNING RESOURCES).
HERE ARE LINKS THAT WILL BE HELPFUL:
COLLEAGUE’S POSTING BY JESSE
Benign Prostate Hypertrophy (BPH) and Prostate Cancer
BPH is nonmalignant hyperplasia of the prostate stoma and epithelial glands of the prostate gland, which increases in size as ages, obstructing the urethra. The significant reasons are aging and hormonal factors. Prostatic androgen levels, especially Dihydrotestosterone (DHT) levels, can make the hormonal reason. The most common site is the pre-urethral and transition zones of the gland. An increase in the mass causes urethral obstruction. The prostatic capsule further causes pressure to the urethra, worsening the problem. Prostatic testosterone converts into DHT by enzyme 5alpha reductase. Activated DHT cells with increasing age can facilitate hyperplasia. Androgen receptor levels remain high with aging, further complicating the androgen-dependent cell growth. Increasing estrogens levels with aging have a supportive role in increased androgen receptor expression in the prostate leading to cell growth. An imbalance in the fibroblast growth factors and transforming growth factors can modulate cell proliferation. The enlarged prostate causes obstruction induced changes and bladder dysfunction like detrusor overactivity leading to frequency and urgency. It can cause decreased detrusor contractility leading to decreased urinary flow and hesitancy. Complications can be bladder hypertrophy, infection, hematuria, and chronic kidney disease (Hammer & McPhee, 2019).
Prostate cancer has a lifetime risk even though incidence before age 50 years is rare. The higher incidence reported in the developed countries due to the Prostate Specific Antigen (PSA) screening tests even though incidence and mortality rates rising in Asian countries. Males of African descent in the Caribbean have the highest mortality rates. Prostate cancer arises from the androgen-sensitive epithelium. Polymorphism of the androgen receptor gene or increased androgen receptor activity seems to be a significant reason. Androgens get metabolized to estrogens by the enzyme aromatase, and altered expression of aromatase and estrogen receptor alpha leads to proliferation. Age-dependent alteration can cause high estrogen and low testosterone. Prostate cancer often manifests with bladder outlet obstruction. The local extension can cause difficulty defecation, and metastasis can include bone pain (Huether & McCance, 2017).
Similarities and Differences
Both involve the prostate gland where BPH is benign, and the other one is malignant with metastasis to bowel, bone, lymph nodes, and liver. The presence of BPH increases the risk for a man to develop prostate cancer in his lifetime. Both increase with age and hormonal factors of increased androgen production and reception. Pathogenesis and clinical features are almost similar. BPH and Prostate cancer can be linked together at a molecular and cellular level on genetic, hormonal, and inflammatory platforms suggesting that these prostatic diseases have common pathophysiological driving factors (Miah & Catto, 2014). Prostatic Specific Antigen (PSA) elevated in both conditions, but a tissue biopsy with a micro examination can make the differential diagnosis.
Age as a Patient Factor in the Diagnosis and Treatment
Considering the age factor help majorly in the diagnosis of prostate cancer and BPH. Prostate cancer is rare before the age of 50, and BPH starts from 40-50 years of age. Both the BPH and prostate cancer are asymptomatic until far advanced and causes obstruction. Advanced Nurse Practitioners (ANP) should consider routine annual screening for individuals who fall in the age group for BPH and prostate cancer, especially those who are at increased risk. Men commonly fail to seek help, and it is vital as an ANP to inquire about urinary function with men over the age of 50. Increased age above 70 years is risky for treatment with prostate cancer due to age-related deterioration of health and metastasis.
Diagnosis can make from medical history, physical exam, and laboratory tests, including urine analysis. Digital Rectal Examination (DRE), PSA blood test, and Trans Rectal Ultrasound (TRUS) are the screening tests available for BPH and prostate cancer. Tissue biopsy and MRI confirms the diagnosis. Watchful waiting with lifestyle changes, pharmacotherapy with alpha-adrenergic antagonists are some treatment plans for BPH. Prostate cancer treatment depends on the stage of neoplasm, age, and general health. Surgical treatment transurethral resection of the prostate (TURP) can perform in both conditions, but followed by radiation, hormone, and chemotherapy in prostate cancer (Huether & McCance, 2017).
References
Hammer, G. D., & McPhee, S. J. (2019). Pathophysiology of disease: An introduction to clinical medicine (8th ed.). New York, NY: McGraw-Hill Education.
Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.
Miah, S., & Catto, J. (2014). BPH and prostate cancer risk. Indian Journal of Urology, 30(2), 214–218. DOI:10.4103/0970-1591.126909
THE RESPONSE GRADING RUBRIC
Response:
Post to colleague’s main post that is reflective and justified with credible sources. 9 (9%) – 9 (9%)
Response exhibits critical thinking and application to practice settings
responds to questions posed by faculty
the use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives 8.5 (8.5%) – 8.5 (8.5%)
Response exhibits critical thinking and application to practice settings 7.5 (7.5%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting 6.5 (6.5%) – 7 (7%)
Response is on topic, may have some depth 0 (0%) – 6 (6%)
Response may not be on topic, lacks depth
Response:
Writing 6 (6%) – 6 (6%)
Communication is professional and respectful to colleagues
Response to faculty questions are fully answered if posed
Provides clear, concise opinions and ideas that are supported by two or more credible sources
Response is effectively written in Standard Edited English 5.5 (5.5%) – 5.5 (5.5%)
Communication is professional and respectful to colleagues
Response to faculty questions are answered if posed
Provides clear, concise opinions and ideas that are supported by two or more credible sources
Response is effectively written in Standard Edited English 5 (5%) – 5 (5%)
Communication is mostly professional and respectful to colleagues
Response to faculty questions are mostly answered if posed
Provides opinions and ideas that are supported by few credible sources
Response is written in Standard Edited English 4.5 (4.5%) – 4.5 (4.5%)
Responses posted in the discussion may lack effective professional communication
Response to faculty questions are somewhat answered if posed
Few or no credible sources are cited 0 (0%) – 4 (4%)
Responses posted in the discussion lack effective
Response to faculty questions are missing
No credible sources are cited
Response:
Timely and full participation 5 (5%) – 5 (5%)
Meets requirements for timely and full participation
posts by due date 0 (0%) – 0 (0%)
NA 0 (0%) – 0 (0%)
NA 0 (0%) – 0 (0%)
NA 0 (0%) – 0 (0%)
Does not meet requirement for full participation
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