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Reproductive System Diseases

Reproductive System Diseases. Introduction to Human Diseases Chapter 9. Male & Female Infertility. Failure to become pregnant after 1 year of regular, unprotected intercourse (despite previous pregnancies) Peak fertility: Females: 24 YOA Most fertile within 24 hrs. of ovulation

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Reproductive System Diseases

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  1. Reproductive System Diseases Introduction to Human Diseases Chapter 9

  2. Male & Female Infertility • Failure to become pregnant after 1 year of regular, unprotected intercourse (despite previous pregnancies) • Peak fertility: • Females: 24 YOA • Most fertile within 24 hrs. of ovulation • Males: 25 YOA • Greatest fertility: intercourse 4 times/wk

  3. Infertility • Etiologies: • Female: hormonal or nutritional, infections, neoplasms, anomalies of reproductive tract, age • Males: sperm deficiencies, congenital anomalies, endocrine disorders, infections of testes, epididymis or vas, age, surgery (vasectomy, etc)

  4. Infertility • Etiology: unknown in 10% • Treatment: • Surgical, hormonal treatment, etc

  5. Sexually Transmitted Diseases (STD’s) • Gonorrhea • Infection with Neisseria gonorrhoeae • S/S: purulent discharge • Often more symptoms in males than in infected females • Gonorrheal ophthalmia neonatorum • Treatment: antibiotics

  6. STD’s • Genital Herpes • Infection with herpes simplex virus • Mostly HSV-2 • S/S: painful, irritated genital vesicular lesions • First outbreak often has systemic signs • Aches, fevers, HA, malaise, etc • Treatment: antiviral medicines

  7. STD’s • Genital warts • Infection with papillomavirus (HPV) • Incubation period: 1-6 months • Treatment: topical meds, laser treatment, cryosurgery, electrocautery

  8. STD’s • Syphilis • Infection with Treponema pallidum • Three clinical stages: • Primary: chancre appears, contagious • Secondary: systemic, rashes, etc. • Tertiary: CNS, aortic, musculoskeletal • Testing: multiple serum tests • Treatment: antibiotics (PCN)

  9. STD’s • Trichomoniasis • Protozoal infection with trichomonas vaginalis • 10-25% females asymptomatic • Treatment: Flagyl

  10. STD’s • Chlamydial infection • Infection with chlamydia trachomatis • S/S: often mild • Treatment: antibiotics

  11. Male Reproductive Diseases • Benign Prostatic Hyperplasia • Also called benign prostate hypertrophy • (BPH) • Overgrowth of prostate cells, causing prostate enlargement • Etiology: unknown, associated with aging • Males over 50 YOA, increasing with age

  12. BPH • Clinically: tends to obstruct urine outflow by obstructing bladder outflow or changing bladder shape • S/S: weak stream, hesitancy, dribbling of urine, nocturia, frequency • Treatment: often surgical (TURP)

  13. Prostatitis • Inflammation of prostate gland • Usually infection (bacterial) • Acute or chronic • Treatment: • Antibiotics, regular ejaculation, possibly surgery depending on type & severity

  14. Epididymitis • Common infection & inflammation of the epididymis • Typically unilateral • Usually bacterial etiology • Treatment: • Antibiotics, scrotal support

  15. Prostate Cancer • Adenocarcinoma • In males: 3rd leading cause of cancer death (lung & colon) • Usually males over 50 YOA • Mets to spine or pelvis early • Treatment: • Surgical resection of variable degrees, hormonal therapies, radiation & chemo

  16. Prostate Cancer • Risk factors associated with this: • Family or racial predisposition • Environmental exposure • Coexisting STD’s • Endogenous hormone influence • High animal fat diet implicated

  17. Testicular Cancer • Usually young and middle-aged males, rare over 40 YOA • Risk factors: • Cryptorchidism, African-Americans, maternal use of diethylstilbestrol • S/S: smooth, painless mass • Treatment: • orchidectomy, radiation, chemotherapy

  18. Female Reproductive Diseases • Premenstrual Syndrome (PMS) • Group of physical & psychological symptoms occurring regularly 3-14 days prior to menses • Relieved by menses • Females in 30-40’s • 30%-40% females experience some degree • Etiology: unknown

  19. PMS • S/S: • Irritability, anxiety, insomnia • Fatigue, depression, headaches • Vertigo, syncope, arthralgias • Abdominal bloating, palpitations • Acne, breast tenderness, appetite changes • Treatment: no single effective treatment

  20. Amenorrhea • Absence of menarche • Primary-no menses until over 16 YOA • Hereditary, body build, environmental • Secondary-6 months without menses in a female previously menstruating • Stress, pregnancy • Etiology: hormonal imbalances that prevent ovulation

  21. Dysmenorrhea • Pain associated with menstruation • Etiology: • Hormonal imbalances, PG’s, endometriosis, polycystic ovaries, tumors • Diagnosis: D & C (also theraputic) • Treatment: • Pain relief, surgical (D & C, fibroid removal)

  22. Ovarian Cysts & Tumors • Cysts • Corpus luteum cyst • Endometrioma • Polycystic ovarian syndrome (endocrine disorder: hirsuitism, obesity, menstrual & ovulation irregularities, insulin resistence) (PCOS)

  23. Ovarian Cysts & Tumors • Tumors • Teratoma (dermoid) • Benign growth, combination of different types of tissues

  24. Endometriosis • Presence of functional ectopic endometrial tissue • 3-5 million in US • S/S: usually pain in site of ectopic tissue • Treatment: hormonal therapy, BCP, laparoscopic surgery if needed

  25. Uterine Leiomyomas (Fibroids) • Benign uterine tumors of the smooth muscle layer • Most common tumor in females • Calcify after menopause • S/S: often asymptomatic • Sometimes palpable mass, increased menstrual bleeding or dysmenorrhea • Treatment: none, surgical

  26. Pelvic Inflammatory Disease • Infection of uterus, fallopian tubes, ovaries • Acute, subacute, chronic, recurrent • Etiologies: bacterial infection • After surgical procedures, parturition, or due to STD’s • S/S: pain, purulent discharge, abnormal uterine bleeding (metrorrhea)

  27. PID • Treatment: • Antibiotics (oral or IV), hospitalization often, some need for surgical drainage of abscesses, pain relief • Complications: sepsis, infertility

  28. Menopause • Cessation of menses and ovarian function, causing decreased estrogen levels • S/S: hot flashes, tachycardia, skin inelasticity, decrease in breast size & firmness, genitalia atrophy, decrease in Bartholin secretions, depression, poor memory & libido

  29. Menopause • Treatment: • None or HRT (hormone replacement therapy) • Combination vs. estrogen only • Risks tend to outweigh benefits • Risks: CAD, CVA, thromboemboli, invasive breast CA, endocmetrial CA • Use: menopausal symptoms & osteoporosis treatment

  30. Ovarian Cancer • 6th most common cancer in US females • 1/57 females in US • Decreased risk for use of BCP for at least 5 years (by 60%) • “silent killer” • Asymptomatic for a long time so poor prognosis • More deaths than endometrial & cervical cancers combined

  31. Ovarian Cancer • Treatment: • Usually surgery & chemotherapy • Sometimes radiation

  32. Breast Diseases • Fibrocystic disease • Palpable masses (cysts), vary with cycle, often tenderness or feeling of fullness in breasts • Aged 30-55 • Benign fibroadenoma • Tumor of fibrous & glandular elements • Usually 20 years post puberty

  33. Carcinoma of the Breast • Variety of malignant neoplasms • Etiology/Risk factors: • Hereditary (FH in maternal relatives), age, atypical hyperplasia, long menstrual hx, obesity after menopause, nulliparous, or no children until 30 YOA • S/S: • A mass, nipple discharge

  34. Carcinoma of the Breast • Diagnosis • Mammography, biopsy • Treatment • Various surgeries • Chemotherapy • Radiation • Hormone therapies

  35. Disorders of Pregnancy and Parturition • Spontaneous Abortion • Miscarriage, most common in 1st pregnancy • Expulsion of fetus & amniotic sac before viability is possible • Etiology: placental or implantation problems, hormone imbalance, trauma, chromosomal abnormalities (most common)

  36. Spontaneous Abortion • S/S: cramping pain, bleeding • Usually during 1st trimester • Treatment: • No prevention is possible

  37. Ectopic Pregnancy • Implantation & growth of fertilized ovum outside of the uterus • Most commonly in fallopian tubes • Other: abdominal cavity, ovary • Etiology: • Scarring of fallopian tubes • S/S: unilateral lower abd pain, abnormal menses or no menses

  38. Ectopic Pregnancy • Diagnosis: • Verification of pregnancy by urine & serum tests, ultrasound • Treatment: • Surgical resection • Complications: shock, exsanguination

  39. Pregnancy-induced Hypertension • HTN developing during 3rd trimester • =preeclampsia • Peripheral edema, HTN, proteinuria • Eclampsia • Seizures & coma develop • Emergency condition • Intracranial bleeding or edema common

  40. Placental Diseases • Placenta Previa • Low uterine implantation of placenta so that it blocks the cervical opening • Treatment: C-section • Abruptio Placentae • Premature separation of placenta from uterine wall • S/S: variable bleeding, cramping, shock

  41. Premature Rupture of Membranes • Early rupture of amniotic sac • Amniotic fluid discharge from vagina • Increased risk of uterine infection and premature labor • Labor prior to fetal maturity • Treatment: • Rest, labor induction or C-section when viability is certain

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