Common Disorders of Male &

Female Reproductive Systems

Prostate Gland

Benign Prostatic Hyperplasia (BPH)

Enlargement

of the prostate gland

Most common problem of adult male
reproductive system
Occurs in 50% of men over 50yrs of age
Thought to be the result of endocrine
changes associated with ageing process

Pathophysiology of BPH
Develops

in inner part of prostate

This enlargement gradually compresses
the urethra, eventually leading to partial
or complete obstruction

Clinical Manifestations of BHP

Symptoms

result from urinary obstruction

Gradual onset
Decrease in calibre & force of urinary
stream
Difficulty in initiating voiding
Intermittency (stopping & starting)
Dribbling at end of urination
Incomplete bladder emptying

Clinical Manifestations of BHP

Urinary

frequency
Urgency
Dysuria
Bladder pain
Nocturia
incontinence

Transurethral Resection of Prostate

(TURP)

Prostate Cancer
Malignant

tumour of prostate gland

Occurs in 1:11
Most common cancer amongst men
Third leading cause of cancer death in NZ
Incidence in less in Maori
Large increase in incidence of newly
diagnosed cases attributed to widespread use
of PSA as a screening procedure
Incidence likely to continue increasing
because of population ageing

Prostate Cancer
Usually

asymptomatic in early stages

Patient may have symptoms similar to BPH
-dysuria, hesitancy, dribbling, frequency,
urgency, haematuria, nocturia, retention,
interruption of urinary stream & inability to
urinate
Pain in lumbosacral area that radiates down to
hips or legs may indicate metastases

Diagnostic Studies
Blood

test may show elevated Prostatespecific antigen (PSA)

Normal PSA is 0-4.0mg/ml
Rectal examination may reveal hard
prostate with asymmetric enlargement
with areas of induration or nodules

Pelvic Inflammatory Disease (PID)

Infectious condition of the pelvic cavity that may

involve infection of the fallopian tubes (salpingitis),
ovaries (oophoritis), and pelvic peritoneum (peritonitis)
Often the result of untreated cervicitis the organism
infecting the cervix ascends higher into the uterus,
tubes, ovaries & peritoneal cavity
Chlamydia trachomatis and Neisseria gonorrhoeae
are the most common causative organisms
PID is the major cause of female infertility
Silent PID can cause damage that cannot be reversed

Risk Factors for PID

Women

at increased risk of chlamydial

infections
-younger than 24 years
- multiple sex partners

Clinical Manifestations of PID

Lower

abdominal pain starts gradually

& is constant, intensity may vary from
mild to severe
Pain associated with intercourse
Spotting after intercourse
Abnormal vaginal discharge
Fever & chills

Complications of PID
Septic

shock
Ectopic pregnancies
Infertility
Chronic pelvic pain

Endometriosis
The

presence of normal endometrial tissue in

sites outside the endometrial cavity
Most frequent sites are in or near ovaries, the
uterosacral ligaments & the uterovesical
peritoneum
Usually occurs in late 20s, early 30s, white &
never had a full-term pregnancy
Found in approx 10% of women of
reproductive age

Clinical Manifestations
Wide

range of manifestations & severity

Dysmenorrhoea
Infertility
Pelvic pain
Dyspareunia
Irregular bleeding

Common Sites of Endometriosis

Uterine Prolapse
Downward

displacement of the uterus

into the vaginal canal

Uterine Prolapse
1st

degree Downward displacement of

the uterus into the vaginal canal
2nd degree - Downward displacement of
the uterus into the vaginal canal with the
cervix at the vaginal opening
3rd degree - Downward displacement of
the uterus into the vaginal canal with the
uterus protruding through the introitus

Uterine Prolapse
First

degree
prolapse

Second

degree
prolapse

Third

degree
prolapse

Clinical Manifestations of Uterine

Prolapse
Vary

with degree of prolapse

Patient may describe a feeing of
something coming down
Dyspareunia
Dragging or heavy feeling in the pelvis
Backache
Bowel or bladder problems

Cystocele and Rectocele

Cystocele

occurs when support

between the vagina and bladder is
weakened
Rectocele results from weakening
between the vagina and rectum
Woman may not be able to empty
bladder or bowel

Cystocele and Rectocele

Cystocele

Rectocele

Ectopic Pregnancy
The

implantation of the fertilised ovum

anywhere outside the uterine cavity
98% occur in the fallopian tube
A life-threatening condition
Risk factors include a history of PID,
prior ectopic pregnancy, use of IUD, in
vitro fertilization procedures

Ectopic Pregnancy

Ruptured Tubal Pregnancy

Ectopic Pregnancy Sites

Clinical Manifestations Of Ectopic

Pregnancy
Abdominal

or pelvic pain
Missed menses
Irregular vaginal bleeding
Other symptoms of pregnancy
With rupture the risk of haemorrhage
and hypovolaemic shock is present