Exam 21: Male Genitourinary System, Anus, Rectum, and Prostate
Describe the prostate gland.
The prostate gland is 2.5 cm long by 4 cm in diameter. The gland lies in front of the anterior wall of the rectum and 2 cm behind the symphysis pubis. It secretes a fluid that contributes to the seminal fluid and consists of a median lobe and two lateral lobes, separated by a shallow groove called the median sulcus. The seminal vesicles, which project like rabbit ears above the prostate, secrete a fluid that nourishes the sperm. Two bulbourethral glands the size of a pea are located inferior to the prostate on either side of the urethra.
Incorporate health promotion concepts when performing an assessment of the anus, rectum, and prostate.
Colorectal cancer is the second leading cancer killer in the United States. Health promotion should include informing adults aged 50 years and older to have regular colorectal screening tests. Early detection of colorectal cancer helps to identify precancerous polyps so that they can be removed before they become cancerous; also, screening helps to find colorectal cancer early, when treatment is most effective. The importance of screening for prostate cancer in males is discussed in Chapter 24.
Describe developmental care for examination of anal, rectal, and prostate structures.
Passage of the first stool (meconium) of a newborn indicates patency of the rectum. The nerves of the rectal area become myelinated at between 1½ and 2 years of age. Toilet training cannot start until this occurs.
At puberty, the prostate doubles to reach adult size.
Benign prostatic hypertrophy is evident in males at the age of 40 years and increases with age.
Discuss the importance of teaching testicular self-examination as health promotion during assessment.
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