NURS 6501 Module 7 Assignment: The case scenario depicts a 42-year-old man with a two-day history of pain when passing urine

The case scenario depicts a 42-year-old man with a two-day history of pain when passing urine, urinary retention, low back pain, severe perineal pain, fever, and chills. He reports that the pain exacerbates when standing and is alleviated to some degree when he lies down. His vital signs include a temperature of 104.0 F, pulse 138, respirations 24, and PaO2 of 96% on room air. On DRE) the prostate is enlarged, very tender, swollen, and warm to touch. This paper seeks to discuss STDs affecting fertility, inflammatory markers in STDs, and causes of prostatitis.

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Factors That Affect Fertility (STDs)

STDs affect fertility in both males and females and are associated with infertility. Chlamydia is a common STD resulting in male infertility by causing genetic damage in sperms (Tsevat et al., 2017). Gonorrhea causes infertility by causing epididymitis, an inflammation of the epididymis which stores and transports sperm. Syphilis is associated with epididymitis and erectile dysfunction, which affect a man’s fertility. Hepatitis B causes lower sperm count and reduced mobility due to infection (Tsevat et al., 2017). In addition, Mycoplasma Genitalium, a less common STI, is associated with infertility. It results in urethritis and epididymitis, affecting men’s fertility (Tsevat et al., 2017). The patient in the case scenario presents with symptoms of STDs such as dysuria, urinary retention, low back pain, severe perineal pain, fever, and chills. If diagnosed with an STD, he is at risk of infertility due to complications such as urethritis and epididymitis.

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Why Inflammatory Markers Rise In STD/PID

STDs are characterized by increased levels of inflammatory markers due to infection and inflammation in the genital tract. For instance, Chlamydia manifests with the highest increase in inflammatory markers because it causes a more severe irritation than other STDs (Park et al., 2017). Inflammatory markers that shoot in STDs include white blood cells, C-reactive protein (CRP), and Erythrocyte sedimentation rate (ESR) (Park et al., 2017). The patient likely has elevated inflammatory markers based on the symptoms of inflammation, such as an enlarged prostate that is tender, swollen, and warm to touch.

Why Prostatitis and Infection Happen

Prostatitis is an inflammation of the prostate gland and is often a complication of STDs. It develops when an infection from the lower urinary tract travels through the urethra or reflux of infected urine into the prostate ducts (Lupo & Ingersoll, 2019). The infection causes inflammation of the prostate gland resulting in prostatitis. It results in urinary frequency and urgency, fever, chills, dysuria, pain in the genital area, lower abdomen, or lower back, nausea, vomiting, body aches, and urinary retention (Lupo & Ingersoll, 2019). The patient in the case scenario presents with symptoms of prostatitis. A systemic reaction in prostatitis occurs when the disease-causing organism spread from the prostate gland to other organs through the lymphatic system. This results in an infection of the lymph nodes causing lymphadenopathy (Lupo & Ingersoll, 2019). The patient is at risk of developing a systemic reaction if the microbes infecting the prostate gland move through the lymphatic system to other body organs.

Conclusion

STDs associated with male infertility include chlamydia, gonorrhea, syphilis, Hepatitis B, and Mycoplasma Genitalium. Inflammatory markers rise in STDs due to inflammation in the genital tract. Prostatitis occurs when infection from the lower urinary tract ascends into the prostate ducts via the urethra or reflux of infected urine. Systemic infection occurs when the infection moves to other body organs through the lymphatic system.

References

Lupo, F., & Ingersoll, M. A. (2019). Is bacterial prostatitis a urinary tract infection?. Nature Reviews Urology, 16(4), 203-204. https://doi.org/10.1038/s41585-019-0150-1

Park, S. T., Lee, S. W., Kim, M. J., Kang, Y. M., Moon, H. M., & Rhim, C. C. (2017). Clinical characteristics of genital Chlamydia infection in pelvic inflammatory disease. BMC women’s health, 17(1), 5. https://doi.org/10.1186/s12905-016-0356-9

Tsevat, D. G., Wiesenfeld, H. C., Parks, C., & Peipert, J. F. (2017). Sexually transmitted diseases and infertility. American journal of obstetrics and gynecology, 216(1), 1–9. https://doi.org/10.1016/j.ajog.2016.08.008

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NURS 6501 Module 7 Assignment: The case scenario depicts a 42-year-old man with a two-day history of pain when passing urine