CHAPTER 9 Genitourinary System^391
poorer prognosis. The diagnosis will also have varied degrees of psychological
impact on the patient.
HALLMARK SIGNS AND SYMPTOMS
- Painless enlargement of the testis
- Palpable mass on surface of testis
- Unilateral feeling of heaviness in the scrotum
- Testicular pain due to bleeding within the testis in a small percentage of patients
- Back pain due to metastasis
- Cough or shortness of breath due to pulmonary metastasis
INTERPRETING TEST RESULTS
- Scrotal ultrasound shows mass on testis.
- CT scan of pelvis, abdomen, and chest may be needed to check for metastasis.
- Human chorionic gonadotropin (hCG) elevated.
- Fetoprotein (AFP) elevated.
- Lactate dehydrogenase (LDH) elevated.
- CBC shows anemia later in disease.
TREATMENT
- Orchiectomy.
- Chemotherapy, combination medications.
- Radiation therapy to reduce chance of recurrence.
- Monitor tumor markers periodically.
- Monitor follow-up CT scans periodically.
- Depending on treatments planned, some patients may want to bank sperm, if
fertility will be a concern after treatment.
NURSING DIAGNOSIS
- Fear
- Anxiety
- Disturbed body image