The Big Picture
Aging, injuries, diseases, and surgeries can affect the structures and functions of the reproductive system.
Three common concerns are an enlarged prostate gland, pelvic organs moving out of their normal position, and difficulty becoming pregnant.
For CCAs, support also includes protecting clients from infection, providing comfort, respecting confidentiality, listening with empathy, and reporting certain concerns.
Look for Nova Scotia CCA Notes throughout this page for current provincial guidance.
Quick tip: Tap, click, or press Enter on any term with a dotted underline and an ⓘ icon to see its plain-English definition.
Start Here If You’re Overwhelmed
Focus on these core ideas:
- Benign prostatic hypertrophy (BPH) means the prostate gland is enlarged and may partly block urine flow.
- Pelvic organ prolapse (POP) happens when one or more pelvic organs move down into the vagina because supporting tissues have weakened.
- Infertility means pregnancy has not occurred after a certain period without contraception or after medical fertilization treatment.
- BPH, POP, and infertility each have different causes, effects, and concerns.
- CCA support includes infection prevention, empathy, comfort measures, confidentiality, reporting UTI symptoms, and reporting and recording pain.
Jump to:
Course Notes: Key Ideas You Need to Know
Benign Prostatic Hypertrophy
Benign prostatic hypertrophy (BPH) means an enlarged prostate gland.
The prostate surrounds the urethra in a client with male genitalia. The urethra carries urine from the bladder out of the body.
As the prostate gets larger, it may partly block the urethra. This can make urination difficult.
BPH is very common in older men. About half of men older than 75 have some symptoms.
What BPH Does Not Mean
BPH is not prostate cancer.
It also:
- does not cause prostate cancer
- does not cause erection difficulties
- does not affect the ability to produce children
Urinary Concerns With BPH
BPH may cause:
- difficulty starting or stopping urination
- frequent urges to urinate, which may disturb sleep
- a weak or slow urine stream
- a feeling that the bladder is still full after urinating
- urinary dribbling or leaking
- blood in the urine, especially when trying to force a urine stream
When Difficulty Urinating Becomes a Concern
If a client cannot urinate without extreme difficulty, the bladder may be blocked.
Report: Notify the supervisor.
A blockage may lead to urinary retention, which means urine backs up instead of leaving the bladder normally.
Urinary retention may lead to:
- bladder infection
- bladder stones
- kidney damage
This problem is rare.
Pelvic Organ Prolapse
In a client with female genitalia, muscles, tissues, and ligaments help hold pelvic organs in place. These organs include the uterus, rectum, and bladder.
Pelvic organ prolapse (POP) happens when one or more pelvic organs move down from their normal position into the vagina because their supporting tissues have weakened.
Two types are:
- Cystocele: prolapse of the bladder
- Rectocele: prolapse of the rectum
POP is often associated with urinary incontinence.
Signs of Pelvic Organ Prolapse
Most clients with POP notice:
- a bulge in the vagina
- pressure in the vagina
- heaviness in the vagina
POP is not life-threatening. Treatment is not needed unless the symptoms are bothersome.
With a large prolapse, bulging may become visible from the vaginal area.
Care With a Visible Prolapse
When providing perineal care to a client with a visible prolapse, health care workers must take great care not to irritate the exposed tissues.
The exposed tissues are delicate.
Risk Factors for Pelvic Organ Prolapse
The exact causes of POP are unknown.
Risk factors involve weakness or damage to tissues, nerves, or muscles.
They include:
- previous pregnancies and vaginal births
- obesity
- aging
- nerve disorders
- connective tissue disorders
- increased abdominal pressure from heavy lifting
- increased abdominal pressure from chronic coughing
Injury from previous pregnancies or vaginal births may be linked with POP later in life.
General Recommendations for Pelvic Organ Prolapse
General recommendations include:
- Avoid straining when urinating or having a bowel movement.
- Keep stools soft and avoid constipation.
- Empty the bladder completely each time.
- Watch for symptoms of a urinary tract infection (UTI), which is an infection in the urinary system.
- Lose weight if necessary because excess weight increases pressure on the pelvic organs.
- Use Kegel exercises, also called pelvic floor exercises.
- Vaginal estrogen may be prescribed.
Kegel exercises strengthen the pelvic floor muscles that support the vagina, bladder, and urethra.
Vaginal estrogen may come as a cream, pill, or ring. It may be prescribed when vaginal tissue is irritated or thin.
UTI Symptoms to Report
Watch for:
- urinary urgency
- urinary frequency
- blood in the urine
- burning during urination
CCA action: Report these symptoms in clients.
Infertility
Infertility means pregnancy has not occurred after a reasonable period of sexual intercourse without contraception or after medical fertilization treatment.
The time period depends on age:
- For women under age 35, the period is 1 year.
- For women over age 35, the period is 6 months.
About 16%, or 1 in 6, couples in Canada experience infertility.
This number has doubled since the 1980s.
Infertility may be related to the man, the woman, or both.
Possible Causes of Infertility in Women
Sexually transmitted infections (STIs) are diseases spread through sexual contact.
Causes may include:
- age, with fertility decreasing after age 35
- difficulty producing eggs
- no menstrual periods or irregular menstrual cycles
- an STI such as chlamydia, which can block the fallopian tubes
- uterine concerns such as fibroids or polyps
- missing or blocked fallopian tubes
- endometriosis
- hormonal imbalances
- early menopause before age 40
Endometriosis involves excess tissue gathering around the reproductive organs.
Possible Causes of Infertility in Men
Causes may include:
- poor sperm quality involving movement or shape
- a low sperm count
- no sperm
- a history of an STI such as chlamydia
- hormonal imbalances
Other Possible Causes of Infertility
Other causes may include:
- previous cancer treatments such as chemotherapy, radiation, or surgery
- some chronic illnesses, including diabetes, and their treatments
- tobacco use
- alcohol use
- being underweight
- being overweight
When Medical Treatment May Be Considered
Fertility challenges may respond to medical treatment in certain situations.
For menstruating clients, these situations include:
- severe pain during menstruation
- severe pain during sex
- no menstrual periods
- irregular menstrual periods
- previous surgery involving the abdomen or uterus
- more than one miscarriage
- a history of an STI
- previous cancer treatment
- a family history of early menopause before age 40
Severe pain during menstruation or sex may be a sign of endometriosis.
No periods or irregular periods may point to problems with ovulation.
Clients with male genitalia should seek medical treatment when they have:
- had surgery involving the testicles
- experienced an injury to the testicles
- premature ejaculation
- difficulty having an erection
- a history of an STI
- previous cancer treatment
Supporting Clients With Reproductive System Disorders
A reproductive system disorder may cause concerns about treatment or the future. Infertility may also raise concerns about future pregnancy.
Protect the Client From Infection
Wear the proper PPE recommended in the client’s care plan.
Follow Standard Practices at all times.
Change out of your uniform before leaving the agency or the client’s home to reduce the risk of spreading pathogens.
Listen With Empathy
Listen to the client and use empathy when speaking.
This shows respect for the client.
Support Comfort
Use supported pain-reducing comfort measures.
Make sure the client:
- has good body alignment at all times
- sits or lies on a clean, dry, wrinkle-free surface at all times
Report and document: Report and record any pain the client experiences.
This helps support the client’s comfort and allows medication to be given according to the care plan.
Protect Confidentiality
Always follow confidentiality rules.
Never discuss the client or details about the client with anyone who is not involved in the client’s care.
Nova Scotia CCA Note
Sorrentino’s Canadian Textbook for the Support Worker, 5th Edition tells CCAs to report certain urinary symptoms, report and record pain, follow care-plan directions, and provide supportive personal care. Nova Scotia’s current Continuing Care Assistant Occupational Standards of Practice makes the role boundary more specific. A CCA’s occupational levels include following, observing, documenting, and reporting. Assessing, analyzing, evaluating, and creating fall outside the CCA occupational levels. (novascotiacca.ca)
In Nova Scotia, a CCA uses an observational point-of-care assessment to notice changes and recognize when they need to be escalated to a supervisor. This is not a nursing assessment and does not permit the CCA to perform the comprehensive evaluation used to make care-planning decisions. The CCA applies the care plan and follows employer documentation requirements. (novascotiacca.ca)
Why this matters in Nova Scotia: When a client has urinary changes or pain, the CCA observes, follows the care plan, reports or escalates changes, and documents as required. The CCA does not perform the nursing assessment or create the care plan. (novascotiacca.ca)
Official source: Continuing Care Assistant Occupational Standards of Practice
Last checked: October 3, 2026
Exam Clue Words
- Report: Report UTI symptoms in a client with POP. Report and record pain the client experiences.
- Must: During perineal care for a visible POP, health care workers must take great care not to irritate exposed tissue.
- Always: Follow Standard Practices at all times and always obey confidentiality rules.
- Never: Never discuss client information with anyone who is not involved in the client’s care.
- Follow the care plan: Wear the PPE recommended in the client’s care plan. Report and record pain so the client is comfortable and medicated according to the care plan.
Common Mix-Ups
| Wrong Idea | Better Idea |
|---|---|
| BPH is prostate cancer. | BPH is an enlarged prostate and is not cancer. |
| BPH causes prostate cancer. | BPH does not cause prostate cancer. |
| A cystocele involves the rectum. | A cystocele is prolapse of the bladder. |
| A rectocele involves the bladder. | A rectocele is prolapse of the rectum. |
| Infertility always comes from one partner. | Infertility may relate to the man, the woman, or both. |
Fast Review
Keep these high-value facts in mind when you review:
- BPH is an enlarged prostate gland that may partly block the urethra and make urination difficult.
- About half of men older than 75 have some symptoms of BPH.
- BPH is not cancer and does not cause prostate cancer, erection difficulties, or an inability to produce children.
- Extreme difficulty urinating may mean the bladder is blocked, so the supervisor should be notified.
- POP happens when one or more pelvic organs move down into the vagina because supporting tissues have weakened.
- A cystocele is bladder prolapse. A rectocele is rectal prolapse.
- UTI symptoms such as urgency, frequency, blood in the urine, or burning during urination should be reported.
- Infertility uses a 1-year period for women under 35 and a 6-month period for women over 35.
- About 16%, or 1 in 6, couples in Canada experience infertility.
- Client support includes infection prevention, empathy, comfort measures, reporting and recording pain, and protecting confidentiality.
Final Pep Talk
This topic has several conditions, symptoms, risk factors, and numbers to keep separate. Focus first on what makes BPH, POP, and infertility different, then review the support rules a second time.