Chapter 14 Flashcards
What is the difference between epispadias and hypospadias?
Hypospadias is the abnormal opening of the urethra on the inferior surface of the penis due to failure of closure of the urethral folds while epispadias is the abnormal superior opening of the urethra due to abnormal positioning of the genital tubercle (associated with bladder exstrophy)
What is this?
condyloma acuminatum of the penis caused by HPV 6/11 (koilocyte change on histo)
What is this?
Lymphogranuloma venereum, a necrotizing granulomatous inflammation of inguinal lymphatics and lymph nodes caused by Chlaymdra trachomatis serotypes L1-L3
What are the main risk factors for squamous cell carcinoma of the penis?
High risk HPV (2/3 of cases)
Lack of circumcision- the foreskin acts as a nidus for inflammation
What is this?
Bowen disease- in situ carcinoma of the penile shat or scrotum that presents as leukoplakia
What is this?
Erythroplasia of Queyrate- in situ carcinoma on the glans that presens as erythroplakia
What is this?
Bowen papulosis- an in situ carcinoma that presents as multiple reddish papules on the penis
Seen most in younger pts (40s) and does NOT progresss to invasive carcinoma
What is cryptorchidism?
Failure of the teticle to descend into the scortal sac (most cases resolve spontaneously but if not, orchioplexy is perfromed before 2 yrs of age)
Complications include testicular atrophy with infertility and increased risk for a seminoma
What is orchitis?
Inflammatio of the testicle
What are the most common causes of orchitis?
Chlamydia trachomatis (serotypes D-k) or Neisseria gonorrhoeae- increased risk of steriliy but libido is not affected because Leydig cells are spared
E. Coli and Pseudomonas- seen in older adults as UTIs that spread into the repro tract
Mumps
Autoimmune orchitis- granulomas involving the seminiferous tubules
What is testicular torsion?
Twisting of the spermatic cord, in which thin-walled veins become osbtructed leading to congestion or infarction
Usually due to congenital failure of the testes to attach to the inner lining of the scrotum vi the processus vaginalis
Cremasteric reflex is usually absent
Dilation of the spermatic vein due to impaired drainage is known as _______
Varicocele- presenting as a bag of worms appearance (usually left-sided due to the left testicular vein draining into the left renal vein, while the RTV drains directly into the IVC)
What is hydrocele?
Fluid collection within the tunica vaginalis that is associated with incomplete closure of the processus vaginalis leading to communication with the peritoneal cavity in infants or blockage of lymp drainage in adults
Basics of testicular tumors
Can arise from germ cells or sex cord-stroma
Typically presents as a firm painless testicular mass that cannot be transilluminated
usually not biopsied for risk fo seeding the scrotum; removed via radical orchiectomy
What are the most common types of testicular cancer?
Germ cell tumors (95%)
Describe Germ cell tumors of the testicle
These usually occur in pts 15-40 yo with risk factors including cryptorchidism and Klinefelter syndrome