Chapter 14 ( Male Genital System ) Flashcards
Mechanism of hypospadias ?
Failure of the urethral folds to close
Epispadias mechanism ? Associated with ?
Due to abnormal positioning of the genital tubercle
Associated with bladder exstrophy
Lymphogranuloma Venereum mechanism ? Cause ? Fate ?
Necrotizing granulomatous inflammation of the inguinal lymphatics and LNs
Sexually transmitted disease caused by : Chlamydia trachomatis ( serotypes L1-L3 )
Eventually heals by fibrosis
Perianal involvement may result in rectal stricture
Penile squamous cell carcinoma risk factors ? Precursor in situ lesions ?
Risk factors :
High risk HPV
Lack of circumcision
Precursor in situ lesions :
1- Bowen disease : in situ carcinoma of the penile shaft or scrotum that presents as Leukoplakia
2- Erythroplasia of Queyrat : in situ carcinoma of the glans that presents as Erythroplakia
3- Bowenoid papulosis : in situ carcinoma that presents as multiple reddish papules , seen in younger patients ( 40y ) and does not progress to invasive carcinoma
Most common congenital male reproductive anomaly ?
Cryptorchidism
Complications of cryptorchidism ?
Testicular atrophy with infertility
Increased risk for seminoma
Causes of Orchitis ?
1- Chlamydia trachomatis ( D-K ) or Neisseria gonorrhea : seen in young adults with increased risk for sterility but libido is not affected because Leydig cells are spared
2- E coli and Pseudomonas : seen in older adults , UTI spreads into the reproductive tract
3- Mumps virus : in teenagers , increased risk for infertility
4- Autoimmune orchitis : characterized by granulomas involving the seminiferous tubules
Cause of testicular torsion ?
Due to congenital failure of testes to attach to the inner lining of the scrotum ( via the processus vaginalis )
Most common type of testicular tumors ?
Germ cell tumors
Germ cell tumors of testicles occur in age ?
Between 15-40 years
Risk factors for germ cell tumors ?
Cryptorchidism
Klinefelter syndrome
Gross appearance of seminoma ?
Homogenous mass with no hemorrhage or necrosis
Embryonal carcinoma of testicles consequence of chemotherapy ? Labs ?
Chemotherapy may result in differentiation into another type of germ cell tumor ( teratoma )
Labs : increased AFP or Beta-hCG may be present
Elevated Beta-hCG may lead to ? Why ?
Hyperthyroidism or Gynecomastia
Because alpha subunit of hCG is similar to that of FSH , LH and TSH
Is teratoma benign or malignant in males ? Labs ?
Malignant
AFP and Beta-hCG may be increased
Presentation of sertoli cell tumor ?
Usually clinically silent
Most common cause of testicular mass in males > 60 years old ?
Lymphoma usually of diffuse large B-cell type
Prostatic glands are composed of ? Secrets ? Maintained by ?
Inner layer of luminal cells and outer layer of basal cells
Secrets alkaline milky fluid thats added to sperms and seminal vesicle fluid to make semen
Maintained by androgens
Acute prostatitis causes ? Presentation ? On DRE ? Inv ?
In young adults : Chlamydia trachomatis and Neisseria gonorrhoeae
In older adults : E coli and Pseudomonas
Presents as dysuria with fever and chills
On DRE : prostate is tender and boggy
Inv : prostatic secretions show WBCs
Culture reveals bacteria
Chronic prostatitis presentation ? Inv ?
Presents as dysuria with pelvic or low back pain
Inv : prostatic secretions show WBCs
Cultures are negative
Mechanism of benign prostatic hyperplasia ?
DHT acts on the androgen receptor of stromal and epithelial cells resulting in hyperplastic nodules
Site of benign prostatic hyperplasia ?
In the central periurethral zone of the prostate
PSA source ? Function ?
Made by prostatic glands
Liquifies semen
Non selective alpha1- antagonist ?
Terazosine ( acts on both alpha1a and alpha1b receptors )
