Disorders of Genitourinary and Reproductive Function Flashcards
Spermatogenesis
Testosterone is also required (the intratesticular concentration of testosterone is 100-fold greater than serum levels)
Male sex hormones and spermatogenesis
Gonadotropin-releasing hormone (GnRH)
Follicle-stimulating hormone (FSH):
Sertoli cells - initiation of spermatogenesis
Luteinizing hormone (LH):
Leydig cells
Production of testosterone
Systems maintaining temperature of testes
Sperm production requires temperature that are 2 to 3 degrees Centigrade below body (core) temperature.
Main actions of testosterone
Promote spermatogenesis and maturation of sperm.
Hypogonadism
Primary - testicular failure
Hypospadias and Epispadias
Congenital disorders of the penis.
Hypospadias - the termination of the urethra is on the ventral surface of the penis.
Categorized as glandular (involving the glans penis), penile, or perineoscrotal.
Epispadias - the opening of the urethra is on the dorsal surface of the penis.
Peyronie disease
A localized and progressive fibrosis of known origin that affects the tunica albuginea.
Manifestations - painful erection, bent erection, and the presence of a hard mass at the site of fibrosis.
Priapism
Erection lasting more than four hours or unrelated to sexual interest or stimulation.
Low-flow (ischemic) priapism: there is stasis of blood flow in the corpora cavernosa with a resultant failure of detumescence.
The two main types of priapism are ischemic and nonischemic priapism.
Ischemic priapism, also called low-flow priapism, is the result of blood not being able to leave the penis. It’s the more common type of priapism and is usually more painful.
Cryptorchidism (undescended testes)
Occurs when one or both of the testicles fail to move down into the scrotal sac.
The testes develop intra-abdominally in the fetus and usually descend into the scrotum through the inguinal canal during the 7th to 9th months of gestation.
Consequences of Cryptorchidism
Infertility
Malignancy
Testicular torsion (10x increased risk)
Disorders of the scrotum and testes
Varicocele: varicosities of the pampiniform plexus; a network of veins supplying the testes
Testicular torsion
Epididymitis
Inflammation of the epididymis.
Types -
Sexually transmitted infections associated with urethritis.
Primary nonsexually transmitted infections associated with urinary tract infections and prostatitis.
Causes - bacterial pathogens
Benign Prostatic Hypertrophy (BPH) pathophysiology
Cause unknown; aging is largest risk factor.
Age-related, nonmalignant enlargement of the prostate gland.
Characterized by the formation of large, discrete lesions in the periurethral region of the prostate rather than the peripheral zones, which commonly are affected by prostate cancer.
Hormone changes -
Reduced testosterone
Increased proportion of estrogen and dihydrotestosterone
Lead to prostatic cell proliferation and growth
Not considered a prostate cancer precursor.
Prostate enlarges; gland impinges on urethra obstructing urine flow.
Urinary frequency:
Dribbling - interrupted urine stream
Hesitancy - trouble starting urine
Size of prostate does not always correlate with symptoms.
Erectile dysfunction
The inability to achieve and maintain an erection sufficient to permit satisfactory sexual intercourse.
Erectile dysfunction pathophysiology
Inability to achieve or maintain an erection sufficient for satisfactory sexual performance.
Medications - antihypertensives
Erectile dysfunction treatment
Pharmacologic treatment - not within 24 hours of nitrates
Sildenafil (Viagra)
Vardenafil
Tadalafil