Male Genital Path

Question 0

What is bladder exstrophy

Answer 0

Opening of the anterior abdominal wall + lower portion Above the bladder -> bladder wall not formed properly and is also exposed

Question 1

Explain hypospadia’s + epispadias is

Answer 1

Abnormal opening of penile urethra

@ventral surface of the penis due to failure of urethral folds to fuse –
Assoc with inguinal hernia + cryptorchidism

@Dorsal surface of penis due to faulty positioning of genital tubercle -
Assoc with exstrophy

Question 2

What is lymphogranuloma venereum

Answer 2

Necrotising granulomatous inflammation of inguinal lymphatics due to Chlamydia trachomatis

Question 3

What’s is the most common congenital reproductive abnormality?

Answer 3

Cryptorchidism

Question 4

By what age is most cases of cryptorchidism resolved spontaneously?

If not resolved by 2 years what damages can occur?

Answer 4

2

Testicular atrophy, infertility, seminoma Due to high-temperature

Question 5

Which serotype of chlamydia causes orchitis?

Answer 5

A-C = blindness due to follicular conjunctivitis

D-K = urogenital infections + staccato cough + conjunctivitis + orchitis

L1 L2 and L3 =
lymphogranuloma venereum = ulcers on genitals
+
swollen painful inguinal lymph nodes

Question 6

Explain how mumps Affects

Answer 6

Makes pratted + balls as big as POM-poms

P = Paramyxovirus + parotitis
O = orchitis
M = meningitis

Question 7

Patient presents with granulomatous Information of testicle tubule. What is the DDX?

How do we distinguish between these two diseases?

Answer 7

AUTOIMMUNE Orchitis + TB

Orchitis = non-necrotising granuloma
TB = acid-fast stain + necrotising granuloma

Question 8

Adolescent presents with sudden testicular pain. Junior doctor performed the cremasteric reflex and finds that it is absent. Explain the diagnosis ?

Answer 8

Congenital failure of testes to attach to interlining of scrotum – >spermatic cord twists – >

Close thin-walled vain
+
Open thick-walled artery – >

Blood cannot leave and goes into the dead loosely organised tissue – > Haemorrhagic infarction of testicle

Question 9

Patient presents with scrotal swelling with a bag of worms appearance . Explain the diagnosis

Answer 9

Impaired drainage of left spermatic vein – >
left spermatic vein dilation – >
scrotal swelling with a bag of worm appearance = veins dilated i.e. see them on surface of scrotum

Question 10

Explain why varicocoels are usually on the left side and what are the associated?

Answer 10

So certain of left-sided renal cell carcinoma

Because left spermatic vein drains into the left renal vein which can get blocked due to left-sided renal cell carcinoma

Question 11

Explain why a child can get a congenital hydrocele

Answer 11

Incomplete obliteration of processes vaginalis – >
tunica vaginalis has a connection with properitoneum – >
peritoneum provide fluid to tunica vaginalis = Hydrocele

Question 12

Explain why an adults can get a Hydrocele

Answer 12

TIT - Trauma infection tumour – >
Block lymphatic drainage – >
Benign and scrotal fluid collection

Question 13

If an adult accumulates blood in the scrotum what is this called

Answer 13

Haematocele

Question 14

A patient presents with
paratesticular fluctuant nodule
what is this and how does this develop?

Answer 14

Spermatocele

Dilated
epididymal duct/rete testes – > cyst

Question 15

Explain what Squamous cell carcinoma is

Answer 15

Malignance proliferation of squamous cells penile skin

Question 16

What are the risk factors of squamous cell carcinoma of the penis

Answer 16

HPV 16 18 31 33
Lack of circumcision – >
foreskin improper maintenance – >
nidus for inflammation + irritation – >
Squamous cell carcinoma

Question 17

What are the precursor diseases to squamous cell carcinoma of the penis

Answer 17

Bowen disease:
In situ carcinoma = leukoplakia (white plaque) of penile shaft /Scrotum

Biopsy = malignant cells not invaded basement membrane

Erythroplasia of Queyrat: in situ carcinoma = erythroplakia @penis glans

Bowenoid papulosis = red papules in situ carcinoma that doesn’t progress to invade unlike Bowens disease

Question 18

Patient presents with benign warty growth + genital skin. What is it?

Answer 18

Condyloma acinatum = HPV 6+11 = koilocytic change