Male Genital System 1 Flashcards by Samuel Latham

What is duplication?

Two or more urethral orifices

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What is epispadias/hypospadias?

Abnormal openings of the urethra on the ventral or dorsal penis from malformation of the urethral canal

Can lead to urethral obstruction or failure of normal ejaculatory function
Can be associated with undescended testes

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What is phimosis?

Inability to easily retract the foreskin

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What is the most common cause of inflammation of the penis?

Phimosis or venereal disease

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What is balanitis? posthitis? Most common cause?

Inflammation of the glans
Inflammation of the foreskin
Poor hygeine

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What are condylomas?

Warty, cauliflower like growths which occur primarily in the anogenital area
-Caused by hPV 6 and 11

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Microscopic appearance of a condyloma?

Exuberant exophytic(growing outward) growth pattern of the papillary lesion; Growth is orderly with few mitoses and no necrosis

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What is Bowen’s Disease?

Squamous cell carcinoma in situ of the penile skin

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What is Erythroplasia of Queyrat?

Squamous cell carcinoma in situ of the glans

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What is the most common cause of both Bowen’s Disease and Erythroplasia of Queyrat?

hPV 16

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Gross Appearance of Bowen’s Disease and Erythroplasia of Queyrat?

Red, slightly raised, rough, painless, nonulcerated lesions

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Histological Appearance of Bowen’s Disease and Erythroplasia of Queyrat?

Hyperkeratosis with disordered maturation and elongation of rete ridges and thickening of epidermis

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Other risk factors for squamous cell carcinoma of the penis? (other than hPV)

Smoking and poor hygeine

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What is cryptorchidism?

Undescended testes

- failure of descent of testis from abdomen to scrotum

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Typical distribution of cryptorchidism?

75% unilateral/25% bilateral

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Can cryptorchidism be related to other anomalies?

Yes - e.g. hypospadias

What is the pathology behind cryptorchidism?

Two phases
1. Transabdominal phase
   ~ Mullerian inhibiting substance 
   ~ Takes testes to brim of pelvis
   ~ Failure here in 5-10% of cases
2. Inguinoscrotal phase
   ~Androgen induced release of CT-related peptide
   ~Takes testis from brim of pelvis to scrotum
   ~Failure here in 90-95% of cases

Cryptochidism complications?

Inguinal testis is susceptible to trauma
Sterility
Decreased spermatogenesis in BOTH testes in unilateral cryptorchidism
5-10 fold increase in risk of malignant neoplasm in cryptorchid testis
- some increased risk in contra lateral normally descended testis

Does orchioplexy help in cryptorchidism?

Yes - but not completely

   - Decreases risk for malignant neoplasms
   - if before 2 improves chances of normal spermatogenesis

Klinefelter syndrome?

Characterized by abnormal # of X chromosomes (typically 47 XXY) and primary gonadal insufficiency

Clinical appearance of Klinefelter Syndrome?

Eunuchoid appearance with increased stature and small-to-normal sized testes
Incomplete virilization
Gynecomastia
Mental retardation, speech difficulties

Histologic appearance of Klinefelter Syndrome?

Small hylanized seminiferous tubules

Pseudoadenomatous clusters of Leydig Cells - only appear to be increased in number

Histologic appearance of Klinefelter Syndrome?

Small hylanized seminiferous tubules

Pseudoadenomatous clusters of Leydig Cells - only appear to be increased in number

Most common cause of infectious orchitis?

Mumps - post puberty

Most common cause of infectious epididymitis?

Ct or GC

Tertiary syphilis involves what first?

Testis then the epididymis

Hows does TB spread?

Prostrate to epididymis to the testes

Hows does TB spread?

Prostrate to epididymis to the testes

When is Idiopathic granulomatous orchitis most prevelant?

5th and 6th decades

Testicular involvement is usually?

Diffuse but may also present as a localized nodular lesion and may simulate a testicular neoplasm

Testicular involvement is usually?

Diffuse but may also present as a localized nodular lesion and may simulate a testicular neoplasm

In idiopathic granulomatous orchitis can the epididymis and spermatic cord be involved?

Yes

Is necrosis seen in idiopathic granulomatous orchitis?

NO!

Testis regression

V - Vascular conditions bring in mind variococeles, which cause atropy on the side of the dilated veins I - Inflammation recalls the atrophy following mumps orchitis and other causes of epidydimoorchitis N - Neoplasms suggest the atrophy that occurs in estrogen tx of prostrate carcinoma D - Degenerative suggests the atrophy that occurs with aging I - Intoxication suggests the atrophy caused by chronic alcoholism, Laennec cirrhosis, and hemochromatosis. X-ray exposure may also produce atrophy C - Congenital recalls undescended testes and torsion A - Autoimmune and allergic recall nothing T - Trauma reminds one of the atrophy following vasectomy and accidental ligation of the blood supply during hernia repair. E - Endocrine suggests the atrophy of hypopituitarism, Klinefelter syndrome, and other eunuchoid states

Testis regression