Male Repro Flashcards
What is episadia and hypospadias and what is it associated w
Episadia- urethral opening on the dorsal surfacee of pen
Hypospadias- urethral opening on ventral surface
- associated w undescended testes
- increased UTI/infertility
What are the 4 inflammatory conditions of the penis
Balantis- inflammation of the glans
Balonoposthitis- inflammation of the foreskin and glans in uncircumcised
Phimosis- Inability of foreskin to be retracted behind glans
Paraphimosis- Traped foreskin behind glans
What is peyronie diisease
Penile fibromatpsos causing penile curvature
What is penile malignancies associated w
Associated w squamous cell carcinoma
Infection HPV serotypes 16/18
Precancers (bowens disease/erythroplasia query)
Mc cause of ED in 50+
Vasculogenic insufficient
- arterial narrowing in the basin of the internal pudendal artery (int iliac)
- DM associated w atherosclerosis
WHat causes neurogenic ED
ED may be symptoms of MS, diabetic neuropathy, radical prostatectomy, spinal diseases etc
Other causes of ED
- BPH
- meds
- smoking/alcohol
- aging (andropause)
- Pseudo ED (same sex attraction)
What is cryptochidism
Condition is which one or both testes fail to descend
can lead to failure of full closure of the urethra
-leads to increased environmental temp for testes leading to a loss of germ cells and atrophy of spermatogenesis
Histopathology of cryptochidism (seminiferous tubules/basement/ changes)
Seminiferous tubules- progressive loss of germ cell elements, low or absent foci of spermatogenesis
Tubular basement is thickened
hyalinization of tubules
interstitial stroma (increease in fibrobascular stroma and conspicous presents of leydig cells)
When do symptoms become apperent in cryptochidism
2 years of age
(asymptomatic but becomes found during the physical exam)
-must undergo surgical correction before 2 years
What happens if undescendied testes go untreated (3)
- if bi- complete sterility, uni- infertility one side
- Inguinal hernia
- Malignancy (30-50 fold increase)
pre testicular, testicular and post testicular causes of male infertility
pre testicular- prob w development of testicle
Testicular- Problem is inside parenchyma of test
post testicular- Normally developed testicle but something is blocking proper delivery of sperm
Pre testicular causes of male infertility
Hormonal disorders are major cause
hypopituitarasim
What hormonal excesses can cause pre testicular infertility
Estrogen excess
Glucocorticoid excess
Testicular causes of male infertility
- Primary hypogondism (leydig cell or seminiferous tubule dysfunction)
- Agonadism (total absence of testis)
- Cryptorchidsm
- Hypospermatogenesis
- klienfleter
- mumps
- rratation damage
Post testicular causes of male infertlity (and two types)
Obstructive
(have normal hormonal profile w normally descended testes but sperm can exit)
- Congenital block- atresia of vas degrens
- Aquired block- Previous gonococcal or urea plasmic or chlymadial infections
Impraired sperm motility
Risk factors of testicular cancers
cryptochidism
testicular dysgenesis
positive fam hx
Caucasion
testicular tumor random facts
1% of all tumors
more in white males
less common in africans and asians
trimodal age distribution (infancy/late adolescence/60+)
Germ cell cancers- % and types
95%
- Seminoma
- spermatocytic seminoma
- Embryonal carcinoma (yolk sac tumor, choriocarcinoma, teratomas)
- Polyembryoma
Sex cord stromal tumors- % anf types
5%
- leydig cell tumor
- sertolo cell tumor
- granulosa cell tumor
- mixed forms
What is a combined germ cell sex stromal tumor
Gonadoblastoma
Seminoatous (SGCT) tumors- look, metastisis, response to radiation, markers, prognosis
-larger (confined)
-Metastisis to regional lymph nodes
-radiosensitive
HCG generally low level marker
Better prognosis
Non seminiferous (NSGST) germ cell tumors- look, metastisis, response to rad, serum markers, prob
Smaller Heamategnous spread early radioresistent HCG, AFP or both high Poor prog
What are the common tumor markers
- Human chorionic gonadotropin
- Alpha foetoprotein
- Carcinoembryonic antigen
- Human placental lactogen
- Testerosterone estrogen + leutanizing hormone
