Male Reproductive Development Disorders Flashcards
Which gene, alongside SRY, will promote male development?
SOX9
Where do the primordial germ cells of both sexes arise?
Epiblast
Leydig cells are present in the foetus until how many weeks gestation?
17-18 weeks
When do leydig cells reappear?
Puberty
How can a hydrocele and an inguinal hernia be differentiated?
By a transluminal test - the hydrocele will glow a reddish colour
When does testicular descent begin?
10 weeks
Which hormone, produced by Leydig cells, causes the enlargement of the gubernaculum?
insulin-like peptide 3
Which hormones control the descent of the testes during the inguinoscrotal phase?
Androgens and calcitonin-gene-related peptide
When do the testis usually arrive in the scrotum?
a few weeks before birth
What structures comprise the inguinal canal?
internal oblique muscle transverse abdominus muscle aponeurosis of external and internal oblique inguinal ligament lacunar ligament transversalis fascia conjoint tendon
Which important structure of the male reproductive tract is transmitted through the inguinal canal?
spermatic cord
How long is the inguinal canal?
4cm
What fibrous structures forms the septa which divide the testis into lobules?
Tunica albuginea
What are the functions of the Sertoli cells?
form the blood-testis barrier
support and protect spermatogenic cells
mediate effects of testosterone and FSH
secret inhibin to regulate spermatogenesis
Which structures are transmitted in the spermatic cord?
ductus deferens testicular artery ductus artery cremaster artery pampniform plexus up to 12 veins nerves lymphatic vessels
What instrument can be used to measure the volume of the testis?
Orchidometer
What is a varicocele?
A large and squidgy vein at the back of the testicle which resembles a bag of worms
What is orchitis?
Infected and swollen testes
How can hydrocele and inguinal hernia be differentiated?
By translumination, a hydrocele will glow red
What are the long-term consequences of cryptorchidism?
impaired testicular function including spermatogenesis and increased risk of testicular cancer
What is the prevalence of cryptorchidism?
2-8%
In a patient with cryptorchidism, will you be able to palpate the testes if they are abdominal?
No
In a patient with cryptorchidism, will you be able to palpate the testes if they are inguinal?
Possibly
In a patient with cryptorchidism, will you be able to palpate the testes if they are prescrotal?
Usually yes
What are the risk factors for cryptorchidism?
birth weight <2.5kg small size for gestational age prematurity maternal diabetes environmental factors - organochlorines, smoking, phthalate monoesters
When is surgery for cryptorchidism usually undertaken?
Between the ages of 6-18 months
Cryptorchidism can be retractile. What does this mean?
The testes do not sit in the scrotum but can be pulled back into the scrotum
What is the increased risk of testicular cancer with cryptorchidism>
5%
The higher in the abdomen, the testes are located the greater the risk of testicular cancer. T/F?
True
What is the name of the surgery to correct cryptorchidism?
Orchidopexy
What are the complications of orchidopexy?
Haemotomas, pain, wound infections, testicular atrophy and recurrent cryptorchidism
What is the hormonal treatment for cryptorchidism?
hCG stimulation test where testosterone levels are artificially increased
What are the side effects of hormonal treatment of cryptorchidism?
pain, penile growth, behavioural problems, temporary inflammatory changes of the teste and reduced testicular volume in adulthood
What conditions are commonly associated with cryptorchidism?
Aarskog, fraser, Noonan, rubinstein-taybi, prune belly, smith-limli-opitz and rubinows syndromes
What is the prevalence of hypospadias?
1 in 300 births
What is a hypospadias?
An ectopic urethral meatus lying proximal to the normal site and on the ventral aspect of the penis
What are epispadias?
Ectopic urethral meatus on the dorsal side of the penis
What causal factors may be implicated in hypospadias?
hormonal fluctuations of testosterone and progesterone advanced maternal age assisted pregnancies teratogenic drugs reduced sensitivity to androgens genetic factors
How are hypospadias treated?
Surgery
Why is it important that children with hypospadias are not circumcised?
The tissue from the foreskin is used by the surgeon to repair the hypospadias
What syndrome would an individual with the karyotype 45X have?
Turner’s syndrome
What syndrome would an individual with the karyotype 47XXY have?
Klinefelter’s syndrome
