Male Reproductive System Flashcards
What are the 3 zones of the prostate gland?
• The peripheral zone accounts for 70% (Prostate cancers arise almost exclusively from the peripheral zone)
• The transition zone 5%
• The central zone 25%.
What are the 3 major prostate pathologies?
What is the mx for BPH?
• FInasteride
• Trans-Urethral Resection of the Prostate (TURP)- A wire loop heated by an electric current is used to remove excess
tissue from your prostate.
• HoLEP - Holmium Laser Enucleation of the Prostate (HoLEP)- Uses a laser rather than a heated loop – very new - not yet widespread
method.
How is prostrate cancer diagnosed?
- digital rectal exam
- abnormal prostate - Increased AR = increased PSA (levels can be affected by: Prostate Biopsy, DRE, Ejaculation, BPH, Prostatitis, intense exercise)
- Trans Rectal Ultra Sonography (TRUS) / Biopsy as follow up from positive DRE and PSA
How is prostate cancer staged?
How can prostate cancer spread?
• Direct – stromal invasion, through prostatic capsule, into seminal vesicle, bladder base, or pelvic side wall
• Lymphatics to sacral, iliac and para-aortic nodes
• Blood to bone (pelvis, lumbosacral spine, femur), lungs and liver
What is the medical mx for prostate cancer?
- goserelin (zoladex)- leads to DECREASED levels of LHRH Receptor levels. The result is sustained suppression of LH and serum testosterone levels.
- casodex (bicalutamide)- portent AR inhibition. First line ADT therapy
- docetaxal (taxotere)- for advanced prostate cancer
What are the specialised cells of the testis?
What is cryptorchidism?
Undescended testes. If they remain undescended the semiferous
tubules remain small and leads to decreased
spermatogenesis. Ultimately the
spermatogonia are replaced by sertoli cells
What is a hydrocele?
What is a haemotocele?
What is a varicocele?
What is orchitis?
Mumps Orchitis
• Acute infection (paramyxovirus) in children
• In adults accompanied by Orchitis – large, swollen and tender testes
• Vascular dilation and oedema with an infiltrate of lymphocyctes
• May lead to ischaemia and necrosis of seminiferous tubules
• In rare cases causes cub fertility
Idiopathic granulomatous orchitis
• Chronic inflammation of unknown origin
• Firm testicular enlargement, Cause – unknown….
• Sufferers have to just “manage” on pain relief medication
STI orchitis
• Syphillis - Treponema pallidum (rare)
• Gonorrhea, chlamydia
What is testicular torsion?
Twisting of the cord leads to cutting off of the blood supply and prevents drainage of the testes. 6 hours to save the testicle
What causes testicular atrophy?
• Progressive atherosclerotic narrowing of the blood supply in old age
• End stage of an inflammatory orchitis
• Cryptorchidism
• Hypopituitarism
• Generalized malnutrition or cachexia
• Irradiation
• Prolonged administration of antiandrogens (treatment for advanced
carcinoma of the prostate)
• Exhaustion atrophy, which may follow the persistent stimulation produced by high levels of follicle-stimulating pituitary hormone.
• Alcoholism
• Kleinfelter’s syndrome
What is the main cause of testicular cancer?
Undescended testes
What is overexpressed in testicular cancer?
c-KIT is over expressed in certain tumours of the testes
What are the 2 cell types present in a Choriocarcinoma?
• Syncytiotrophoblastic cells – large with hyperchromatic nuclei
• Cytotrophophoblastic cells – regular cells with defined borders, uniform
nucleus
What are the stages of testicular cancer?
Stage 1
• The cancer is contained within the testicle and hasn’t spread to nearby
lymph nodes or other organs.
Stage 1S
• This means that there are raised markers (particular testicular proteins) in the blood after surgery.
Stage 2
• Cancer cells have spread from the testicle into nearby lymph nodes or pelvis. Possible raised levels of markers.
Stage 3
• Cancer has spread to lymph nodes or other organs. It is split into stages 3A, 3B and 3C. These refer to where the cancer has spread and the levels of markers in the blood
