Pathology of the Male Reproductive System Flashcards
What are some common disorders of the prostate?
Benign prostatic hyperplasia, Carcinoma, prostatitis
What is benign nodular hyperplasia?
- Non-neoplastic enlargement of the prostate which is associated with hormonal imbalance. It obstructs urine flow and is associated with infection
Where does benign nodular hyperplasia (benign prostatic hyperplasia) effect?
Normally the transition zone of the prostate plus peri-urethral glands. Results in nodules of glands and stroma. It can also involve the peri-urethral zone interferes with urethral sphincter.
What are the types of urinary retention caused by BPH?
Acute - Painful,
Chronic - Painless and more gradual
What are some of the complications of BPH?
- Compression of the urethra,
- Nodular enlargement of prostate gland,
- Diverticulum,
- Muscular hypertrophy,
- Bilateral hydroureter,
- Bilateral hydronephrosis,
- kidney infections, renal failure, calculi and septicaemia.
describe the difference in symptoms between BPH and prostate carcinoma
- BPH tends to effect the peri-urethral zone which results in urinary symptoms early whereas carcinomas tend to occur in the subcapsular zone and therefore doesn’t produce symptoms till late one.
Describe general features of prostatic carcinomas?
Adenocarcinomas usually occurs in 50+ years mainly the posterior subcapsular area, has asymmetric enlargement and metastasis to bone.
What is the precursor for prostatic carcinomas?
Prostatic intraepithelial neoplasia
Describe the spread and clinical features of prostatic carcinomas
Gleason score measures differentiation and distribution. TNM staging and they present with urinary symptoms, incidental finding on rectal exam, bone metastases and lymph node metastasis.
How do you diagnose prostatic carcinomas?
- Imaging (US, Xray)
- Cystoscopy,
- Biochemistry,
- Haematological,
- Biopsy.
What is the treatment for prostatic carcinoma?
- Oestrogenic,
- GnRH analogues,
- Orchidectomy (removal of one or both testicles),
- Radiotherapy,
- Radicle prostatectomy.
What are some pathologies of the penis and scrotum? (congenital, inflammation and tumours
Sexually transmitted,
- Congenital; Hypospadias and Epispadias,
- Inflammation and infections; Phimosis and paraphimosis.
- Tumours - Bowen’s disease and invasive squamous cell carcinoma.
What is hypospadias and epispadias?
H- Urethral opening on inferior aspect.
E - Often accompanied by abnormal development of the bladder.
What is phimosis and paraphimosis
Phimosis - Inability to retract the foreskin,
Paraphimosis - foreskin can no longer be pulled over the penis
Name some pathologies that can affect the urethra?
Obstruction (congenital valves, rupture and stricture),
- Urethritis (Gonococcal and non-gonococcal),
- Rupture,
- Tumours (warts and transitional cell carcinoma)
What are some of the developmental and cystic lesions of the testies?
Undescended testies (risk factor for cancer), hydrocoele and haematocoele
What are some causes of orchitis?
- Mumps orchitis,
- Idiopathic granulomatous orchitis,
- Symphilitic orchitis
What are the two most common types of testicular carcinomas?
- Teratoma (peak incidence 20-30years, more agressive),
- Seminoma (peak incidence 30-50 years)
What are the different categories of seminomas and teratomas?
Seminomas - Classical, spermatocytic, anaplastic, combined.
Teratoma - Differentiated, intermediate, undifferentiated and trophoblastic.
What are some other germ cell tumours?
- Intratubular germ cell neoplasia,
- Yolk sac tumour (AFP is a useful marker),
- Combined germ cell tumours.
What are some non-germ cell tumours?
- Malignant lymphoma,
- Leydig cell tumour,
- Sertoli cell tumour,
- Metastatic tumours.
What is significant is about testicular tumours and what is their presentation?
They can present with painless unilateral enlargement of testies, secondary hydrocele, symptoms of metastasis however they metastasis to para-aortic lymphnodes so aren’t palpable. Retroperitoneal mass and gynaecomastia
What are some causes of mail infertility?
- Endocrine disorders (gnRH deficiency, oestrogen excess),
- Testicular lesions (cryptochidism, abnormal spermatogensis)
- Post testicular lesions (obstruction of efferent ducts
What are some abnormalities of the epididymis and spermatic cord?
Congenital, epididymis cysts and spermatocoeles, varicocele, torsion of the spermatic cord and testies, inflammatory lesions and tumours
