Male genital system 1
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Male Genital System 1. Dr. Amitabha Basu MD. Penis. Mal formations Inflammatory conditions Premalignant lesions and malignant conditions. Mal formations of penis. Epispadias: Infection and urinary incontinence. Inflammation of penis and prepuce.

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Male Genital System 1

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Male Genital System1

Dr. Amitabha Basu MD


Penis

  • Mal formations

  • Inflammatory conditions

  • Premalignant lesions and malignant conditions


Mal formations of penis


Epispadias: Infection and urinary incontinence.


Inflammation of penis and prepuce

Banalities & Balanoprosthitis : Hyperemia and exudates.


Banalities & Balanoprosthitis Complications : Phimosis and Paraphimosis

Paraphimosis


Genital candidiacis

  • Etiology: Diabetes Mellitus


Penis

  • Premalignant lesions

  • Malignant conditions


Premalignant lesions

  • Etiology

  • Carcinogens in smegma

  • HPV type 16


Types of Premalignant lesions : Penis

  • Carcinoma in situ ( Following types).

    • Bowen disease (HPV type 16).

    • Erythroplasia of Queyrat (HPV type 16)

    • Bowenoid Papulosis (Etiology = Venerally transmitted diseases)


Bowen disease : gross – Solitary plaque like lesion


Bowen disease : micro – in situ carcinoma ; intact basement membrane ; severely dysplastic epithelium

10 % progress to invasive carcinoma


Etiology

Types of malignancy

Morphology

Clinical features

Squamous cell carcinoma

Verrucous carcinoma

Malignant lesion pf Penis


Etiology of carcinoma penis

  • Carcinogens in smegma

  • HPV type 16


Squamous cells carcinoma : penis

This is a squamous cell carcinoma of the penis ( penectomy specimen )


Keratinized squamous cell carcinoma


Verrucous carcinoma : Papillary growth pattern- good prognosis.


Scrotun , Testis and epididymis

  • Cryptorchidism

  • Inflammatory conditions of testis

  • Male infertility

  • Hydrocele

  • Hematocele, chylocele, elephantiasis

  • Testicular torsion


Cryptorchidism : Definition

  • Definition: crypto=hidden, orchid= testicle,

  • Testis fails to descend in the scrotum by age 12 months.

  • Cause:

  • Hormonal abnormality

  • Intrinsic testicular abnormality.

  • Mechanical obstruction in inguinal canal.


Morphology ( Testicular atrophy)

  • Right testis more commonly involves. Small testis.

  • Tubular atrophy with hyalinization present.


Microscopy of Atrophic Tubules ( diffuse) of testis.


Complication ; Cryptorchidism

  • Infertility

  • Seminoma ( malignancy) particularly with unilateral undescended testis.


Causes of testiculate atrophy and that may lead to Infertility

  • Cryptoorchitism ( unilateral / bilateral).

  • Chronic alcoholism ( Bilateral)

  • Chronic Ischemia ( unilateral / bilateral)

  • Chemotherapy or radiation ( Bilateral)

  • Mumps orchitis ( focal atrophy)

Never forget


Inflammatory lesion of testis

  • Epididymitis

  • Orchitis.


Testis : infection


Orchitis.

Etiology

  • Mumps ( mumps orchitis ) : common in adult.

  • Plasma cells and lymphocytes are present.


Focal atrophy of the testis tubules ; Mumps orchitis

NORMAL


Laboratory

  • Sperm count will be low BUT not NIL.

  • Infertility do not occur usually.


Tuberculosis

  • Epithelioid cell granuloma is present with cassation necrosis.


Causes of Male Infertility 1 of 2

  • Mumps (unilateral / Bilateral)- temporary infertility.

  • Cryptoorchitism ( unilateral / bilateral).

  • Chronic alcoholism ( Bilateral)

  • Chronic Ischemia ( unilateral / bilateral)

  • Chemotherapy or radiation ( Bilateral)

  • Hydrocele and Varicocele

Never forget


Other causes of male infertility 2 of 2

  • Klienfelter syndrome : patient present with gyenecomastia.

  • Sertoli cell-only syndrome : No Sperm-Producing Cells, tubules contain only Sertoli cells.


Sertoli cell-only syndrome; sperm count NIL.


Hydrocele : etiology

  • Inflammation

  • Idiopathic


Hydrocele : Accumulation of serous fluid in tunica vaginalis.


Hematocele, chylocele, elephantiasis

  • Hematocele : blood in tunica vaginalis ( in trauma)

  • Chylocele : lymph in tunica vaginalis ( in lymphatic obstruction).

  • Elephantiasis : in filarial infection ( lymphatic obstruction).


Elephantiasis


Varicocele : Dilation of the pampiniform plexus

Complication : infertility


Testicular torsion : hemorrhagic infarction

Etiology : Trauma or tumor in the testis


Testis


Self assessment

  • Premalignant lesion of Penis

  • Causes of infertility

  • Etiology of testicular atrophy.


Self assessment

  • Cryptorchidism and clinical significance

  • Carcinoma penis: Type: prognosis, microscopy


Thank you


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