12. Male Reproductive Medicine. Male Reproductive Medicine. The medical specialty that studies the anatomy and physiology of the male genitourinary system and uses diagnostic tests, medical and surgical procedures, and drugs to treat male reproductive diseases.
Male Reproductive Medicine
The medical specialty that studies the anatomy and physiology of the male genitourinary system and uses diagnostic tests, medical and surgical procedures, and drugs to treat male reproductive diseases.
Figure 12-1 Male genitourinary system
Soft pouch of skin behind the penis and in front of the legs
Few degrees cooler than the core body temperature
Muscles in wall of the scrotum contract or relax to move the scrotum closer to, or farther away from, the body to adjust to temperature changes
Figure 12-2 External and internal male genitalia
Perineum is the area between the anus and the scrotum
The scrotum contains the testes or testicles.
Egg-shaped glands about 2 inches in length.
Testes are the gonads, or sex glands.
Function as part of the male genitourinary system and the endocrine system
Contains the seminiferous tubules that produce spermatozoa, or sperm
Acts as a gland and secretes the hormone testosteroneAnatomy of the Male Genitourinary System (cont’d)
A long, coiled tube (over 20 feet) that is attached to the outer wall of each testis.
Within the epididymis, the head of each spermatozoon is given a cap-like layer of enzymes that helps it penetrate and fertilize the ovum of the female.
Destroys defective spermatozoaAnatomy of the Male Genitourinary System (cont’d)
Figure 12-3 Structures of the testis and penis.
Figure 12-4 Descent of the testes
The vas deferens is a long duct that receives spermatozoa from the epididymis.
Spermatozoa can be stored in the vas deferens for several months in an inactive state.
The vas deferens goes behind the urinary bladder, where it merges with a seminal vesicle.Anatomy of the Male Genitourinary System (cont’d)
A round gland at the base of the bladder that produces prostatic fluid.
Prostatic fluid contains an antibiotic substance that kills bacteria and also contains acid phosphatase, an enzyme that breaks the deposit of semen apart and releases the spermatozoa in the woman’s vagina.Anatomy of the Male Genitourinary System (cont’d)
Small, bulblike glands about the size of peas, located on either side of the urethra just below the prostate gland
Produce thick mucus that makes up some of the volume of the semen and neutralizes the acidity of any urine remaining in the urethra at the time of ejaculationAnatomy of the Male Genitourinary System (cont’d)
Functions as an organ of the male genitourinary system and the urinary system
In uncircumcised males, the urethral meatus is covered by the prepuce, or foreskin, of the penis.
Three columns of erectile tissue fill with blood during sexual arousal, causing the penis to become firm and erect.Anatomy of the Male Genitourinary System (cont’d)
At the onset of puberty, the anterior pituitary gland in the brain begins to secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH) to stimulate the testes.
FSH stimulates spermatocytes in the testes to begin dividing.
LH stimulates the interstitial cells to begin to secrete testosterone.
Testosterone causes the male sexual characteristics to develop: enlargement of the external genitalia; development of large muscles; deepening of the voice; growth of body hair on the face, chest axillae, and genital areas; development of the sexual drive
Figure 12-5 Ejaculation (cont’d) Testosterone
Thoughts or sensations initiate sexual arousal.
Smooth muscle relaxes in the wall of arteries in the penis, and vasodilation increases blood flow within the penis.
The corpora cavernosa and the corpus spongiosum distend with blood and produce an erection.
Ejaculation (cont’d) Ejaculation (cont’d)
Muscles at the base of the penis contract
Spermatozoa mix with seminal fluid, move into the urethra, and are mixed with mucus from the bulbourethral glands.
A series of contractions cause semen to be expelled from the penis through the urethral meatus.Physiology of Spermatogenesis, Sexual Maturity, and Ejaculation (cont’d)
sperm count. Oligospermia
Figure 12-6 Ejaculation (cont’d) Oligospermia
Custom Medical Stock Photo, Inc.
Testis and Epididymis (cont’d)
swelling (inflammation) of one or both of the testicles
Seminoma- germ cell cancer
is a widening of the veins along the cord that holds up a man's testicles (spermatic cord).
Benign prostatic hypertrophy (BPH)
is an increase in size of the prostate
Cancer of the prostate gland
a painful infection of the prostate gland
is swelling (inflammation) of the foreskin and head of the penis
is a condition in which the head of the penis curves downward or upward, at the junction of the head and shaft of the penis
Erectile dysfunction (ED)
is when a man has trouble getting or keeping an erection; Impotence
is a condition where, in men, the foreskin cannot be fully retracted over the glans penis.
occurs when a man has an orgasm sooner during intercourse than he or his partner wishes
is a potentially painful medical condition, in which the erect penis or clitoris does not return to its flaccid state
Sexually transmitted disease (STD)
are infections that you can get from having sex with someone who has the infection
Venereal Disease Research Laboratory
typical skin lesion of the primary stage of infectious syphilis, usually appearing on the penis, labia, cervix, or anorectal region
Enlargement of male breasts
Table 12-1 Ejaculation (cont’d) Sexually Transmitted Diseases (STDs)
Prostate-specific antigen (PSA)
Figure 12-8 Ejaculation (cont’d) Spermatozoa
John Walsh/Photo Researchers, Inc.
Digital rectal examination (DRE)
Newborn genital examination
Testicular self-examination (TSE)
Surgical Procedures (cont’d)
Surgical Procedures (cont’d)
Transurethral resection of the prostate (TURP)
Figure 12-10 Ejaculation (cont’d) Transurethral resection of the prostate (TURP)
Figure 12-11 Ejaculation (cont’d) Laser for prostate surgery
Custom Medical Stock Photo, Inc.
These categories of drugs are used to treat male genitourinary Diseases and Conditions:
Drugs for benign prostatic hypertrophy
Drugs for erectile dysfunction