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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.

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12

Male Reproductive Medicine


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.


Figure 12-1 Male genitourinary system


Anatomy and physiology
Anatomy and Physiology

External Genitalia

Scrotum

Testes

Epididymides

Penis

Urethra


Anatomy and physiology cont d
Anatomy and Physiology (cont’d)

  • Internal Genitalia

    • Vas deferens

    • Seminal vesicles

    • Ejaculatory ducts

    • Prostate gland

    • Bulbourethral glands


Anatomy and physiology cont d1
Anatomy and Physiology (cont’d)

  • The male genitourinary system shares the urethra with the urinary system and is also known as the urogenital system.


Anatomy of the male genitourinary system
Anatomy of the Male Genitourinary System

Scrotum

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


Anatomy of the male genitourinary system cont d
Anatomy of the Male Genitourinary System (cont’d)

Scrotum (cont’d)

Perineum is the area between the anus and the scrotum

Testis

The scrotum contains the testes or testicles.

Egg-shaped glands about 2 inches in length.

Testes are the gonads, or sex glands.


Anatomy of the male genitourinary system cont d1

Testis (cont’d)

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 testosterone

Anatomy of the Male Genitourinary System (cont’d)


Anatomy of the male genitourinary system cont d2

Epididymis

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 spermatozoa

Anatomy of the Male Genitourinary System (cont’d)


Figure 12-3 Structures of the testis and penis.


Figure 12-4 Descent of the testes


Anatomy of the male genitourinary system cont d3

Vas Deferens, Seminal Vesicles, and Ejaculatory Duct

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)


Anatomy of the male genitourinary system cont d4
Anatomy of the Male Genitourinary System (cont’d)

  • Vas Deferens, Seminal Vesicles, and Ejaculatory Duct (cont’d)

    • The seminal vesicles produce seminal fluid, which makes up most of the volume of semen.

    • The ejaculatory duct is a large collecting duct that holds spermatozoa and seminal fluid.

    • The ejaculatory duct enters the prostate gland, then joins the urethra within the prostate gland.


Anatomy of the male genitourinary system cont d5

Prostate Gland

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)


Anatomy of the male genitourinary system cont d6

Bulbourethral Glands

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 ejaculation

Anatomy of the Male Genitourinary System (cont’d)


Anatomy of the male genitourinary system cont d7

Penis

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)


Physiology of spermatogenesis sexual maturity and ejaculation
Physiology of Spermatogenesis, Sexual Maturity, and Ejaculation

Spermatogenesis

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.


Physiology of spermatogenesis sexual maturity and ejaculation cont d
Physiology of Spermatogenesis, Sexual Maturity, and Ejaculation (cont’d)

Sexual Maturity

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


Physiology of spermatogenesis sexual maturity and ejaculation cont d1
Physiology of Spermatogenesis, Sexual Maturity, and Ejaculation (cont’d)

Ejaculation

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.


Physiology of spermatogenesis sexual maturity and ejaculation cont d2

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)


Diseases and conditions
Diseases and Conditions Ejaculation (cont’d)

Infertility

spermatozoa motility.

sperm count. Oligospermia

spermatozoa morphology.


Figure 12-6 Ejaculation (cont’d) Oligospermia

Custom Medical Stock Photo, Inc.


Diseases and conditions cont d
Diseases and Conditions (cont’d) Ejaculation (cont’d)

Testis and Epididymis (cont’d)

Orchitis

swelling (inflammation) of one or both of the testicles

Testicular cancer

Seminoma- germ cell cancer

Varicocele

is a widening of the veins along the cord that holds up a man's testicles (spermatic cord).


Diseases and conditions cont d1
Diseases and Conditions (cont’d) Ejaculation (cont’d)

Prostate Gland

Benign prostatic hypertrophy (BPH)

is an increase in size of the prostate

Cancer of the prostate gland

Prostatitis

a painful infection of the prostate gland


Diseases and conditions cont d2
Diseases and Conditions (cont’d) Ejaculation (cont’d)

Penis

Balanitis

is swelling (inflammation) of the foreskin and head of the penis

Dyspareunia

Painful intercourse

Chordee

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


Diseases and conditions cont d3
Diseases and Conditions (cont’d) Ejaculation (cont’d)

Penis (cont’d)

Erectile dysfunction (ED)

is when a man has trouble getting or keeping an erection; Impotence

Phimosis

is a condition where, in men, the foreskin cannot be fully retracted over the glans penis.

Premature ejaculation

occurs when a man has an orgasm sooner during intercourse than he or his partner wishes


Diseases and conditions cont d4
Diseases and Conditions (cont’d) Ejaculation (cont’d)

Penis

Priapism

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


Diseases and conditions cont d5
Diseases and Conditions (cont’d) Ejaculation (cont’d)

VDRL

Venereal Disease Research Laboratory

Chancre

typical skin lesion of the primary stage of infectious syphilis, usually appearing on the penis, labia, cervix, or anorectal region


Diseases and conditions cont d6
Diseases and Conditions (cont’d) Ejaculation (cont’d)

Gynecomastia

Enlargement of male breasts


Table 12-1 Ejaculation (cont’d) Sexually Transmitted Diseases (STDs)


Table 12-1 (cont’d) Ejaculation (cont’d) Sexually Transmitted Diseases (STDs)


Table 12-1 (cont’d) Ejaculation (cont’d) Sexually Transmitted Diseases (STDs)


Table 12-1 (cont’d) Ejaculation (cont’d) Sexually Transmitted Diseases (STDs)


Table 12-1 (cont’d) Ejaculation (cont’d) Sexually Transmitted Diseases (STDs)


Diseases and conditions cont d7
Diseases and Conditions (cont’d) Ejaculation (cont’d)

Male Breast

Gynecomastia


Laboratory and diagnostic procedures
Laboratory and Diagnostic Procedures Ejaculation (cont’d)

Blood Tests

Acid phosphatase

Hormone testing

Prostate-specific antigen (PSA)

Syphilis testing


Laboratory and diagnostic procedures cont d
Laboratory and Diagnostic Procedures (cont’d) Ejaculation (cont’d)

Semen Tests

Acid phosphatase

DNA analysis

Semen analysis


Figure 12-8 Ejaculation (cont’d) Spermatozoa

John Walsh/Photo Researchers, Inc.


Laboratory and diagnostic procedures cont d1
Laboratory and Diagnostic Procedures (cont’d) Ejaculation (cont’d)

Radiologic Tests

ProstaScint scan

Ultrasonography


Medical and surgical procedures
Medical and Surgical Procedures Ejaculation (cont’d)

Medical Procedures

Digital rectal examination (DRE)

Newborn genital examination

Testicular self-examination (TSE)


Medical and surgical procedures cont d
Medical and Surgical Procedures (cont’d) Ejaculation (cont’d)

Surgical Procedures (cont’d)

Biopsy

Circumcision

Orchiectomy

Orchiopexy


Medical and surgical procedures cont d1
Medical and Surgical Procedures (cont’d) Ejaculation (cont’d)

Surgical Procedures (cont’d)

Penile implant

Prostatectomy

Transurethral resection of the prostate (TURP)

Vasectomy


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.


Drug categories
Drug Categories Ejaculation (cont’d)

These categories of drugs are used to treat male genitourinary Diseases and Conditions:

Androgen drugs

Antiviral drugs

Drugs for benign prostatic hypertrophy

Drugs for erectile dysfunction


Abbreviations
Abbreviations Ejaculation (cont’d)


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