Male Genital System Penis

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PENISCongenital Anomalies Epispadias

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Male Genital System Penis

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1. Male Genital System Penis

2. PENIS Congenital Anomalies Epispadias & Hypospadias =Malformations of the urethral groove: Epispadias - opening on the Dorsal surface of penis Hypospadias - Ventral, More common): lack of covering, Complications: Urinary obstruction? ? risk of ascending UTI, cant ejaculate properly? infertility 2. Phimosis =Abnormally narrow prepuce prevents normal retraction; Results in Urinary obstruction, ? risk of recurrent infections, ? risk of cancer 3. Paraphimosis = forcible retraction of the prepuce in cases of Phimosis, extremely painful, severe congestion of the Glans, acute urinary obstruction


4. Phimosis & Paraphimosis

5. PENIS Inflammations 1. Balanitis= Inflammation of the Glans, Commonly caused by Phimosis; 2. Balanoposthitis =Infection of the Glans and prepuce; Both caused by- Bacteria including gonococcus, Fungi Candida (seen in diabetics) Mycoplasma, Chlamydia. results in fibrosis; most often consequence of poor local hygiene in uncircumcised males & underlying systemic disorder such as Diabetes 3. Specific STDs include: Syphilis, Gonorrhea (Neisseria gonorrhoeae), Chanchroid (caused by H. ducreyi), Granuloma inguinale (Calymatobacterium donovani), Lymphogranuloma venereum (C. trachomatis), Herpes (HSV-2), HPV

6. Syphilis

7. Syphilis Condyloma lata seen in secondary syphilis and condyloma accumulatum seen in HPVCondyloma lata seen in secondary syphilis and condyloma accumulatum seen in HPV

8. Syphilis obliterative end- arteritis seen in the vasa vaserum lost lumen perivasculitis ? plasma cells

9. Sexually transmitted diseases Chanchroid painful and soft Haemophilis Ducreyi NB stellate abases NB stellate abases

10. Sexually transmitted diseases Granuloma inguinale Calymmatobacterium donovani donovan bodies

11. PENIS Tumors Benign 1.Condyloma Accuminatum (genital warts) = Benign, HPV (types 6 & 11) transmitted by sexual contact. Gross: A papillary excrescence at coronal sulcus or inner surface of the prepuce. Histologically: Papillae covered by hyperplastic, hyperkeratotic stratified squamous epithelium of orderly maturation sequence; koilocytosis (vacuolation) of scattered superficial cells; recur, but benign as a rule; Malignant 1. Carcinoma in situ or Bowens Disease Variant - Erythroplasia of Queyrat- A shiny red plaque. 3. Bowenoid Papulosis-

12. PENIS Tumors Malignant 4. Squamous cell carcinoma -Age-60 yrs.; Almost exclusively seen in non-circumcised males (Possible carcinogens in smegma); HPV types 16 & 18; well-differentiated Sq cell ca. with keratin pearls: Progressive growth Spreads to inguinal & iliac lymph nodes, Later by blood. Prognosis: Overall 5-year survival rate is <50% (with positive nodes<30%).

13. Condyloma Accuminatum

14. Giant Condyloma Pre-operative picture showing extent of lesion. Pre-operative pelvic CT scan. A large tumor involving the whole of the anal canal extending into the right ischiorectal fossa and perirectal fat is seen.

16. 2. Bowens Disease A thickened gray-white plaque. Carcinoma penis in 10% Associated with ? risk of visceral malignancies. 1/3 patients have visceral malignancies >35 Yrs. Erythroplasia of Queyrat clinical variant of Bowens A shiny red plaque

17. Squamous Cell Carcinoma

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