PENISCongenital Anomalies Epispadias
1. Male Genital System Penis
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, can’t 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
3. 1. HYPOSPADIAS & EPISPADIAS
4. Phimosis & Paraphimosis
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)
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
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
? plasma cells
9. Sexually transmitted diseases Chanchroid –
painful and soft
Haemophilis Ducreyi NB stellate abases NB stellate abases
10. Sexually transmitted diseases Granuloma inguinale
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;
1. Carcinoma in situ or Bowen’s Disease
Variant - Erythroplasia of Queyrat- A shiny red plaque.
3. Bowenoid Papulosis-
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. Bowen’s Disease A thickened gray-white plaque.
Carcinoma penis in 10%
Associated with ? risk of visceral malignancies. 1/3 patients have visceral malignancies
Erythroplasia of Queyrat
clinical variant of Bowen’s
A shiny red plaque
17. Squamous Cell Carcinoma