1 / 38

Male Genital System Abnormalities and Diseases

Explore malformations, inflammatory lesions, and neoplasms of the male genital system, including the penis, scrotum, testis, epididymis, prostate, and more. Learn about conditions like hypospadias, balanitis, penile neoplasms, and testicular neoplasms.

timothyjones
Download Presentation

Male Genital System Abnormalities and Diseases

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Male genital system

  2. MALE GENITAL SYSTEM • PENIS • SCROTUM, TESTIS, & EPIDIDYMIS • PROSTATE

  3. PENIS • MALFORMATIONS • INFLAMMATORY LESIONS • NEOPLASMS

  4. MALFORMATIONS OF THE PENIS Abnormal location of urethral orifice along penile shaft • Hypospadias (ventral aspect) • Most common (1/250 live male births) • Epispadias (dorsal aspect)

  5. Hypospadias (ventral)

  6. Epispadias (dorsal)

  7. HYPOSPADIAS AND EPISPADIAS • May be associated with other genital abnormalities • Inguinal hernias • Undescended testes • Clinical consequences • Constriction of orifice • Urinary tract obstruction • Urinary tract infection • Impaired reproductive function

  8. INFLAMMATORY LESIONS OF THE PENIS • Sexually transmitted diseases • Balanitis (balanoposthitis) • Inflammation of the glans (plus prepuce) • Associated with poor local hygiene in uncircumcised men • Smegma • Distal penis is red, swollen, tender • +/- Purulent discharge

  9. INFLAMMATORY LESIONS OF THE PENIS • PHIMOSIS • PREPUCE CANNOT BE EASILY RETRACTED OVER GLANS • MAY BE CONGENITAL • USUALLY ASSOCIATED WITH BALANOPOSTHITIS AND SCARRING • PARAPHIMOSIS (TRAPPED GLANS) • URETHRAL CONSTRICTION

  10. INFLAMMATORY LESIONS OF THE PENIS • FUNGAL INFECTIONS • CANDIDIASIS • ESPECIALLY IN DIABETICS • EROSIVE, PAINFUL, PRURITIC • CAN INVOLVE ENTIRE MALE EXTERNAL GENITALIA

  11. NEOPLASMS OF THE PENIS • SQUAMOUS CELL CARCINOMA (SCC) • EPIDEMIOLOGY • UNCOMMON – LESS THAN 1 % OF CA IN US MEN • UNCIRCUMCISED MEN BETWEEN 40 AND 70 • PATHOGENESIS • POOR HYGIENE, SMEGMA, SMOKING • HUMAN PAPILLOMA VIRUS (16 AND 18) • CIS FIRST, THEN PROGRESSION TO INVASIVE SQUAMOUS CELL CARCINOMA

  12. Squamous Cell Carcinoma

  13. SCC OF THE PENIS • Clinical course • Usually indolent • Locally invasive • Has spread to inguinal lymph nodes in 25% of cases at presentation • Distant mets rare • 5 yr survival • 70% without ln mets • 27% with ln mets

  14. LESIONS INVOLVING THE SCROTUM • Inflammation • Tinea cruris (jock itch) • Superficial dermatophyte infection • Scaly, red, annular plaques, pruritic • Inguinal crease to upper thigh • Squamous cell carcinoma • Historical significance • Chimney sweeps used to have this

  15. LESIONS INVOLVING THE SCROTUM • Scrotal enlargement • Hydrocele - most common cause • Accumulation of serous fluid within tunica vaginalis • Infections, tumor, idiopathic • Hematocele • Chylocele • Filiariasis - elephantiasis • Testicular disease

  16. Hydrocele

  17. LESIONS OF THE TESTES • CONGENITAL • INFLAMMATORY • NEOPLASTIC

  18. Cryptorchidism and testicular atrophy • Failure of testicular descent • Epidemiology • About 1% of males (at 1 yr) • Right > left, 10% bilateral • Pathogenesis • Hormonal abnormalities • Testicular abnormalities • Mechanical problems

  19. Atrophic testes secondary to cryporchidism

  20. Cryptorchidism and testicular atrophy • Clinical course • When unilateral, may see atrophy in contralateral testis • Sterility • Increased risk of malignancy (3-5x) • Orchiopexy • May help prevent atrophy • May not eliminate risk of malignancy

  21. Other causes of testicular atrophy • Chronic ischemia • Inflammation or trauma • Hypopituitarism • Excess female sex hormones • Therapeutic administration • Cirrhosis • Malnutrition • Irradiation • Chemotherapy

  22. Inflammatory lesions of the testis • Usually involve the epididymis first • Sexually transmitted diseases • Nonspecific epididymitis and orchitis • Secondary to uti • Bacterial and non-bacterial • Swelling, tenderness • Acute inflammatory infiltrate

  23. Inflammatory lesions of the testis • Mumps • 20% of adult males with mumps • Edema and congestion • Chronic inflammatory infiltrate • May cause atrophy and sterility • Tuberculosis • Granulomatous inflammation • Caseous necrosis

  24. TESTICULAR NEOPLASMS • Epidemiology • Most important cause of painless enlargement of testis • 5/100,000 males, whites > blacks (us) • Increased frequency in siblings • Peak incidence 20-34 yrs • Most are malignant • Associated with germ cell maldevelopment • Cryptorchidism (10%) • Testicular dysgenesis(xxy)

  25. TESTICULAR NEOPLASMS • Pathogenesis • 95% arise from germ cells • ISOCHROMOSOME 12, i(12p), IS A COMMON FINDING • Intratubular germ cell neoplasms • Rarely arise from sertoli cells or leydig cells • These are often benign • Lymphoma • Men > 60 yo

  26. WHO CLASSIFICATION OF TESTICULAR TUMORS • One histologic pattern (60%) • Seminomas (50%) • Embryonal carcinoma • Yolk sac tumor • Choriocarcinoma • Teratoma • Multiple histologic patterns (40%) • Embryonal ca + teratoma • Choriocarcinoma + other • Other combinations

  27. HISTOGENESIS OF TESTICULAR NEOPLASMS (PEAK INCIDENCE) GERM CELL PRECURSOR GONADAL DIFFERENTIATION TOTIPOTENTIAL DIFFERENTIATION (NONSEMINOMA) SEMINOMA (40-50 Y) EMBRYONAL CA (UNDIFFERENTIATED) (20-30 Y) SOMATIC DIFFERENTIATION TROPHOBLASTIC DIFFERENTIATION YOLK SAC DIFF TERATOMA (ALL AGES) MATURE IMMATURE MALIGNANT TX YOLK SAC TUMOR (< 3 Y) AFP + CHORIOCARCINOMA (20-30 Y) hCG +

  28. Seminoma, with focal hemorrhage and necrosis

  29. Normal testicular tissue

  30. Seminoma

  31. Seminoma Syncytiotrophoblast

  32. Dermoid Cyst

  33. Immature Teratoma With Embryonal Carcinoma

  34. Clinical course • Usually present with painless enlargement of testis • May present with metastases • Nonseminomas (more common) • Lymph nodes, liver and lungs • Seminomas • Usually just regional lymph nodes • TUMOR MARKERS (hcg AND AFP) • Treatment success depends on histology and stage • Seminomas very sensitive to both radio- and chemotherapy

  35. Thank You

More Related