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Male Genital System 1. Dr. Amitabha Basu MD. Penis. Mal formations Inflammatory conditions Premalignant lesions and malignant conditions. Mal formations of penis. Epispadias: Infection and urinary incontinence. Inflammation of penis and prepuce.
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Male Genital System1 Dr. Amitabha Basu MD
Penis • Mal formations • Inflammatory conditions • Premalignant lesions and malignant conditions
Inflammation of penis and prepuce Banalities & Balanoprosthitis : Hyperemia and exudates.
Banalities & Balanoprosthitis Complications : Phimosis and Paraphimosis Paraphimosis
Genital candidiacis • Etiology: Diabetes Mellitus
Penis • Premalignant lesions • Malignant conditions
Premalignant lesions • Etiology • Carcinogens in smegma • HPV type 16
Types of Premalignant lesions : Penis • Carcinoma in situ ( Following types). • Bowen disease (HPV type 16). • Erythroplasia of Queyrat (HPV type 16) • Bowenoid Papulosis (Etiology = Venerally transmitted diseases)
Bowen disease : micro – in situ carcinoma ; intact basement membrane ; severely dysplastic epithelium 10 % progress to invasive carcinoma
Etiology Types of malignancy Morphology Clinical features Squamous cell carcinoma Verrucous carcinoma Malignant lesion pf Penis
Etiology of carcinoma penis • Carcinogens in smegma • HPV type 16
Squamous cells carcinoma : penis This is a squamous cell carcinoma of the penis ( penectomy specimen )
Verrucous carcinoma : Papillary growth pattern- good prognosis.
Scrotun , Testis and epididymis • Cryptorchidism • Inflammatory conditions of testis • Male infertility • Hydrocele • Hematocele, chylocele, elephantiasis • Testicular torsion
Cryptorchidism : Definition • Definition: crypto=hidden, orchid= testicle, • Testis fails to descend in the scrotum by age 12 months. • Cause: • Hormonal abnormality • Intrinsic testicular abnormality. • Mechanical obstruction in inguinal canal.
Morphology ( Testicular atrophy) • Right testis more commonly involves. Small testis. • Tubular atrophy with hyalinization present.
Complication ; Cryptorchidism • Infertility • Seminoma ( malignancy) particularly with unilateral undescended testis.
Causes of testiculate atrophy and that may lead to Infertility • Cryptoorchitism ( unilateral / bilateral). • Chronic alcoholism ( Bilateral) • Chronic Ischemia ( unilateral / bilateral) • Chemotherapy or radiation ( Bilateral) • Mumps orchitis ( focal atrophy) Never forget
Inflammatory lesion of testis • Epididymitis • Orchitis.
Orchitis. Etiology • Mumps ( mumps orchitis ) : common in adult. • Plasma cells and lymphocytes are present.
Laboratory • Sperm count will be low BUT not NIL. • Infertility do not occur usually.
Tuberculosis • Epithelioid cell granuloma is present with cassation necrosis.
Causes of Male Infertility 1 of 2 • Mumps (unilateral / Bilateral)- temporary infertility. • Cryptoorchitism ( unilateral / bilateral). • Chronic alcoholism ( Bilateral) • Chronic Ischemia ( unilateral / bilateral) • Chemotherapy or radiation ( Bilateral) • Hydrocele and Varicocele Never forget
Other causes of male infertility 2 of 2 • Klienfelter syndrome : patient present with gyenecomastia. • Sertoli cell-only syndrome : No Sperm-Producing Cells, tubules contain only Sertoli cells.
Hydrocele : etiology • Inflammation • Idiopathic
Hydrocele : Accumulation of serous fluid in tunica vaginalis.
Hematocele, chylocele, elephantiasis • Hematocele : blood in tunica vaginalis ( in trauma) • Chylocele : lymph in tunica vaginalis ( in lymphatic obstruction). • Elephantiasis : in filarial infection ( lymphatic obstruction).
Varicocele : Dilation of the pampiniform plexus Complication : infertility
Testicular torsion : hemorrhagic infarction Etiology : Trauma or tumor in the testis
Self assessment • Premalignant lesion of Penis • Causes of infertility • Etiology of testicular atrophy.
Self assessment • Cryptorchidism and clinical significance • Carcinoma penis: Type: prognosis, microscopy