Transcript Document

Male Genital System
1
Dr. Amitabha Basu MD
Penis
a. Mal formations
b. Inflammatory conditions
c. Premalignant lesions and malignant
conditions
Mal formations of penis
Hypospadias
Urethral opening
below tip of penis on
ventral surface.
Epispadias :
Urethral opening
above the tip of
penis on dorsal
surface.
Epispadias: Infection and urinary
incontinence.
Inflammation of penis and prepuce
Banalities &
Balanoprosthitis :
Hyperemia and
exudates.
Banalities & Balanoprosthitis
Complications : Phimosis and
Paraphimosis
Paraphimosis
Genital candidiacis

Etiology: Diabetes Mellitus
Penis
1. Premalignant lesions
2. Malignant conditions
Premalignant lesions
Etiology
1. Carcinogens in smegma
2. HPV type 16

Types of Premalignant lesions : Penis
1. Carcinoma in situ ( Following
types).
a. Bowen disease (HPV type 16).
b. Erythroplasia of Queyrat (HPV type 16)
c. Bowenoid Papulosis (Etiology = Venerally
transmitted diseases)
Bowen disease : gross – Solitary
plaque like lesion
Bowen disease : micro – in situ carcinoma ;
intact basement membrane ; severely
dysplastic epithelium
10 % progress to invasive carcinoma
Malignant lesion pf Penis
Etiology
 Types of
malignancy
 Morphology
 Clinical features

 Squamous
cell
carcinoma
 Verrucous
carcinoma
Etiology of carcinoma penis
1. Carcinogens in smegma
2. HPV type 16
Squamous cells carcinoma : penis
This is a squamous cell carcinoma of the
penis ( penectomy specimen )
Keratinized squamous cell carcinoma
Verrucous carcinoma : Papillary
growth pattern- good prognosis.
Scrotun , Testis and epididymis
1. Cryptorchidism
2. Inflammatory conditions of testis
3. Male infertility
4. Hydrocele
5. Hematocele, chylocele,
elephantiasis
6. Testicular torsion
Cryptorchidism : Definition


Definition: crypto=hidden, orchid=
testicle,
Testis fails to descend in the scrotum by
age 12 months.
Cause:
1. Hormonal abnormality
2. Intrinsic testicular abnormality.

3. Mechanical obstruction in inguinal canal.
Morphology ( Testicular atrophy)
Right testis more commonly involves.
Small testis.
 Tubular atrophy with hyalinization present.

Microscopy of Atrophic Tubules ( diffuse)
of testis.
Complication ; Cryptorchidism
1. Infertility
2. Seminoma ( malignancy)
particularly with unilateral
undescended testis.
Causes of testiculate atrophy and that
may lead to Infertility
1.
2.
3.
4.
5.
Cryptoorchitism ( unilateral / bilateral).
Chronic alcoholism ( Bilateral)
Chronic Ischemia ( unilateral / bilateral)
Chemotherapy or radiation ( Bilateral)
Mumps orchitis ( focal atrophy)
Never forget
Inflammatory lesion of testis
1. Epididymitis
2. Orchitis.
Testis : infection
Epididymitis
Orchitis
Acute:
< 35 yr: N. Gonorrhoea,
Chlamydia
>35 yr: E. coli
Chronic: Tuberculosis
Viral: Mumps
Association: parotid and
pancreas involvement
Orchitis.
Etiology
 Mumps ( mumps orchitis ) : common in
adult.
 Plasma cells and lymphocytes are present.
Focal atrophy of the testis tubules ;
Mumps orchitis
NORMAL
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
1.
2.
3.
4.
5.
6.
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 SpermProducing Cells, tubules contain only
Sertoli cells.

Sertoli cell-only syndrome; sperm
count NIL.
Hydrocele : etiology
Inflammation
 Idiopathic

Hydrocele : Accumulation of serous fluid
in tunica vaginalis.
Hematocele, chylocele, elephantiasis
1. Hematocele : blood in tunica
vaginalis ( in trauma)
2. Chylocele : lymph in tunica vaginalis
( in lymphatic obstruction).
3. Elephantiasis : in filarial infection (
lymphatic obstruction).
Elephantiasis
Varicocele : Dilation of the
pampiniform plexus
Complication : infertility
Testicular torsion : hemorrhagic
infarction
Etiology : Trauma or tumor in the testis
Testis
Spermatocele
Dilated efferent duct of
epididymus , containing sperm
Self assessment



Premalignant lesion of Penis
Causes of infertility
Etiology of testicular atrophy.
Self assessment
Cryptorchidism and
clinical significance
Carcinoma penis: Type:
prognosis, microscopy
Thank you