LOM Male Reproductive Notes

CHAPTER 6 - MALE REPRODUCTIVE SYSTEM

INTRODUCTION

The male sex cell, the spermatozoon (sperm cell), is microscopic—in volume, only one third
the size of a red blood cell and less than 1/100,000 the size of the female ovum. A
relatively uncomplicated cell, the sperm is composed of a head region, containing nuclear
hereditary material (chromosomes), and a tail region, consisting of a flagellum (hair-like
process). The flagellum makes the sperm motile and makes it look somewhat like a tadpole.
The spermatozoon cell contains relatively little food and cytoplasm, because it lives only
long enough (3 to 5 days) to travel from its point of release from the male to where the
egg cell lies within the female reproductive tract (fallopian tube). Only one spermatozoon
out of approximately 300 million sperm cells released during a single ejaculation (ejection
of sperm and fluid from the male urethra) can penetrate a single ovum and result in
fertilization of the ovum.

If more than one egg is passing down the fallopian tube when sperm are present, multiple
fertilizations are possible, and twins, triplets, quadruplets, and so on may occur. Twins
resulting from the fertilization of separate ova by separate sperm cells are called
fraternal twins. Fraternal twins, developing with separate placentas, can be of the same
sex or different sexes and resemble each other no more than ordinary brothers and
sisters. Fraternal twinning is hereditary; the daughters of mothers of twins can carry the
gene.

Identical twins result from fertilization of a single egg cell by a single sperm. As the
fertilized egg cell divides and forms many cells, it somehow splits, and each part continues
separately to undergo further division, each producing an embryo. Most identical twins
have one placenta and two amniotic sacs. Identical twins are always of the same sex and
are very similar in form and feature.

The organs of the male reproductive system are designed to produce and release billions
of spermatozoa throughout the lifetime of a male from puberty onward. In addition, the
male reproductive system secretes a hormone called testosterone. Testosterone is
responsible for the production of the bodily characteristics of the male (such as beard,
pubic hair, and deeper voice) and for the proper development of male gonads (testes) and
accessory organs (prostate gland and seminal vesicles) that secrete fluids to ensure the
lubrication and viability of sperm.

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ANATOMY

Each male gonad is a testis. There are two testes (plural) or testicles that develop in the
abdomen at about the level of the kidneys before descending during embryonic
development into the scrotum, a sac enclosing the testes on the outside of the body.

The scrotum, lying between the thighs, exposes the testes to a lower temperature than
that of the rest of the body. This lower temperature is necessary for the adequate
maturation and development of sperm (spermatogenesis). Located between the anus and
the scrotum, at the floor of the pelvic cavity in the male, the perineum is analogous to the
perineal region in the female.

The interior of a testis is composed of a large mass of narrow, coiled tubules called the

seminiferous tubules. These tubules contain cells that manufacture spermatozoa.

The seminiferous tubules are the parenchymal tissue of the testis, which means that they
perform the essential work of the organ (formation of sperm). Other cells in the testis,
lying adjacent to seminiferous tubules, are interstitial cells. They manufacture an
important male hormone, testosterone.

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All body organs contain parenchyma, which perform the essential functions of the organ.

Organs also contain supportive, connective, and framework tissue, such as blood vessels,
connective tissues, and sometimes muscle as well. This supportive tissue is called stroma

(stromal tissue).

After formation, sperm cells move through the seminiferous tubules and collect in ducts
that lead to a large tube, the epididymis, at the upper part of each testis. The
spermatozoa mature, become motile in the epididymis, and are temporarily stored there.
An epididymis runs down the length of each testicle (the coiled tube is about 16 feet long)
and then turns upward again and becomes a narrow, straight tube called the vas deferens
or ductus deferens. The vas deferens is about 2 feet long and carries the sperm up into
the pelvic region, at the level of the urinary bladder, merging with ducts from the seminal
vesicles to form the ejaculatory duct leading toward the urethra. During a vasectomy or
sterilization procedure, the urologist cuts and ties off each vas deferens by making an
incision in the scrotum.

The seminal vesicles, two glands located at the base of the bladder, open into the
ejaculatory duct as it joins the urethra. They secrete a thick, sugary, yellowish substance
that nourishes the sperm cells and forms a portion of ejaculated semen. Semen, a
combination of fluid (seminal fluid) and spermatozoa (sperm cells account for less than 1%
of the semen volume), is ejected from the body through the urethra. In the male, as
opposed to that in the female, the genital orifice combines with the urinary (urethral)
opening.

The prostate gland lies at the region where the vas deferens enters the urethra, almost
encircling the upper end of the urethra. It secretes a thick fluid that, as part of semen,
aids the motility of the sperm. The muscular tissue of the prostate aids in the expulsion of
fluid during ejaculation. About 60% of ejaculate comes from seminal vesicles and 40%

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from the prostate. Bulbourethral glands, lying below the prostate gland, also secrete fluid
into the urethra.

The urethra passes through the penis to the outside of the body. The penis is composed of
erectile tissue and at its tip expands to form a soft, sensitive region called the glans penis.
Ordinarily, a fold of skin called the prepuce, or foreskin, covers the glans penis. During a
circumcision the foreskin is removed, leaving the glans penis visible at all times.

Erectile dysfunction (impotence) is the inability of the adult male to achieve an erection.

Viagra (sildenafil), Cialis (tadalafil), and Levitra (vardenafil) are drugs that increase blood
flow to the penis, enhancing ability to have an erection.

The flow diagram traces the path of spermatozoa from their formation in the
seminiferous tubules of the testes to the outside of the body.

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SYMPTOMS

 Abdominal fullness: Bladder gets filled with urine, but the patient finds it
difficult to urinate.
 Fever
 Masses
 Pain in scrotum
 Swelling of scrotum
 Swelling of testes
 Urinary frequency: Urinating more often than normal.
 Urinary urgency: Excessive or frequent urges to urinate.
 Urinary burning: Burning type of urinary pain or burning during urination.
 Urinary hesitancy: An involuntary delay or inability in starting the urinary
stream.
 Urinary dribbling: Uncontrollable passage of drops of urine particularly just after
voiding.
 Dysuria: Difficult or painful urination.
 Urethral pain: Pain in any part of the urinary system.
 Malaise: General feelings of discomfort or being ill-at-ease. Malaise can occur in
conditions like stress, emotional problems, fatigue, certain urinary disorders,urinary
tract infections, pelvic inflammatory diseases, prostate disorders, etc.
 Hematuria: Blood or blood-like discoloration of urine.
 Nocturia: Purposeful urination at night, after waking from sleep
 Oliguria: Marked reduction in the volume of urine excreted in 24 hours.

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 Pollakiuria: Increased frequency of urination without an increase in the total

volume of urine excreted in 24 hours.
 Urinary incontinence: Inability to prevent the discharge of urine.

PATHOLOGICAL CONDITION

Topic Description
Disease BENIGN PROSTATIC HYPERPLASIA
Definition Benign prostatic hyperplasia (BPH) is the enlargement, or
hypertrophy, of the prostate.
Cause  Benign prostatic hyperplasia is probably a normal part of
the aging process in men, caused by changes in hormone
balance and in cell growth.
Risk Factors  Aging.
 Family history.
 Diabetes and heart disease.
 Lifestyle.
Signs and symptoms  Urinary dribbling
 Urinary urgency
 Urinary hesitancy
 Urinary frequency
 Dysuria
Diagnosis/ Investigation  Urinalysis
 Ultrasonography
 PSA test
Treatment  Five-alpha-reductase inhibitors (5-ARIs) and alpha-
blockers are the main types of drugs used for BPH
treatment.
 Transurethral resection of the prostate (TURP)
 Laparoscopic prostatectomy
Complication  Sudden inability to urinate (urinary retention). The
patient might need catheterization to drain the urine.
 Urinary tract infections (UTIs)
 Bladder stones
 Bladder damage
 Kidney damage

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Topic Description
Disease CRYPTORCHISM

Definition Failure of one or both of the testes to descend into the

scrotum
Cause  The exact cause of an undescended testicle isn't known.
A combination of genetics, maternal health and other
environmental factors might disrupt the hormones,
physical changes and nerve activity that influence the
development of the testicles.
Risk Factors  Factors that might increase the risk of an undescended
testicle in a newborn include:
o Low birth weight
o Premature birth
 Family history of undescended testicles or other
problems of genital development
 Conditions of the fetus that can restrict growth, such
as Down syndrome or an abdominal wall defect
 Alcohol use by the mother during pregnancy
 Cigarette smoking by the mother or exposure to
secondhand smoke
 Parents' exposure to some pesticides
Signs and symptoms  Most of the time there are no symptoms other than the
absence of the testicle in the scrotum.
Diagnosis/ Investigation  Physical examination
 Ultrasound
 CT scan
Treatment Hormone injections (B-HCG or testosterone) to try to bring
the testicle into the scrotum
 Surgery (orchiopexy) to bring the testicle into the
scrotum
Complication  Infertility. This is most common when both testes don't
descend.
 Risk for testicular cancer. This risk increases greatly by
age 30 or 40
 Inguinal hernia
 Testicular torsion
 Emotional stress

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Topic Description
Disease EPIDIDYMITIS

Definition Epididymitis is an inflammation of the epididymis.

Cause The causes of epididymitis vary depending on your age and
behavior
In children
 Urinary tract infections
In young
 Sexually transmitted infection
Older men
 Enlargement of the prostate gland
 Bacterial infections
Risk Factors  Frequent urinary tract infections (e.g., urethritis,
kidney infection)
 Untreated bacterial prostatitis.
 Untreated bacterial STD.
 Urinary catheterization.
 Unprotected sex.
 Severely compromised immunity.
Signs and symptoms  Low-grade fever
 Pain in the pelvic area
 Pressure, pain and tenderness in the testicles
 Redness and warmth in the scrotum
 Enlarged lymph nodes in the groin
 Pain during sexual intercourse and ejaculation, urination
or bowel movements
 Abnormal penile discharge
 Blood in the semen
Diagnosis/ Investigation  Rectal examination
 CBC
 Urinalysis
 Testicular ultrasound
Treatment  Antibiotics E.g. Doxycycline, Ciprofloxacin
 Anti-inflammatory medication like piroxicam (Feldene)
or ketorolac (Toradol)
 Bed rest
 Elevating the scrotum, for at least two days if possible
 Applying cold packs to the scrotum
 Wearing an athletic cup for support
 Avoiding lifting heavy objects
Complication  Scrotal abscess and pyocele.

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 Testicular infarction: Cord swelling can limit testicular

artery blood flow.
 Fertility problems.
 Testicular atrophy.

Topic Description
Disease EPISPADIASIS

Definition An epispadias is a rare type of malformation of the penis in

which the urethra ends in an opening on the upper aspect of
the penis

Cause  Idiopathic
 It may occur because the pubic bone does not develop
properly.
Risk Factors  Family history
 Genetics
 Maternal age over 35.
Signs and symptoms  Abnormal opening from the bladder neck to the area
above the normal urethra opening
 Backward flow of urine into the kidney
 Urinary incontinence
 Urinary tract infections
 Widened pubic bone
Diagnosis/ Investigation  Blood test
 Intravenous pyelogram (IVP), a special x-ray of the
kidneys, bladder, and ureters
 MRI and CT scans
 Pelvic x-ray
 Ultrasound of the urinary system and genitals
Treatment  Patients who have more than a mild case of epispadias
will need surgery.
 Leakage of urine (incontinence) can often be repaired at
the same time. However, a second surgery may be
needed.
Complication  Abnormal appearance of the penis
 Problems learning to use a toilet
 Abnormal curvature of the penis with erection
 Problems with impaired ejaculation

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Topic Description
Disease HEMATOCELE

Definition A hematocele is a medical term used to describe a collection of

blood in the scrotum of males.
Cause  Possible causes most often include direct trauma of the
scrotum, torsion, tumor and surgery.
Signs and symptoms  An unusual lump.
 Sudden pain.
 A dull aching pain or feeling of heaviness in the scrotum.
 Pain that radiates throughout the groin, abdomen or
lower back.
 Tender, swollen or hardened testicle.
Diagnosis/ Investigation  Physical examination
 Ultrasound
Treatment  Foot elevation and bed rest
 Applying ice packs
 Anti-inflammatory medications
Complication  Rare complications include infection, suppuration, and
scrotal gangrene

Topic Description
Disease HYDROCELE

Definition A hydrocele is a sac filled with fluid that forms around a

testicle.
Cause  May be congenital or occur as a response to infection or
tumors
Risk Factors  Injury or inflammation to the scrotum.
 Infection, including a sexually
transmitted infection (STI)
Signs and symptoms  Swollen scrotum
 Feeling of heaviness in the scrotum
Diagnosis/ Investigation  Physical exam
 Ultrasound
Treatment  Hydrocelectomy
Complication  sexual dysfunction
 infertility
 pain

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 pyocele
 infection
 hematocele

Topic Description
Disease HYPOSPADIASIS

Definition Hypospadias is a birth (congenital) defect in which the opening

of the urethra is on the underside of the penis.
Cause  Idiopathic(Unknown)
Risk Factors  Family history
 Genetics
 Maternal age over 35
Signs and symptoms  Abnormal spraying of urine
 Having to sit down to urinate
 Foreskin that makes the penis looks like it has a "hood"
Diagnosis/ Investigation  Physical exam
Treatment  Hypospadias repair
Complication  Bleeding and hematoma.
 Edema.
 Wound infection.
 Wound dehiscence.
 Skin necrosis.
 Flap necrosis.
 Fistula.

Topic Description
Disease IMPOTENCE

Definition Erectile dysfunction (ED), also known as impotence, is a type of

sexual dysfunction characterized by the inability to develop or
maintain an erection of the penis during sexual activity in
humans.
Cause  Drugs (anti-depressants, such as SSRIs,and nicotine
most common)
 Neurogenic disorders

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 Psychological causes: performance anxiety, stress, and

mental disorders
 Surgery
 Aging
 Kidney failure
 Lifestyle: smoking is a key cause of erectile dysfunction
Risk Factors  cardiovascular disease
 hypertension
 diabetes mellitus (DM)
 tobacco use
 hyperlipidemia
Signs and symptoms  Trouble getting an erection.
 Trouble keeping an erection.
 Reduced sexual desire.
Diagnosis/ Investigation  Nocturnal penile tumescence (NPT) test
Treatment  sidenafil (Viagra)
 tadalafil (Cialis)
 vardenafil (Staxyn, Levitra)
 Testosterone replacement
 Blood vessel surgery
 Psychological counseling
Complication  An unsatisfactory sex life.
 Stress or anxiety.
 Embarrassment or low self-esteem.
 Relationship problems.

Topic Description
Disease BALANOPOSTHITIS

Definition In the uncircumcised male, balanitis (inflammation of the glans,

the rounded head of the penis) and posthitis (inflammation of
the foreskin) usually occur together as balanoposthitis:
inflammation of both the glans and foreskin.
Cause  Fungal infection
 Herpes Simplex
 Human papilloma virus
 Primary/ Secondary syphilis
Risk Factors  Eczema
 Psoriasis
 Tight foreskin
 Injuries/accidents

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Signs and symptoms  Tight, shiny skin on the glans.

 Redness around the glans.
 Inflammation, soreness, itchiness, or irritation of the
glans.
 A thick, lumpy discharge under the foreskin.
 An unpleasant smell.
 Tight foreskin that cannot be pulled back.
 Painful urination.
 Swollen glands near the penis
Diagnosis/ Investigation  History collection
 Physical examination
Treatment  Topical antibiotics (metronidazole cream)
 Antifungal (clotrimazole cream)
 Circumcision
Complication  development of pain
 ulcerative lesions of the glans/foreskin
 phimosis

Topic Description
Disease PHIMOSIS

Definition Phimosis is the inability to fully retract the foreskin (or

prepuce) over the glans penis due to a narrow opening.
Cause  Poor hygiene
 Forceful retraction of the foreskin over the glans penis
 Balanoposthitis
 Repeated cathertization
 Loss of skin elasticity and infrequent erections in
elderly males
 Untreated diabetics lead to residual glucose in the urine
causing foreskin infection leading to phimosis
Risk Factors  Trauma
 Bacterial infections such as balanitis
 Poor hygiene.
Signs and symptoms  Preputial pain
 Inability to fully retract the foreskin over the glans
 Skin irritation
 Local infections
 Pain during urination and weak urinary stream

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 Presence of blood in urine

 Frequent episodes of urinary tract infections
 Meatal opening is small
 Painful erections
 Pain during sexual intercourse
Diagnosis/ Investigation  physical examination
 Swab test
Treatment  Topical steroid E.g. betamethasone, mometasone furoate
and cortisone
 Circumcision
Complication  penile irritation or bleeding
 ballooning of the foreskin with urination resulting in
forceful/difficult urination
 urinary retention
 painful urination (dysuria)
 painful erections
 recurrent infections of the foreskin

Topic Description
Disease CARCINOMA OF THE TESTES

Definition Malignant tumor of the testicles.

Risk Factors  Age
 Weight
 exposure to carcinogens
 genetics
Signs and symptoms  A lump or enlargement in either testicle
 A feeling of heaviness in the scrotum
 A dull ache in the abdomen or groin
 A sudden collection of fluid in the scrotum
 Pain or discomfort in a testicle or the scrotum
 Enlargement or tenderness of the breasts
 Back pain
Diagnosis/ Investigation  Ultrasound
 Blood test
 CT Scan
Treatment  Surgey
 Radiation therapy
 Chemotherapy

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Topic Description
Disease PRIAPISM

Definition Priapism is condition that causes persistent and sometimes

painful erections. This is when an erection lasts for four hours
or more without sexual stimulation. Priapism is uncommon, but
when it occurs, it typically affects males in their 30s.

Cause  Sickle cell anemia

 Leukemia
 Multiple myeloma
 Medications for erectile dysfunction
 Antidepressants
 Hormone therapy
Signs and symptoms  Erections lasting for more than four hours
 Rigid penile shaft with a soft tip
 Penis pain
Diagnosis/ Investigation  Physical exam
 Blood tests
 Doppler ultrasound
 Arteriogram
Treatment  If you have low-flow priapism, your doctor may use a
needle and syringe to remove excess blood from your
penis. This can relieve pain and stop involuntary
erections.
 Another treatment method involves injecting medication
into your penis. The medication will shrink the blood
vessels carrying blood into your penis, and expand the
blood vessels carrying blood out of your penis.
Increased blood flow can reduce an erection.
 Cold therapy with ice packs
 Decongestant such as phenylephrine
 Surgery
Complication  untreated priapism can cause erectile dysfunction

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Topic Description
Disease PEYRONIES DISEASE

Definition Peyronie’s disease is a form of erectile dysfunction that causes

a bend in the penis that can make an erection quite painful.
Cause  Unknown
Risk Factors  Genetic
 Age
Signs and symptoms  Scar tissue (Plaque)- upper side of the penis also in
bottom side
 Painful errection
Diagnosis/ Investigation  Physical Exam
 X ray
 Ultrasound
Treatment  Medication
 Lifestyle changes-quitting smoking, reducing alcohol
consumption, exercise regular
 Surgery
Complicaion  Inability to have sexual intercourse.
 Difficulty achieving or maintaining an erection (erectile
dysfunction)
 Anxiety or stress about sexual abilities or the
appearance of your penis.
 Stress on your relationship with your sexual partner.

MUMPS

Topic Description
Disease MUMPS

Definition It is a contagious and infectious viral disease causing swelling

of the parotid salivary glands in the face, and a risk of sterility
in adult males.
Cause  Mumps is due to an infection by the mumps virus. It can
be transmitted by respiratory secretions (e.g. saliva)
from a person already affected with the condition.
When contracting mumps, the virus travels from the
respiratory tract to the salivary glands and reproduces,
causing the glands to swell.
 Individuals infected with the mumps virus are
contagious for approximately 15 days (6 days before the
symptoms start to show, and up to 9 days after they

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start).
Risk Factors  Failure to vaccinate completely (two separate doses)
with exposure to those with mumps
 Age: The highest risk of contracting mumps is to a child
between 2-12 years of age.
 Season: Outbreaks of mumps were most likely during
the winter/spring seasons.
 Travel to high-risk regions of the world: Africa, general
Indian subcontinent region, and Southeast Asia. These
areas have a very low rate of immunization.
 Weakening immune system: either due to diseases (for
example, HIV/AIDS, cancer) or medication (oral steroid
use for more than two weeks, chemotherapy).
 Born before 1956: Generally, these individuals are
believed to have experienced mumps infection in
childhood. However, if they did not, they are at risk for
adult mumps disease.

Signs and symptoms  Pain in the swollen salivary glands on one or both sides
of your face
 Pain while chewing or swallowing
 Fatigue
 Body aches
 Headache
 Loss of appetite
 Low-grade fever
Diagnosis/ Investigation  Physical examination
Treatment  Rest
 Take over-the-counter pain relievers, such as
acetaminophen and ibuprofen, to bring down your fever.
 Soothe swollen glands by applying ice packs.
 Drink plenty of fluids to avoid dehydration due to fever.
 Eat a soft diet of soup, yogurt, and other foods that
aren’t hard to chew (chewing may be painful when your
glands are swollen).
 Avoid acidic foods and beverages that may cause more
pain in your salivary glands.
Complication complication of mumps in children
 meningitis, sometimes associated with encephalitis
In young adults
 orchitis.

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Topic Description
Disease PROSTATE CANCER

Definition Prostate cancer is a disease in which cells in the prostate gland

become abnormal and start to grow uncontrollably, forming
tumors.
Risk Factors  Age
 Race
 Family history
 Obesity
Signs and symptoms  Trouble urinating
 Decreased force in the stream of urine
 Blood in semen
 Discomfort in the pelvic area
 Bone pain
 Erectile dysfunction
Diagnosis/ Investigation  Digital rectal exam (DRE)
 Prostate-specific antigen (PSA) test
 Ultrasound
 Prostate biopsy
 MRI fusion
Treatment  Radiation therapy
 Hormone therapy
 Chemotherapy
 Biological therapy (immunotherapy)

Complication  Cancer that spreads (metastasizes).
 Incontinence.
 Erectile dysfunction.

Topic Description
Disease PROSTITIS
Definition Prostatitis is inflammation of the prostate gland.
Cause 
Risk Factors  A prior history of prostatitis
 Having a recent urinary tract infection
 Recent use of a urinary catheter or a recent urologic

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procedure
 Enlarged prostate gland
 Engaging in rectal intercourse
 Having a structural or functional urinary tract
abnormality
 Dehydration (not enough fluids)
 Local pelvic trauma or injury such as from bicycle riding
or horseback riding
Signs and symptoms  Painful, difficult and/or frequent urinating
 Blood in the urine
 Groin pain, rectal pain, abdominal pain and/or low back
pain
 Fever and chills
 Malaise and body aches
 Urethral discharge
 Painful ejaculation or sexual dysfunction
Diagnosis/ Investigation  Digital rectal examination
 Complete blood count (CBC)
 Prostate-specific antigen (PSA)
 Ultrasound
 Computed tomography (CT) imaging
 Cystoscopy
 Prostate biopsy
Treatment  Antibiotics
 Anti-inflammatory medication
 Alpha-blockers
 Warm sitz baths
Complication  Bacterial infection of the blood (bacteremia)
 Inflammation of the coiled tube attached to the back of
the testicle (epididymitis)
 Pus-filled cavity in the prostate (prostatic abscess)
 Semen abnormalities and infertility, which can occur
with chronic prostatitis

Topic Description
Disease SPERMATOCELE

Definition A spermatocele is an abnormal sac (cyst) that develops in the

epididymis
Cause  Unknown

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Risk Factors 
Types 
Signs and symptoms  Spermatocele usually causes no signs or symptoms
 Pain or discomfort in the affected testicle
 A feeling of heaviness in the testicle with the
spermatocele
 A mass, or fullness, behind and above the testicle
Diagnosis/ Investigation  Transillumination
 Ultrasound
Treatment 
Complication 

Topic Description
Disease TESTICULAR TORSION

Definition Twisting of the spermatic cord. The rotation of the spermatic

cord cuts off blood supply to the testis.
Cause 
Risk Factors  Torsion occurs most frequently in childhood.
Types 
Signs and symptoms  Sudden, severe pain in the scrotum — the loose bag of
skin under your penis that contains the testicles.
 Swelling of the scrotum.
 Abdominal pain.
 Nausea and vomiting.
 A testicle that's positioned higher than normal or at an
unusual angle.
 Frequent urination.
 Fever
Diagnosis/ Investigation  Urine test. This test is used to check for infection.
 Scrotal ultrasound. This type of ultrasound is used to
check blood flow. Decreased blood flow to the testicle
is a sign of testicular torsion. But ultrasound doesn't
always detect the reduced blood flow, so the test might
not rule out testicular torsion.
 Surgery. Surgery might be necessary to determine
whether your symptoms are caused by testicular torsion
or another condition.
Treatment  Surgical correction within hours of onset of symptoms
can save the testis.

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Complication  Damage to or death of the testicle. When testicular

torsion is not treated for several hours, blocked blood
flow can cause permanent damage to the testicle. If the
testicle is badly damaged, it has to be surgically
removed.
 Impotence


Topic Description
Disease VARICOCELE

Definition Enlarged, dilated veins near the testicle

Cause  It's not certain what causes varicoceles. However, many
experts believe a varicocele forms when the valves
inside the veins in the cord prevent your blood from
flowing properly.
Signs and symptoms  May have no symptoms associated with a varicocele.
 A lump in one of your testicles
 Swelling in your scrotum
 Visibly enlarged or twisted veins in your scrotum, which
are often described as looking like a bag of worms
 A dull, recurring pain in your scrotum
Diagnosis/ Investigation  Physical exam
 Scrotal ultrasound
Treatment  Varicocelectomy
 Varicocele embolization
Complication  Potential complications from varicocele repair include
persistent/recurrent varicocele, bruising, infection and
testicular tenderness.

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SEXUALLY TRANSMITTED DISEASE (VENEREAL DISEASE)

Topic Description
Disease CHLAMYDIAL INFECTION

Definition Bacterial invasion (by Chlamydia trachomatis) of the urethra

and reproductive tract.

Cause  Chlamydia trachomatis

Risk Factors Factors that increase your risk of chlamydia trachomatis
include:
 Being sexually active before age 25
 Multiple sex partners within the past year
 Not using a condom consistently
 History of prior sexually transmitted infection
Signs and symptoms In men
 burning sensation on urination
 White or clear discharge from the penis.
In women
 may notice a yellowish vaginal discharge (from the
endocervix)
 Often the disease is asymptomatic.
Diagnosis/ Investigation  A urine test. A sample of your urine analyzed in the
laboratory may indicate the presence of this infection.
 A swab. For women, your doctor takes a swab of the
discharge from your cervix for culture or antigen
testing for chlamydia.
Treatment  Antibiotics
Complication  Salpingitis (Pelvic inflammatory disease [PID])
 infertility

Topic Description
Disease GONNORRHEA

Definition Inflammation of the genital tract mucosa, caused by infection

with gonococci (berry-shaped bacteria).
Cause  gonococci

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Risk Factors  Sexually active women younger than 25 and men who
have sex with men are at increased risk of getting
gonorrhea.
 Other factors that can increase your risk include:
 Having a new sex partner
 Having a sex partner who has other partners
 Having more than one sex partner
 Having had gonorrhea or another sexually transmitted
infection
Signs and symptoms  Dysuria
 Yellow, mucopurulent (purulent means pus-filled)
discharge from the male urethra.
Many women carry the disease asymptomatically, whereas
others have
 Pain
 vaginal and urethral discharge
 salpingitis (PID).
Diagnosis/ Investigation  Urine test. This can help identify bacteria in urethra.
 Swab throat
Treatment  Antibiotics
Complication  Infertility in women. Gonorrhea can spread into the
uterus and fallopian tubes, causing pelvic inflammatory
disease (PID). PID can result in scarring of the tubes,
greater risk of pregnancy complications and
infertility. PID requires immediate treatment.
 Infertility in men. Gonorrhea can cause a small, coiled
tube in the rear portion of the testicles where the
sperm ducts are located (epididymis) to become
inflamed (epididymitis). Untreated epididymitis can lead
to infertility.
 Infection that spreads to the joints and other areas
of your body. The bacterium that causes gonorrhea can
spread through the bloodstream and infect other parts
of your body, including your joints. Fever, rash, skin
sores, joint pain, swelling and stiffness are possible
results.
 Increased risk of HIV/AIDS. Having gonorrhea makes
you more susceptible to infection with human
immunodeficiency virus (HIV), the virus that leads
to AIDS. People who have both gonorrhea and HIV are
able to pass both diseases more readily to their
partners.

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 Complications in babies. Babies who contract gonorrhea

from their mothers during birth can develop blindness,
sores on the scalp and infections.

HERPES GENITALIS

Topic Description
Disease HERPES GENITALIS

Definition Infection of skin and genital mucosa

Cause Herpes simplex virus (HSV).

Risk Factors  oral lesions

 a higher level of perceived stress
Types  HSV-1: primarily causes oral herpes, and is generally
responsible for cold sores and fever blisters around the
mouth and on the face.
 HSV-2: primarily causes genital herpes, and is generally
responsible for genital herpes outbreaks.
Signs and symptoms  reddening of skin with formation of small
 fluid-filled blisters
 Ulcers
 inguinal lymphadenopathy
 fever
 headache
 malaise
Diagnosis/ Investigation  physical exam
 Sore swab
 Blood test
Treatment  Antiviral creams

Topic Description
Disease SYPHILIS
Definition  a chronic contagious usually venereal and often
congenital disease caused by a spirochete (Treponema
pallidum)
Cause  Chronic STD caused by a spirochete (spiral-shaped
bacterium).

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Risk Factors  Engaging in unprotected vaginal, anal, or oral sex.

 Having sex with multiple partners.
 Being a man who has sex with men.
 Having HIV.
 Having a sexual partner who has tested positive for
syphilis.
Stages  Primary
 Secondary
 Latent
 Tertiary (Late)
Signs and symptoms Primary
 Painless sores appear at the site of infection
(mouth, anus, rectum, vagina, or penis). These are called
chancres.
 The sores heal on their own after 3 to 6 weeks, but you
can still spread syphilis.
 It’s easily treated and cured with medicine.
 Secondary
 Rough red or reddish brown rash on palms of hands and
soles of feet
 Swollen lymph nodes
 Fever
 Sore throat
 Patchy hair loss
 Headaches and body aches
 Extreme tiredness (fatigue)
 These symptoms will go away, even if you don’t get
treated. But if you’re not treated, your infection will get
worse.
Latent
 During this phase, the syphilis bacteria are still alive in
your body, but you have no signs or symptoms of the
infection. You’re not contagious during this stage, but
syphilis may still affect your heart, brain, nerves, bones,
and other parts of your body. This phase can last for
years.
 Not everyone who has syphilis will enter this phase of
the infection. Some people will go into the tertiary
stage.
Tertiary (Late)
 This stage begins when symptoms from the secondary
stage disappear. Syphilis isn’t contagious at this point,

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LOM Male Reproductive Notes

but the infection has started to affect your organs.

This can lead to death. Symptoms of tertiary syphilis
may include:
 Problems controlling muscle movements
 Numbness
 Vision problems (you may start going blind)
 Dementia
Diagnosis/ Investigation  Blood.
 Cerebrospinal fluid.
Treatment  Penicillin
Complication  Meningitis
 stroke,
 dementia
 heart disease
 may occur, with serious consequences, even death.

HUMAN PAPILLOMA VIRUS (HPV) INFECTION

Topic Description
Disease HUMAN PAPILLOMA VIRUS (HPV) INFECTION

Definition An infection that causes warts in various parts of the body,

depending on the strain.
Cause  papillomavirus.
Risk Factors  Number of sexual partners. The more sexual partners
you have, the more likely you are to contract a genital
HPV infection.
 Age. Common warts occur mostly in children. ...
 Weakened immune systems. ...
 Damaged skin. ...
 Personal contact.
Signs and symptoms  HPV may not cause symptoms at once, but they can
appear years later. Some types can lead to warts, while
others can cause cancer
Diagnosis/ Investigation  Physical Examination
Treatment  Podophyllin (chemical applied by a doctor)
 Imiquimod (Aldara, Zyclara)
 Podofilox (Condylox)
 Trichloroacetic acid (chemical applied by a doctor)
 In certain situations, surgical interventions may be
necessary and include:
 Cryotherapy: This method uses liquid nitrogen to freeze

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the abnormal areas.

 Electrocautery: Electrical current is used to burn the
abnormal areas.
 Laser therapy: A light beam removes unwanted tissue.
 Interferon injection: This is rarely used due to the high
risk of side effects and cost.
 Surgical removal
Complication  Oral and upper respiratory lesions.
 Cancer

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VOCABULARY

Anorchism: Absence of testis.

Aspermia: No semen (impotency).

Azoospermia: No sperm cells (impotency).

Flagellum: Hair-like process on a sperm cell that makes it motile.

Foreskin: Skin covering the tip of the penis.

Fraternal twins: Twins resulting from two separate concurrent fertilizations.

Glans penis: Sensitive tip of the penis.

Identical twins: Twins resulting from the separation of one fertilized egg into
two distinct embryos.

Interstitial cells of the testis: Cells that lie between the seminiferous tubules and
produce the hormone testosterone. A pituitary gland hormone (luteinizing hormone (LH))
stimulates the interstitial cells to produce testosterone.

Oligospermia: Scanty amount of sperm.

Orchiectomy: Removal of testicles.

Parenchymal tissue: Tissue composed of essential cells of an organ. In the testes these
are the seminiferous tubules that produce sperm.

Prostate-specific antigen: This is a protein tumor marker because it is elevated in

carcinoma of the prostate.

Prepuce: Foreskin.

Semen: Spermatozoa and fluid (prostatic and other glandular secretions).

Spermatolith: Stone in the spermatic cord or vas deferens. 8

Spermatozoan: Sperm cell.

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Sterilization: Any procedure rendering an individual incapable of reproduction.

Vasectomy and salpingectomy are examples.

Testosterone: Hormone secreted by the interstitial tissue of the testes, responsible for
male sex characteristics.

ABBREVIATIONS

AIDS: Acquired immunodeficiency syndrome.

BPH: Benign prostatic hypertrophy/hyperplasia.

TURP: Transurethral resection of prostate.

HSV: Herpes simplex virus.

STD: Sexually transmitted disease.

VD: Venereal disease.

DRE: Direct rectal examination.

NGU: Nongonococcal urethritis.

RPR: Rapid plasma reagin (test for syphilis)

PSA: Prostate specific antigen.

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