SEMIOLOGY
MALE REPRODUCTIVE SYSTEM
Prof . THONG SOK HEA , M . D
MALE REPRODUCTIVE SYSTEM
Introduction
. The main function of the Male Reproductive System is to produce sperm
cells and deliver them to the female reproductive system.
. It consists of external and internal genital organs which are essential for
continuous reproduction of life
MALE REPRODUCTIVE SYSTEM
. Consists of a number sex organs and that are apart of the humen
reproductive process ..
. Produces , stores and releases the male gametes or sperm
MALE REPRODUCTIVE SYSTEM
. ORGANS
. FUNCTION
. PATHWAY OF SPERM CELLS
MALE REPRODUCTIVE SYSTEM
External Genital Organs Internal Genital Organs
1 . Penis 1 . Testis
2 . Scrotum 2 . Epididymis
3 . Vas Deferens
4 . Accessory Glands
a. Seminal Vesicles
b. Prostate Gland
c. Bulbourethral Gland
MALE REPRODUCTIVE SYSTEM
MALE REPRODUCTIVE SYSTEM
External Genital Organs Internal Genital Organs
1 . Penis 1 . Testis
2 . Scrotum 2 . Epididymis
3 . Vas Deferens
4 . Accessory Glands
a. Seminal Vesicles
b. Prostate Gland
c. Bulbourethral Gland
MALE REPRODUCTIVE SYSTEM
Penis
. Is the organ by wich the sperm is introduced in to the female
. Is a pendulous organ suspended from the front to the side of the pubis arch and
countaining the urethra
. Contains spongy tissue that becomes turgid and
erect when filled with the blood
. Consists of internal root, external shaft and glans
. Prepuce ( Forskin) : is a covering of the skin
over the penis glan
MALE REPRODUCTIVE SYSTEM
Penis
. The roof of the penis consists of the two crura ,
wich are proximal part of the corpora cavernosa
attached to the pubis arch and the bulbe of the penis,
and the proximal part of the corpus spongiosum
attached to the perineal membrane
MALE REPRODUCTIVE SYSTEM
Penis : Erectile Tissue
. Corpus cavernosa is one of a pair of songe- regions
of erectil tissue which contains most of the blood
in the penis during penis erection
. Corpus spongiosum is the mass of spongy tissue
surrounds urethra and involves in erection by
allowing rushing of blood into it
MALE REPRODUCTIVE SYSTEM
Penis
. The body of the penis is essentially composed of three
cylinders of erectil tissue in a tubular sheath of Buuck’s fascia
. The erectil tissue is made up of two corpora cavernosa
and a corpus spongiosum
. The distal of the corpus spongiosum expands to form
the glans of the penis that covers the distal end
of the corpus carvernosa
. On the tip of the glans penis is the urethral meatus
MALE REPRODUCTIVE SYSTEM
External Penile structures
. Corona is the rim of the penile glans
. Frenulum is the thin strip of skin connecting
the glans to the shaft on the underside of the penis
BOTH are highly sensitive areas to the touch
MALE REPRODUCTIVE SYSTEM
Blood supply of the penis
Arteries Veins
. The branch of the internal pudental artery . The veins drain into the internal
. The copora carvernosa are supplied pudental veins
by the deep arteries of the penis;
the corpus spongiosium is supplied
by the artery of the bulbe
. The dorsal artery of the penis
.
Arterial blood supply of the Penis
Dorsal artery of Penis
Deep artery of Penis Internal pudendal artery
Circumflex artery
Urethral artery
Helical artery Bulbar artery
Mechanism of Erections:
Vascular Circulation
Smooth muscles relaxed >
Smooth muscles contracted >
vasodilation > high flow
vasoconstriction > low blood flow
Flaccid Penis Erect Penis
MALE REPRODUCTIVE SYSTEM
Blood supply of the penis
Arteries Veins
. The branch of the internal pudental artery . The veins drain into the internal
. The copora carvernosa are supplied pudental veins
by the deep arteries of the penis;
the corpus spongiosium is supplied
by the artery of the bulbe
. The dorsal artery of the penis
.
MALE REPRODUCTIVE SYSTEM
Blood supply of the penis
.
MALE REPRODUCTIVE SYSTEM
Lymphatic of the penis
. Lympatic Drainage
. The skin of the penis is drained into
the medial group of the superficial
Inguinal nodes
. The deep structures of the penis are
drained into the internal iliac nodes
MALE REPRODUCTIVE SYSTEM
Innervation of the penis
Nerve Supply
Sensation
. Pudental nerve and Pelvic plexuses
Erection function
. Parasympathetic (excitatory )
. Sympathetic (inhibitory)
MALE REPRODUCTIVE SYSTEM
UROLOGIC SYMPTOMS
Penil Pain
• Pain in the flaccid penis is usually due to bladder or urethral inflammation
or a stone and spread to urethral meatus
• Pain in the erect penis is usually due to :
- Peyronie's disease or
- Para phimosis: The uncircumcised foreskin is trapped behind the
glans penis
- Priapism: Painful, persistent, purposeless penile erection
PHYSICAL EXAMINATION OF THE PENIS
Inspection:
- Skin : search for lesion or sexually transmitted diseases( chancroid,
primary syphilis, herpes simplex, genital wart…)
- Prepuce :
. If the patient has not been circumcised, the foreskin should be retracted
. If retraction is not possible due to phimosis, surgical correction
(dorsal slit or circumcision) is indicated.
Abnormalities: Chancres and carcinomas or Smegma (whitish material,
may accumulate normally under the foreskin). Phymosis, Paraphimosis.
PHYSICAL EXAMINATION OF THE PENIS
Inspection:
- GLANS : Look for ulcer ( herpes simplex) , scar (syphilis ) ,nodule ,
tumor or inflammation ( Balanitis , Balanopostitis )
- Base of the penis : Check the skin around the base of the penis for
excoriation or inflammation ,
Look for nits or lice at the bases of the pubis hairs
( lice or scrabies)
- Urethra meatus : Location ( Hypospadia , Epispadias )
Discharge ?
Stenosis
- Micropenis / Macropenis
Male External genitalia : Urethra Meatus Position
Hypospadia Epispadias
hypospadia
ULCERS OF THE PENIS
EXAMINATION OF THE EXTERNAL MALE GENITALIA
Urethral Discharge
. Urethral discharge is the most common complaint referable to the male sex organ.
. Gonococcal pus is usually profuse, thick, and yellow or gray-brown.
. Nongonorrheal (chlamydiae ) discharges may be similar in appearance but
are often thin, mucoid, and scant.
. Bloody discharge suggests the possibility of a foreign body in the urethra,
urethral stricture, or tumor.
Urethral discharge must always be sought before the patient is asked to void.
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