Chapter 12 - Male Reproductive Medicine

re-

again and again; backward; unable to

product/o

produce

-ive

pertaining to

Male Genitourinary System

Consists of male reproductive and urinary pathways

• external genitalia

• internal genitalia

Functions

• produce testosterone

• develop male secondary sex characteristics

• produce sperm

• release semen

genit/o

genitalia

urin/o

urinary system, urine

gynecomastia

enlargement of male breast tissue that may occur during:

• puberty,

• aging,

• after testicular removal

• hormone therapy for prostate cancer

gynec/o

female

mast/o

breast

Scrotum

pouch of skin behind the penis

• contains testes, epididymides, and part of the vas deferens

• helps regulate testicular temperature

Anatomy of the testes

Egg-shaped glands about 2 inches long

• contains seminiferous tubules

  • small tighrly coiled tubes which produce spermatozoa

• function:

  • produce sperm

  • serve as male gonads

  • secrete testosterone

Anatomy of the epididymis

structure:

• long tightly coiled tube attached to the testis

• connects to the testes to each testis

function:

• sperm maturation

• sperm storage

• removal of defective sperm

• sperm gain acrosome, an enzyme-filled cap needed for fertilization

epi-

above

didymis

twin or two

cryptochidism

• one or both testes fail to descend into the scrotum

  • usually identified by about 9 months of age

• Higher temps in the body can impair sperm development

• may lead to low sperm count or infertility later in life

• spermatozoa (sperm cells) require the lower temp to develop properly

orchid/o

testis

crypt/o

hidden

epididymitis

inflammation of the epididymis

caused by:

• UTI
  STI

Infertility

Inability to cause pregnancy after 1 year of regular, unprotected intercourse

causes:

• Hormone/Developement

  • hormone imbalance

  • undescended testes

• Testicular/sperm problem

  • testicular damage

  • infection

  • low sperm count

  • abnormal sperm

varicocele

varicose veins of the testes

oligospermia

fewer than normal number of sperm cells are produced

• may be caused by hormone imbalance or undescended testes

olig/o

few or scanty

sperm/o

sperm

Seminoma

Testicular Cancer

• cancerous tumor of one or both of the testes

• often arises from abnormal immature sperm cells

Warning Signs:

• lump in the testis

• change in size or shape of the testis

• swelling or heaviness of the scrotum

Most common cancer in males 12-35

Anatomy of the Prostate Gland

• doughnut shaped gland located at the base of the bladder, with the urethra passing through it

• Produces prostatic fluid

  • Milky substance found in the semen

  • contains antibiotic substance that kills bacteria in the woman’s vagina

  • Also contains phosphatase

    • an enzyme that helps release the sperm from the semen deposit in the woman’s vagiina

BPH

Benign Prostatic Hyperplasia

• gradual enlargement of the prostate gland

• common age related issue

• can compress the bladder

• bladder may not empty completely

may cause:

• urinary hesitancy

• dribbling

• frequent urination

• weak or narrow stream

Cancer of the prostate gland

• typically are adenocarcinomas (gland cancer)

• often slow growing

• may have few early signs or symptoms

• treatment may include monitoring, surgery, radiation, or medication

prostatitis

inflammation of the prostate gland

• may be acute or chronic

• often caused by bacterial infection

• can result from UTI or STI

• may cause pain fever and difficulty urinating

aden/o

gland

cancin/o

cancer

-oma

mass; tumor

Anatomy of the Penis

• The urethra extends through the penis and opens at the urethral meatus in the glans penis

prepuce

foreskin

dyspareunia

painful or difficult sexual intercourse

• may occur before during or after intercourse

• postcoital pain = pain after intercourse

dys-

painful or difficult

pareun/o

sexual intercourse

ED

Erectile Dysfunction

• inability to acheive or maintain an erection

• May result from:

  • Cardiovascular or neurologic disease

  • diabetes mellitus

  • low testosterone

  • smoking

  • medication side effects

  • psychological factors

Impotence

Erectile Dysfunction

Phimosis

Congenital condition in which the foreskin is too tight to retract over the glans penis

• may trap smegma (sebaceous secretions) in the foreskin

• can increase risk of irritation or infection

-osis

abnormal condition

priapism

persistent often painful erection that lasts for an abnormally long time

• may be associated with pain and tenderness

• can become a medical emergency if prolonged

priap/o

persistent erection

STDs

Sexually Transmitted Diseases

• infectous diseases spread through sexual contact with an infected person

• can be passed form mother to fetus

• come can cause serious complications including blindness, severe illness, or death in newborms

treatment depends on the cause and may include:

• antibiotics for bacterial infections

• antiviral drugs for viral infections

AIDS

Acquired Immunodeficiency Syndrome

• Caused by HIV

• may include fever, night sweats, weight loss, and fatigue

• no cure available

• antiretroviral drugs can slow disease progression

Chlamydia

caused by the bacterium chlamydia trachomatis

• men may experience painful urination, burning, itching, and urethral discharge

• women may have no symptoms or mild vaginal discharge

• treated with oral antibiotics

Genital herpes

• caused by Herpes Simplex Virus (HSV), type 2

  • affected individuals experience blisters on the genitals and/or the anus, when broken they become ulcers

  • some patients may have flue like symptoms

  • topical and oral antiviral drugs shorten the duration of outbreaks but do not completely eliminate the virus from the body

Genital Warts

Caused by Human papillomavirus (HPV)

• affected individuals experience itchy, flesh-colored, irregular lesions that are raised and cauliflower like

• women may also have vaginal discharge

• treatment is with topical chemicals or procedures to remove the warts

Gonorrhea

caused by bacterium Neisseria gonnorrhoeae

• individuals may have no symptoms or experience painful urination and thick yellow discharge

• treated with oral antibiotics

Syphillis

caused by bacterium Treponema pallidum

• affected individuals have a painless chancre on the genitals that ulcerates, forms a crust, and heals

• later there is fever, rash, and various symptoms that mimic other diseases

• treated with oral antibiotics

acid phosphatase

• test that detects the presence of an enzyme found in semen

• used in rape investigations to prove intercourse has occured

HSV Testing

Herpes Simplex Virus Testing

• detects the presence of DNA form the HSV type 2, which causes genital herpes

• can be performed on blood or fluid form skin lesions

HIV Testing

Tests take a variety of forms and may be performed on blood, urine, or saliva (depending on test type)

• orasure: delivers accurate results for antibodies to HIV-1

PSA

prostate-specific antigen

• test that detects a glycoprotein present in the cells of the prostate gland; l

  • evels are increased in men with prostate cancer

PAP

Prostatic Acid Phosphatase

• test that measures levels of acid phosphatase produced by the prostate gland

• increased levels can indicate prostate cancer that has metasized elsewhere in the body

semen analysis

• Microscopic analysis of the spermatozoa in a semen sample, including their number, morphology, and motility

• performed as part of a workup for infertility or to confirm a vasectomy was successful

Brachytheraphy

a form of radiation therapy used to treat prostate cancer

• improves implantation of radioactive pellets in the prostate gland near the tumor to deliver a concentrated dose of radiation

brachy-

short (distance away)

Ultrasonography

radiologic procedure that uses ultra-high frequency sound waves to produce an image

• may be used to view the testes or prostate gland

ultra-

beyond or higher

son/o

sound

-graphy

process of recording

DRE

Digital Rectal Examination

• procedure to placate (using digits/fingers) the prostate gland and check for signs of tendernes, nodules, hardness, or enlargement

TSE

Testicular Self-Examination

• procedure in which the patient palpates his own testes and scrotum to look for early signs of cancer

  • new lumps, bumps, or changes in size or shape

Newborn genital examination

• procedure in which a baby’s external male genitalia are examined at birth to look for:

  • undescended testes

  • ambiguous genitalia (refers to external genitals not being clearly male or female)

  • abnormal positioning of the urethral meatus

androgen drugs

treat low testosterone levels due to various medical conditions

• may be used to treat delayed puberty or prostate cancer

antibiotics

treat bacterial infections, including chlamydia, gonorrhea, and syphilis

antiviral drugs

treat the viral infections that cause genital herpes and genital warts

antiretroviral drugs

treats HIV and AIDS

benign prostatic hyperplasia drugs

inhibit the hormone that normally causes prostate enlargement

• may also relax smooth muscle to allow urine to flow more freely

Erectile Dysfunction Drugs

increase blood flow into the penis to create an erection

Bx

Procedure to obtain samples of prostate or testicular tissue to test for cancer cells

• may involve fine-needle aspiration or surgical removal

aspiration

to withdraw fluid or tissue using suction

circumcision

procedure to remove the prepuce (foreskin) on the penis

• may be performed for health related, social, or religious reasons

circum

around

cis/o

cut

Orchiectomy

surgical removal of a testis

Orchiopexy

procedure to reposition an undescended testis and fix it within the scrotum

-pexy

to fix into place

penile implant

procedure to implant an inflatable penile prosthesis; used to treat ED

prostatectomy

removal of the entire prostate gland

• also includes related lymph nodes, seminal vesicles, and vas deferens

• used in treatment of prostate cancer

Vasectomy

Surgical removal of part of the vas deferens to prevent spermatozoa from entering the semen

• performed to prevent pregnancy

• Can be reversed via vasovasostomy

AIDS

acquired immunodeficiency syndrome

BPH

Benign Prostatic Hyperplasia

-plasia

formation, growth, development

Bx

biopsy

CDC

Center for Disease Control and preventiion

DRE

digital rectal examination

ED

Erectile dysfunction

FSH

Follicle-stimulating hormone

GC

Gonococcus (Neisseria gonorrhoeae)

• can be used as abbreviation for gonorrhea or gonococcus

GU

Genitourinary

Gonococcal Urethritis

HIV

Human Immunodeficiency Virus

HoLEP

Holmium Laser Enucleation of the Prostate

HPV

Human Papilomavirus

HSV

Herpes Simplex Virus

LH

Luteinizing Hormone

PAE

Prostate Artery Embolization

PSA

Prostate-specific antigen

PUL

Prostate Urethral Lift