Lower urinary tract and male genital tract (Condensed) 2026

Most common cause of hydronephrosis in infants and children

Ureteropelvic junction (UPJ) obstruction - Which is due to disorganized smooth muscle bundles or increased stromal collagen at the UPJ

Retrograde flow of urine from the bladder into the ureter; most common and serious congenital anomaly of the lower genital tract

Vesicoureteral reflux

Condition wherein the bladder communicates directly with the abdominal surface, increasing the risk of adenocarcinoma and infections

Bladder exstrophy

Viruses known to cause hemorrhagic cystitis (2)

Adenovirus, BK virus

Chemotherapeutic drug known to cause hemorrhagic cystitis

Cyclophosphamide

Most common bladder tumor, causing painless hematuria

Urothelial tumors

Most important risk factor for urothelial tumors

Smoking. Other risk factors include arylamines (2-Naphthylamine, long-term analgesic use, cyclophosphamide, irradiation)

Triad of reactive arthritis

Conjunctivitis, Urethritis, Arthritis (Can't see, can't pee, can't climb a tree)

Abnormal opening on the ventral shaft of the penis; more common congenital anomaly

Hypospadia

Abnormal opening on the dorsal shaft of the penis

Epispadia

Condition in which the foreskin orifice is too small to permit normal retraction; causes increased risk of penile cancer

Phimosis

Benign, flat, papular, or exophytic cauliflower-like lesions on the vulva, cervix, penis, or anal region due to infection with low-risk HPV 6 > 11

Condyloma acuminatum

Complete/partial failure of the intra-abdominal testes to descend into the scrotal sac

Cryptorchidism

Type of malignancy that is at risk of occurring in cryptorchidism

Testicular germ cell tumors on both testes

Most common cause of non-specific epididymitis and orchitis in sexually active men >35 years (2)

Chlamydia trachomatis, Neisseria gonorrhoeae

Congenital malformation in which the tunica vaginalis attaches high on the spermatic cord, increasing testicular mobility and the risk of intravaginal testicular torsion

Bell-clapper deformity

The most common type of testicular tumors

Germ cell tumors

The prognosis of seminomas is _____, while the prognosis of non-seminomatous germ cell testicular tumors is _____

Favorable; Unfavorable

Seminomas primarily spread late via the ____ route, while non-seminomatous germ cell tumors spread early via the ____ route.

Lymphatic; Hematogenous

Site of first lymphatic spread for germ cell tumors of the testicles

Retroperitoneal para-aortic nodes

Most common site of metastasis hematogenously in testicular germ cell tumors

Lungs

Marker used to assess the tumor burden of testicular germ cell tumors

Lactate dehydrogenase (LDH)

Marker elaborated by yolk sac tumors of the testicles

α fetoprotein (AFP)

Marker elaborated by the syncytriotrophoblastic elements of testicular germ cell tumors

HCG

Most common germ cell tumor of the testicles

Seminomas

Most common prepubertal testicular tumor in infants and children up to 3 years; (+) perivascular glomeruloid structures (Schiller Duval bodies)

Yolk sac (endodermal sinus) tumor

Rare testicular germ cell tumor composed of trophoblastic cells, (+) manifests with testicular mass and highly increased serum hCG

Choriocarcinoma

2nd most common testicular germ cell tumor in infants and children up to 3 years; (+) tissue from different germinal layers (e.g., skin, adnexa, cartilage)

Teratomas

Most common testicular sex-cord stromal tumor; elaborates androgens and estrogens, causing precocious puberty and gynecomastia; mostly benign; (+) Crystalloids of Reinke

Leydig cell tumor

Genetic condition in which a male inherits one or more additional chromosomes (e.g., 47 XXY); associated with Leydig cell tumors

Klinefelter syndrome

Testicular sex-cord stromal tumor that derives from normal Sertoli cells, (+) hormonally silent; mostly benign

Sertoli cell tumor. This is the second most common sex-cord stromal tumor

Most common testicular tumor in men >60 years; frequently bilateral with spermatic cord involvement

Testicular lymphoma. Usually histologically a diffuse large B cell lymphoma (DLBCL)

Most common benign prostatic disease in men >50 years old; non-neoplastic glandular and stromal hyperplasia of the prostate

Benign prostatic hyperplasia (BPH)

Most common site of hyperplasia in benign/nodular prostatic hyperplasia (2)

Transition zone, Inner periurethral zone

Ultimate mediator of prostatic growth in benign prostatic hyperplasia

Dihydrotestosterone - Formed by type 2 5-alpha-reductase (which is expressed only in prostatic stromal cells)

Laminated, eosinophilic concretions found in benign, dilated prostatic acini; which increase in size and number + calcify with age

Corpora amylacea

Most common cancer in men in the USA; associated with androgen excess and advancing age

Prostatic (acinar) adenocarcinoma

Most common zone affected by prostatic adenocarcinoma

Peripheral zone

Score used to grade prostate cancer based on the histological findings on transrectal ultrasound-guided biopsy or radical prostatectomy samples

Gleason score - Most dominant pattern + 2nd most dominant pattern

Most frequent site of hematogenous metastasis of prostate adenocarcinoma

Lumbar spine