11.12 · Male reproductive disorders

Cryptorchidism

Group of abnormalities in which the testis fails to descend completely, remaining in the abdomen or only partially descending; infants 1-6 months

Hydrocele

Excess fluid builds up between the tissue layers surrounding the testes; may be congenital or result from injury or infection

Varicocele

Varicosities of the veins supplying the testes, usually on the left side

Torsion of the testis

Testis rotates on its axis, interrupting its blood supply; can occur with exertion or trauma

Predisposition to testicular torsion

Congenital abnormalities of the tunica vaginalis or spermatic cord

Testicular torsion urgency

Causes ischemia with pain and swelling and must be corrected within 6 hours of symptoms to preserve 100% normal function

Benign prostatic hyperplasia (BPH)

Age-related, non-malignant enlargement of the prostate gland

BPH prevalence

More than 50% of men older than 60, with normal enlargement beginning around 40-45 years

When BPH becomes a problem

When enlargement interferes with passage of urine through the urethra

BPH cause

Complex interaction between sex hormones, chronic inflammation, and growth factors

BPH early symptoms

Frequent urges to urinate, delay in starting urination, and decreased force of flow

Overflow incontinence in BPH

The bladder cannot empty all the urine, leading to involuntary release from an overfull bladder with any increase in intra-abdominal pressure

BPH complications

Increased risk for infection and bladder stones, and back-pressure on ureters and kidneys promoting hydroureter, hydronephrosis, and eventual kidney failure

Prostate cancer age distribution

More than 85% of cases occur in men over 65

PSA

Prostate specific antigen, a compound secreted by prostate cells used to screen for prostate cancer

Why PSA screening is controversial

PSA is secreted by both benign and malignant cells

Prostate cancer confirmation

Biopsy

Diet and prostate cancer

Increased total fat intake increases risk while tomato products potentially decrease risk

Prostate cancer location

Usually the periphery of the prostate, not around the urethra as in BPH

Prostate cancer early symptoms

Often none until far advanced; if present, bladder outlet obstruction, sometimes with rectal obstruction

Prostate cancer late symptoms

Bone pain from bone metastasis, enlarged lymph nodes, liver enlargement, and mental confusion from brain metastasis