Chapter 36 – Male Reproductive Disorders

Delayed Puberty

• No secondary sex characteristics by age 14–14.5

Important:

• 95% = normal variation

• 5% = problem (HPG axis or disease)

Urethritis

• Inflammation of urethra

• Usually caused by STDs

Symptoms:

• Burning/itching

• Urinary urgency

• Discharge (white/cloudy)

Urethral Strictures

• Narrowing due to scar tissue

Causes:

• Infection

• Trauma

Symptoms:

• Weak urine stream

Complications:

• Hydronephrosis → kidney failure

Phimosis

• Foreskin cannot be pulled back

• Causes:

  • Poor hygiene

  • Infection

Paraphimosis

• Foreskin stuck behind glans

• Can cut off blood supply → necrosis

Peyronie Disease

• Fibrous plaques → curved penis

• Causes:

  • Painful erections

Priapism

• Prolonged erection

• Medical emergency

Balanitis

• Inflammation of glans penis

• Often due to poor hygiene

Penile Cancer

• Rare

• Usually squamous cell carcinoma

• Risk ↓ with:

  • Circumcision

Varicocele

• Dilated veins → “bag of worms”

• Often causes infertility

• Usually on left side

Hydrocele

• Fluid buildup → swelling

• Glows with light (transillumination)

Spermatocele

• Benign cyst in epididymis

• Painless

Cryptorchidism

• Testes fail to descend

Important:

• ↑ risk of testicular cancer

Torsion of the Testis

• Twisting cuts off blood supply

Symptoms:

• Sudden severe pain

• Swelling

Key fact:

• SURGICAL EMERGENCY (within 6 hours!)

Orchitis

• Inflammation of testes

Cause:

• Mumps (classic exam question)

Testicular Cancer

• Common in young men

First sign:

• Painless lump

Good news:

• Highly curable

Epididymitis

• Inflammation of epididymis

Cause:

• STDs (gonorrhea, chlamydia)

Symptom:

• Scrotal pain

Benign Prostatic Hyperplasia (BPH)

• Enlarged prostate → compresses urethra

Symptoms:

• Weak stream

• Urinary retention

Prostatitis

• Inflammation of prostate

Acute:

• Infection → fever, pain

Chronic:

• Recurrent symptoms

Prostate Cancer

• Very common in older men

Screening:

• PSA blood test

• Digital rectal exam

sexual dysfunction

Causes:

• Vascular

• Hormonal

• Neurologic

• Psychological

Treatment:

• Medications (e.g., PDE5 inhibitors like Viagra)

• Treat underlying cause

male infertility

🔹 Causes:

• Low testosterone

• Poor sperm production

• Abnormal sperm

🔹 Key factors:

• Sperm count

• Motility (movement)

Gynecomastia

• Enlarged breast tissue in males

Cause:

• Hormone imbalance

Male Breast Cancer

• Rare

• Signs:

  • Lump

  • Nipple discharge

bacterial STI

(treatable)

• Gonorrhea

• Chlamydia

• Syphilis

viral STI

(NOT curable)

• HPV

• HIV

• Herpes

Parasitic/Fungal STI

• Trichomoniasis

• Candida