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PATHOLOGY & PATHOPHYSIOLOGY

DISORDERS OF THE MALE REPRODUCTIVE SYSTEM

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THE MALE REPRODUCTIVE SYSTEM

Learner Study Guide – Pathology & Pathophysiology, Chapter 18, pages 136-138


UNDESCENDED TESTES

Testes that remain in the abdomen instead of descending into

the scrotum just before birth

Most testes descend on their own during 1st year of age

No symptoms

Increases risk for: Testicular torsion, infertility and testicular

cancer later in life

Treatment: Surgery if the testes have not descended by 2nd

year of age



TESTICULAR TORSION

Definition: The twisting of a testis on its spermatic cord so that

the blood supply is blocked.

Normally occurs during puberty both spontaneous and due to

trauma (can occur at any age)

The testicle can die within 6 to 12 hours if left untreated

Signs and symptoms: Sudden severe pain and swelling in a

testis. Pain may seem to come from the abdomen. Nausea and

vomiting.

Requires urgent surgery



TESTICULAR TORSION



INGUINAL HERNIA

Definition: The protrusion of a part of the intestine through the

inguinal canal.


Signs and symptoms:

Painless bulge in the groin

or scrotum. The bulge may

enlarge when person stands

and shrinks when the person

lies down.


TESTICULAR CANCER

Mostly develops in men younger than age of 40 (15-35)

Risk factor: Undescended testes by age 3

Signs and symptoms:

An enlarged testis

A painless lump in the testis or scrotum

Detection: Regular self-examination

Diagnosis: Physical examination by a medical doctor. Blood test

for tumour markers, ultrasound.

Treatment: Removal of testis and inguinal lymph nodes



BENIGN PROSTATIC HYPERPLASIA (BPH)

Benign enlargement of the prostate gland that can make

urination difficult

Occurs in 50% of men over the age of 65




Signs and symptoms:

Difficulty starting urination

Volume and force of urination

is decreased

Dribbling at the end of

urination

Urination may feel incomplete

Must urinate more frequently,

often at night




Diagnosis:

Rectal exam

Ultrasound

A PSA to exclude prostate

cancer




Complications:

Urinary retention

Bladder infections

Kidney stones

Kidney damage


Treatment:

Medication

Surgery, but carries risks: Incontinence (1%), erectile

dysfunction (5 to 10%)

Essential fatty acids, zinc, pumpkin seeds, Saw Palmetto


PROSTATE CANCER

Most common cancer in men

1 in 6 men will develop prostate cancer during their lifetime

Third leading cause of cancer death in men

Signs and symptoms:

Usually no symptoms until it is far advanced

Difficulty urinating

Frequent urination

Blood in the urine



PROSTATE CANCER

Screening:

Rectal examination

Blood test: PSA

Treatment:

Surgery

Radiotherapy

Hormonal therapy

The treatments have a high risk of complications such as

urinary incontinence, impotence, lack of libido, osteoporosis



ERECTILE DYSFUNCTION

Impotence

Not part of normal ageing

Prevalence: Half of men over 65 years of age. Three quarters of

men over 80 years of age.




Impotence

Not part of normal ageing


Prevalence: Half of men

over 65 years of age. Three

quarters of men over 80

years of age.



Causes:

Atherosclerosis

Diabetes

Blood clot

Damage to the nerves: Surgery (e.g. prostate surgery), spinal

disease, MS, diabetes, stroke, alcohol, drugs

Illness, fatigue, stress

Medicine: Antihypertensives, antidepressants, sedatives,

cimetidine, digoxin, lithium, antipsychotics

Depression, anxiety, guilt

Low testosterone levels

Zinc deficiency

Radiation to the pelvic area




Treatment:

Medication: Sildenafil, testosterone

Psychotherapy



QUESTIONS

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