 Congenital anomalies  1. Hypospadias is an anomaly in which the urethral meatus opens on the ventral surface of the penis.  2. Epispadias is an anomaly in which the urethral meatus opens on the dorsal surface of the penis. It is less common than hypospadias.

 Balanitis is inflammation of the glans penis.  Gonorrhea often manifested as acute purulent urethritis, extend to the prostate and seminal vesicles, epididymis.  Chlamydial infection cause nongonococcal urethritis and epididymitis bacteria are not demonstrated in a purulent urethral discharge.

 Treponema pallidum,  chancre.  darkfield illumination,

 1. Carcinoma in situ  a. Most common in uncircumcised men.  related to the accumulation of squamous cell and inflammatory debris (“smegma”) and infection with high-risk (HPV)  (primarily types 16 and 18).  b. Divided into Bowen disease,  erythroplasia of Queyrat,  bowenoid Papulosis.  Manifest microscopically in full-thickness atypia of the squamous epithelium.

 squamous cell carcinoma.  rare in circumcised men.  Seen in Far East, Africa, and Central America.  Predisposing factors include poor personal hygiene and venereal disease.  Disease is often associated with HPV infection types 16, 18, 31, and 33.

 A. Cryptorchidism is developmental failure of a testis to descend into the scrotum.  associated, even after surgical correction, with a greatly increased incidence of germ cell tumors.  associated with testicular atrophy and sterility.  B. Torsion of the spermatic cord compromises blood supply and may result in testicular gangrene.

C. Hydrocele  Is serous fluid filling & distending the tunica vaginalis.  1. This condition is most often idiopathic.  Sometimes, it is congenital in origin due to persistence of continuity of the tunica vaginalis with the peritoneal cavity.  It can be secondary to infection or to lymphatic blockage by tumor.  2. can be distinguished by physical examination and transillumination.

 D. Hematocele is an accumulation of blood distending the tunica vaginalis. It is most often caused by trauma, although it is occasionally due to a tumor.  E. Spermatocele is a sperm-containing cyst.

E. Varicocele is a varicose dilation of multiple veins of the spermatic cord.

 Caused by or associated with:  a. Orchitis, especially mumps orchitis.  b. Trauma  c. Hormonal excess or deficiency due to:  (1) Disorders of the hypothalamus or pituitary  (2) Hormonal therapy, especially with estrogens  (3) Cirrhosis of the liver  d. Cryptorchidism  e. Klinefelter syndrome  f. Chronic debilitating disease  g. Old age

 1. Orchitis  a. When bacterial, orchitis is often associated with epididymitis. Orchitis may be caused by syphilis.  b. When viral, orchitis is most often due to mumps virus.  c. When bilateral, orchitis may result in sterility due to atrophy of the seminiferous tubules.  Serum testosterone is decreased, whereas FSH and LH are increased.  2. Epididymitis  a. This condition is more common than orchitis.  b. Causes most often include:  (1) Neisseria gonorrhoeae  (2) Chlamydia trachomatis  (3) E. coli  (4) Mycobacterium tuberculosis

 Are divided into 3 groups:  Germ cell tumors: which categorised into 2 main groups—seminomatous and non- seminomatous.  Sex cord-stromal tumors.  Mixed forms.

 is a malignant germ cell tumor.  analogous to dysgerminoma.  The most common testicular germ cell tumor.  Peak incidence is in the mid-30s age group.  painless enlargement of the testis.  Sometimes this tumor is associated with increased serum human chorionic gonadotropin (hCG)  Seminomas are very radiosensitive and can often be cured, even when there are metastases to abdominal LNs.  comprised of large cells with centrally located nuclei and prominent nucleoli.  Cell borders are distinct and a prominent lymphoid response is present.  A precursor lesion known as intratubular germ cell neoplasia (ITGCN) is often identified in the background tubules.

is a rare tumor seen in older men. Prognosis is excellent.  Despite its name, it is unrelated to conventional seminoma.  It is comprised of three distinct cell types and, unlike conventional seminoma, lacks ITGCN and shows no significant lymphocytic response.

 is a malignant germ cell tumor.  a. This tumor is analogous to a similar tumor occurring in the ovary.  b. Cells are strikingly pleomorphic and ITGCN may be present.  c. Often metastatic at presentation  d. The serum hCG is often increased.  The prognosis is much worse than for seminoma

 is a malignant germ cell tumor.  a. This tumor is analogous to endodermal sinus tumor of the ovary.  b. The pure form occurs exclusively in infancy and early childhood and is the most common testicular tumor in this age group.  In adults, it frequently appears as a component of mixed germ cell tumors.  c. This tumor causes an increase in serum α- fetoprotein,  d. The classic finding is the Schiller- Duval body.  ITGCN may be present.

 a. This germ cell tumor is derived from two or more embryonic layers.  b. It is most frequently malignant.  c. It contains multiple tissue types, such as cartilage islands, ciliated epithelium, liver  cells, neuroglia, embryonic gut, or striated muscle.  d. It can be classified as one of three subtypes:  (1) Mature teratoma. seen more frequently in infants and children and has favourable prognosis. (2) Immature teratoma. Primitive neural elements are often present, and behavior is  malignant.  (3) Teratoma with malignant transformation. This teratoma contains malignant tissue,such as squamous cell carcinoma.

 is a malignant germ cell tumor that can occur as an element of other germ cell tumors.  a. This tumor is analogous to choriocarcinoma of the ovary.  b. Incidence peaks in the second to third decade.  c. Histologic characteristics include cells that resemble placental syncytiotrophoblasts  and cytotrophoblasts.  d. This tumor causes an increase in serum hCG.  e. Highly chemosensitive.

 Consist of varying combinations of germ cell tumor types; prognosis is dictated by the least mature element.  The most common combinations of mixed germ cell tumours are:  1. Teratoma, embryonal carcinoma, yolk sac tumour and syncytiotrophoblast.  2. Embryonal carcinoma and teratoma (teratocarcinoma).  3. Seminoma and embryonal carcinoma

 is a non-germ cell tumor derived from testicular stroma.  a. This tumor is similar to the Sertoli-Leydig cell tumor of the ovary.  b. It is most often benign.  c. It is often characterized by intracytoplasmic Reinke crystals. The tumor is characteristically known as androgen- producing, but sometimes produces both androgens and estrogens and sometimes corticosteroids.  d. The tumor is most often associated with precocious puberty in children and with  gynecomastia in adults.

 Is a non-germ cell tumor derived from the sex cord stroma.  a. This tumor is also similar to the Sertoli- Leydig cell tumor of the ovary.  b. It is usually benign.  c. It is characterized by a paucity of endocrine manifestations.

 Combined proliferations of germ cells and sex cord-stromal elements.  Is composed of 2 principal cell types—large germ cells resembling seminoma cells, and small cells resembling immature Sertoli, Leydig and granulosa cells.