1. Male Reproductive System
Chapter 28
Male Reproductive System

2. Anatomy of Male Reproductive System
External anatomy
Penis
Delivery of semen into female reproductive tract via vagina
Glans (head)
Corpus cavernosum
Corupus spongiosum
Urethra

3. Anatomy of Male Reproductive System
External anatomy
Testes
Secretion of hormones
Responsible for spermatogenesis
Held within soft tissue structure (scrotum)
Scrotum made of two layers

4. Anatomy of Male Reproductive System
External anatomy
Epididymis
Attached to each testicle
Spermatazoa produced in testes
Enters epididymis for storage
Attached to epididymis is vas deferens
Conducts mature sperm to penis during ejaculation

5. Anatomy of Male Reproductive System
Internal anatomy
Vas deferens attaches to urethra inside body of prostate
Prostate plum-sized gland at base of urinary bladder
Provides 1/3 of fluid that composes semen
Seminal vesicles make 70% of fluid portion of semen

6. Anatomy of Male Reproductive System
Internal anatomy
Vasectomy: surgical interruption of vas deferens to disrupt pathway of sperm to outside of body
Vasectomy (one side)>>
[FIGURE 28-1]

7. Anatomy of Male Reproductive System
Internal anatomy
Cowper’s or bulbourethral glands located internally at base of penis
Manufactures and discharges clear viscous secretion (pre-ejaculate)

8. Disorders of the Penis Priapisam Erection lasting more than 4 hours
Can occur with or without sexual stimulation
Can result in tissue death and permanent erectile dysfunction
(See Table 28-1: Male Reproductive System Diseases and Disorders)

9. Disorders of the Penis Priapisam
Predisposing factors: sickle cell disease; use of pharmacologic agents to enhance sexual function
Treatment: ice packs to groin area, increased physical activity, emergency medical treatment

10. Disorders of the Penis Erectile dysfunction
Impotence occurs when man unable to achieve or sustain erection of penis
Not normal at any age
Inability to achieve erection more than 50% of the time

11. Disorders of the Penis Erectile dysfunction Treatment based on cause
Referral to urologist, psychologist, or both
Treatment: oral medications, penile injections, sex therapy, surgery, vacuum pumps, lifestyle changes

12. Disorders of the Penis Penile cancer
Incidence greater in uncircumcised men
Symptoms: lesions that do not heal on penis, penile pain, bleeding
Psychologically devastating disease
Treatment: chemotherapy, radiation, surgery, total removal of penis (penectomy)

13. Disorders of the Penis Other disorders of the penis
Peyronie’s disease: curvature of penis during erection
Balanitis: swelling and/or inflammation of glans penis
Phimosis: tightening of foreskin that does not allow retraction; common in children

14. Disorders of the Testes
Testicular trauma
Direct blow to area
Object that penetrates scrotum
Injury that involves removal of protective integument
Treatment: scrotal support, methods to decrease inflammation, bed rest, surgical intervention

15. Disorders of the Testes
Testicular torsion
Twisting of spermatic cord
Emergency situation if not resolved, with or without medical intervention
Common in males between 12 to 18 years

16. Disorders of the Testes
Testicular cancer
Young men between ages of 15 and 40
At higher risk with family history
Seminoma cancer spreads via lymph system; highly curable if detected early
Monthly testicular self-exams recommended

17. Testicular Self-Examination
[FIGURES 28-4A, 28-4B, 28-4C, 28-4D]
(See Procedure 28-1: Instructing Patient in Testicular Self-Examination)

18. Disorders of the Testes
Testicular cancer
Nonseminoma: testicular tumors
Treatment depends on extent of metastasis
Treatment: radical orchiectomy, radiation, chemotherapy

19. Disorders of the Testes
Hypogonadism
Testes produce little or no testosterone
Often result of chromosomal abnormality, Klinefelter syndrome
Other factors: cyrptorchisism, infection of testicles from mumps, injury to testicles, cancer treatment
Treatment: testosterone replacement therapy

20. Disorders of the Prostate
Prostatitis
Inflammation of prostate gland
Can be acute or chronic
Causes:
Bacterial infection
Immune or nervous system disorder
Irritation of gland itself by insertion of foley catheter
Anal intercourse
Some types of athletic activities

21. Disorders of the Prostate
Benign prostatic hyperplasia (BPH)
Enlargement of prostate gland not due to infection or cancer
Common in men over age of 50
Nocturia: not being able to sleep through night due to frequent urination
Treatment based on severity of symptoms

22. Disorders of the Prostate
Benign prostatic hyperplasia (BPH)
Prostate-specific antigen (PSA)
Rectal digital exam
Urinalysis
Treatment: medications that relax bladder neck or shrink prostate

23. Disorders of the Prostate
Benign prostatic hyperplasia (BPH)
TURP or transurethral resection of prostate>>
[FIGURE 28-5]

24. Disorders of the Prostate
Prostate cancer
Leading cause of cancer-related death in men 75 and older
Symptoms similar to those associated with BPH
Staged to determine prognosis and treatment plan
Treatment: prostatectomy, chemotherapy, radiation, hormone therapy

25. Other Disorders of the Male Reproductive System
Sexually transmitted diseases
STDs affect men and women
Can damage health and become life-threatening
(See Table 28-2: Sexually Transmitted Diseases)

26. Other Disorders of the Male Reproductive System
Infertility
Inability or diminished ability to conceive
Sperm not of sufficient number or quality
Infection in genitourinary tract
Presence of STD
Injury to blood or nerve supply in area
Radiation exposure
Stress
Hormonal imbalances

27. Other Disorders of the Male Reproductive System
Infertility
Treatment depends on cause
Surgery to remove blockage
Antibiotics to treat infection
Artificial insemination
Use of pharmaceuticals

28. Assisting with the Male Reproductive Examination
Female medical assistant usually not required to assist
Conduct yourself in respectful, appropriate manner, including nonverbal communication
Provider examines penis and foreskin of penis in uncircumcised patient

29. Assisting with the Male Reproductive Examination
Remember that cultural norms vary from country to country
Penis and testes examined for swelling, masses, discomfort
Provider performs digital rectal examination

30. Assisting with the Male Reproductive Examination
[FIGURE 28-6]