1. 33 The Reproductive System Lesson 4:
Pathology of the Male Reproductive System

2. Lesson Objectives
Upon completion of this lesson, students should be able to …
Define and spell the terms to learn for this chapter.
List common disorders associated with the female and male reproductive systems.

3. Disorders of the Male Reproductive System
Anorchism
Congenital absence of one or both testes
Aspermia
The lack of, or failure to, eject sperm
Azoospermia
Absence of sperm in the semen

4. Critical Thinking Question
What communication guidelines can you suggest for discussing sensitive issues with patients?

5. Disorders of the Male Reproductive System
Carcinoma of the testes
Cancer of one or both testes
Cryptorchidism
Failure of the testes to descend into the scrotal sac before birth
Could result in sterility
A surgical procedure called an orchidopexy may be required to bring the testes down into the scrotum and secure them permanently

6. Epispadias
Congenital opening of the male urethra on the dorsal surface of the penis

7. Hypospadias
Congenital opening of the male urethra on the underside of the penis

8. Phimosis Narrowing of the foreskin over the glans penis
Can lead to infection or difficulty with urination
Treated with circumcision, the surgical removal of the foreskin
Circumcision using the Plastibell. The bell is fitted over the glans. A suture is tied around the bell’s rim, and then the excess prepuce is cut away. The plastic rim remains in place for 3 to 4 days until healing occurs. The bell may be allowed to fall off; it is removed if still in place after 8 days.

9. Disorders of the Male Reproductive System
Prostatitis
An inflamed condition of the prostate gland that may be the result of infection
Varicocele
Enlargement of the veins of the spermatic cord
Commonly occurs on the left side of adolescent males
Seldom needs treatment

10. Benign Prostatic Hyperplasia (BPH)
Also known as benign prostatic hypertrophy
Enlargement of the prostate gland

11. Characteristics of BPH
May occur in men 50 years of age and older
By age 60, four out of five men have an enlarged prostate
As the prostate enlarges, it compresses the urethra, restricting the normal flow of urine
The restriction generally causes a number of symptoms collectively known as prostatism (any condition of the prostate gland that interferes with the flow of urine from the bladder)

12. Symptoms of BPH Weak or hard-to-start urine stream
Feeling that the bladder is not empty
Need to urinate often, especially at night
Feeling of urgency (sudden need to urinate)
Abdominal straining
Interruption of the stream
Acute urinary retention
Recurrent urinary infections

13. Treatment for BPH Drug therapy Nonsurgical procedures Surgery
Medications work either by:
Reducing the size of the prostate
Relaxing the smooth muscle of the prostate and the bladder neck to improve urine flow and reduce bladder outlet obstruction

14. Epididymitis
Inflammation or infection of the epididymis (the long coiled tube attached to the upper part of each testicle, where mature sperm are stored before ejaculation)
Most common cause of pain in the scrotum
Most severe pain and swelling are usually associated with the acute form

15. Epididymitis
If symptoms last for more than 6 weeks after treatment begins, the condition is considered chronic
Can occur anytime after the onset of puberty, but is most common between the ages of 18 and 40

16. Risk Factors of Epididymitis
Infection of the bladder, kidney, prostate, or urinary tract
Other recent illness
A narrowing of the urethra
Use of a urethral catheter

17. Cause of Epididymitis
Can be caused by the same organisms that cause some STIs or as a result of prostate surgery
Generally caused by pus-generating bacteria associated with infections in other parts of the body
Can also be caused by injury or infection of the scrotum or by irritation from urine that has accumulated in the vas deferens

18. Characterizations of Epididymitis
Sudden redness and swelling of the scrotum
Affected testicle is hard and sore, and the other testicle may feel tender
Chills, fever, and acute urethritis, or inflammation of the urethra
Enlarged lymph nodes in the groin may cause scrotal pain that intensifies throughout the day, sometimes to the point that walking becomes impossible

19. Treatment of Epididymitis
Because it can cause sterility antibiotic therapy must be initiated as soon as symptoms appear
To prevent reinfection, medication must be taken exactly as prescribed, even if symptoms disappear or the patient begins to feel better
If approved by a family physician or urologist, over-the-counter anti-inflammatories can be used for pain relief

20. Treatment of Epididymitis
Bed rest is also recommended until symptoms subside
Patients are advised to wear athletic supporters when they resume normal activities

21. Erectile Dysfunction
Inability to achieve or maintain an erection sufficient for sexual intercourse
Occurs
When not enough blood is supplied to the penis
When the smooth muscle in the penis fails to relax, or
When the penis does not retain the blood that flows into it

22. Erectile Dysfunction
According to studies at the National Institutes of Health, 5 percent of men have some degree of erectile dysfunction at age 40, and by age 65 and older that figure rises to 15 to 25 percent
Erectile dysfunction is not an inevitable part of aging

23. Risk Factors of Erectile Dysfunction
Hypertension
Hyperlipidemia
Endocrine disorders
Low testosterone
Thyroid disease
Diabetes
Coronary artery disease
Peripheral vascular disease
Anemia
Smoking
Alcohol abuse
Medications
Surgical procedures
Neurological conditions
Psychiatric illness

24. Treatment Options for Erectile Dysfunction
Medication therapy
Medication changes
Vacuum constriction device
Urethral and penile injection therapies
Surgery, including penile prostheses

25. Hydrocele
Painless buildup of watery fluid around one or both testicles that causes swelling in the scrotum or groin area

26. Hydrocele
Although it may be unsightly and uncomfortable, this swelling is not painful and generally not dangerous
Can be congenital (present at birth) or acquired (develops after birth)
A congenital hydrocele develops when, after the normal process of testicle migration, the space around the testicles does not close, or the closure is delayed – Fluid from the abdominal cavity fills this space, creating the hydrocele

27. Symptoms of Hydrocele A swollen scrotum or groin area The scrotum may:
Have a bluish tinge
The swelling is painless, may be soft or firm, and cannot be reduced by changing its position or gently pushing it up
The swelling may change size, starting out small in the morning and gradually increasing in size throughout the day, and the skin on the scrotum may appear to be translucent

28. Symptoms of Hydrocele
Any pain accompanying the swelling may indicate the presence of an inguinal hernia, injury to the testicles, or some other problem

29. Prostate Cancer Malignant tumor that grows in the prostate gland
Most common cancer among American men
Second leading cause of death as a result of cancer in men, exceeded only by lung cancer
By age 50, one in four American men have some cancerous cells in the prostate gland

30. Prostate Cancer By age 80, the ratio increases to one in two
The average age of diagnosis is 70 – However, only 1 in 32 men with this diagnosis actually dies from prostate cancer

31. Risk Factors Associated with Prostate Cancer
Advanced age
A diet high in animal fats
Being of African or Northern European origin
Family history of cancer
History of vasectomy, smoking, or cadmium exposure

32. Symptoms of Prostate Cancer
Dull pain in the lower pelvic area
General pain in the lower back, hips, and upper thighs
Blood in the urine or semen
Dribbling when urinating
Erectile dysfunction
Frequent urination, especially at night
Painful urination or ejaculation
Smaller stream of urine or urgent need to urinate
Loss of appetite and weight

33. Treatment Options for Prostate Cancer
Chemotherapy
Cryosurgery to freeze cancer cells
External radiation to the prostate and pelvis
Hormone therapy
Radioactive implants in the prostate
Surgery to remove part or all of the prostate and the surrounding tissue

34. Treatment Options for Prostate Cancer
Surgical removal of the testes to block testosterone production
Hormones and chemotherapy are used for advanced cancer

35. Critical Thinking Question
Men put their testes in physical danger with sports. How catastrophic can injuries be to the testes? 35

36. Questions? 36