1. Chapter 9
Objectives
Name, locate, and describe the functions of the organs of the male reproductive system.
Define abnormal conditions and infectious diseases that affect the male reproductive system.
Differentiate among several types of sexually transmitted infections.
Define combining forms used to describe the structures of this system.
Describe various laboratory tests and clinical procedures pertinent to disorders of the reproductive system, and recognize related abbreviations
Apply your new knowledge to understanding medical terms in their proper contexts, such as medical reports and records.

2. Male Reproductive System
Chapter 9
Pages 311 – 341

3. Vocabulary Pages 315 – 316 bulbourethral glands
interstitial cells of the testes
seminiferous tubules
ejaculation
parenchymal tissue
spermatozoon
ejaculatory duct
sterilization
epididymis
penis
stromal tissue
erectile dysfunction
perineum
testis
prepuce
testosterone
flagellum
prostate gland
vas deferens
fraternal twins
scrotum
glans penis
semen
identical twins
seminal vesicles
BULBOURETHRAL GLANDS (bŭl-bō-ū-RĒ-thrăl glăndz) One of a pair of exocrine glands, located on either side of the male urethra [gland just below the prostate gland], it secretes fluid that is part of semen; Also called Cowper gland
EJACULATION (ē-jăk-ū-LĀ-shŭn) Ejection of sperm and fluid from the male urethra as a result of sexual stimulation.
EJACULATORY DUCT (ē-JĂK-ū-lă-tōr-ē dŭkt) Tube through which semen enters the male urethra.
EPIDIDYMIS (ĕp-ĭ-DĬD-ĭ-mĭs) [plural: epididymides] One of a pair of long, tightly coiled tubes lying on top of each testis; It stores and carries sperm from seminiferous tubules to the vas deferens.
ERECTILE DYSFUNCTION (ē-RĔK-tīl dĭs-FŬNK-shŭn) Inability of an adult male to achieve an erection; Also known as impotence (ĬM-pō-tĕns),
FLAGELLUM (flă-JĔL-ŭm) a hair-like projection on a sperm cell that makes it motile [able to move].
FRATERNAL TWINS (fră-TĔR-năl twĭnz) Two infants born from a pregnancy resulting from the fertilization of two separate ova by two separate sperm cells (Figure 9-5).
GLANS PENIS (glănz PĒ-nĭs) Sensitive tip (surrounded by foreskin) of the penis; comparable to the clitoris in the female.
IDENTICAL TWINS (ī-DĔN-tĭ-kăl twĭnz) Two infants resulting from division of one fertilized egg into two distinct embryos. Conjoined (“Siamese”) twins are incompletely separated identical twins.
INTERSTITIAL CELLS OF THE TESTES (ĭn-tĕr-STĬ-shŭl sĕlz of the TĔS-tĭs) Specialized cells that lie adjacent to the seminiferous tubules in the testes. These cells produce testosterone; Also called Leydig cells.
PARENCHYMAL TISSUE (pă-RĔNG-kĭ-măl TĬS-ū) Essential distinctive cells of an organ. In the testis, the seminiferous tubules that produce sperm are parenchymal.
PENIS (PĒ-nĭs) Male external organ of reproduction
PERINEUM (pĕr-ĭ-NĒ-ŭm) In a male, the external area between the anus and scrotum; in a female, the external area between the anus and the vagina.
PREPUCE (PRĒ-pŭs) Fold of skin covering the glans penis [tip of the penis]; Also called the foreskin.
PROSTATE GLAND (PRŎS-tāt glănd) Exocrine gland at the base of the male urinary bladder; it secretes fluid that contributes to semen during ejaculation.
SCROTUM (SKRŌ-tŭm) External sac that contains the testes and associated organs.
SEMEN (SĒ-mĕn) Fluid discharged at ejaculation; consisting of sperm cells [Spermatozoa] and secretions from the prostate gland, seminal vesicles, and bulbourethral glands – discharged from the urethra during ejaculation.
SEMINAL VESICLES (SĔM-ĭn-ăl VĔS-ĭ-klz) One of a pair of sac-like male exocrine glands lying behind the urinary bladder and opening into the vas deferens; it secretes fluid that is the major part of semen.
SEMINIFEROUS TUBULES (sĕ-mĭ-NĬF-ĕr-ŭs TOOB-ūlz) Narrow, coiled tubules that produce sperm [spermatozoa] in the testes.
SPERMATOZOON (spĕr-mă-tō-ZŌ-ĕn) Single sperm cell; plural: spermatozoa(spĕr-mă-tō-ZŌ-ă)
STERILIZATION (stĕr-ĭ-lĭ-ZĀ-shŭn) Procedure that removes an individual's ability to produce or release reproductive cells; EXAMPLE: removal of testicles, vasectomy, and oophorectomy.
STROMAL TISSUE (STRŌ-măl TĬS-ū) Supportive, connective tissue of an organ, as distinguished from its parenchyma; Also called stroma.
TESTIS (TĔS-tĭs) Male gonad [testicle] that produces sperm cells [spermatozoa] and the hormone testosterone. Remember: Testis means one testicle, and testes are two testicles.
TESTOSTERONE (tĕs-TŎS-tĕ-rōn) Male hormone secreted by the interstitial cells of the testes; responsible for male sex characteristics.
VAS DEFERENS (văs DĔF-ĕr-ĕnz) Narrow tube (one on each side) that carries sperm from the epididymis into the body, around the urinary bladder toward the urethra; Also called ductus deferens.

4. Combining Forms Pages 317 – 318
Meaning Examples
andr/o balan/o cry/o crypt/o epididym/o gon/o hydr/o orch/o, orchi/o, orchid/o pen/o prostat/o
male
glans penis
cold
hidden
epididymis
seed
water, fluid
testis, testicle
penis
prostate gland
androgen
balanitis
cryogenic surgery
cryptorchidism
epididymitis
gonorrhea
hydrocele
orchiectomy, orchitis
penile, penoscrotal
prostatitis, prostatectomy
ANDROGEN (ĂN-drō-jĕn) Hormone that stimulates development of male secondary sex characteristics, such as beard growth and deepening of voice – Testosterone is an androgen. The testes in males and the adrenal glands in both men and women produce androgens.
BALANITIS (băl-ă-NĪ-tĭs) Inflammation of the glans penis – An inflammation usually caused by overgrowth of organisms (bacteria and yeast) (Figure 9-6A).
CRYOGENIC SURGERY (krī-ō-GĔN-ĭk SŬR-jĕr-ē) Use of extremely cold temperatures to freeze or destroy tissue – This technique is used for prostate cancer.
CRYPTORCHIDISM (krĭp-TŎR-kĭdĭzm) One or both testes fail to descend from the abdomen in the scrotal sac near the time of birth – this is a congenital anomaly (Figure 9-6B).
EPIDIDYMITIS (ĕp-ĭ-dĭd-ĭ-MĪ-tĭs) Inflammation of an epididymis usually caused by bacteria. SYMPTOMS: fever, chills, pain in the groin, and tender/swollen epididymis.
GONORRHEA (gŏn-ō-RĒ-ă) Sexually transmitted infection involving inflammation of genital tract mucous membranes and caused by gonococci (berry-shaped bacteria).
HYDROCELE (HĪ-drō-sēl) Hernia (sac of clear, watery fluid) within the scrotum.
ORCHIECTOMY (ŏr-kē-ĔK-tō-mē) Removal (excision) of a testis – Castration in males. Also called orchidectomy. ORCHITIS (ŏr-KĪ-tĭs) Inflammation of a testis – Caused by injury or by the mumps virus, which also infects the salivary glands.
PENILE (PĒ-nīl) Pertaining to the penis – -ile means pertaining to. PENOSCROTAL (pē-nō-SKRŌ-tăl) Pertaining to the penis and scrotum.
PROSTATITIS (prŏs-tă-TĪ-tĭs) Inflammation of the prostate gland – Bacterial (E. coli) prostatitis often is associated with urethritis and infection of the lower urinary tract. PROSTATECTOMY (prŏs-tă-TĔK-tō-mē) Removal (excision) of the prostate gland.

5. Combining Forms (Cont’d)
Pages 318 – 319
Combining Forms (Cont’d)
Meaning Examples
semin/i sperm/o terat/o test/o varic/o vas/o zo/o
semen, seed
spermatozoa, semen
monster
testis, testicle
varicose veins
vessel duct; vas deferens
animal life
seminiferous tubules
spermolytic, oligospermia, aspermia
teratoma
testicular
varicocele
vasectomy
azoospermia
SEMINIFEROUS TUBULES (sĕ-mĭ-NĬF-ĕr-ŭs TOOB-ūlz) Narrow, coiled tubules that produce sperm [spermatozoa] in the testes – The suffix -ferous means pertaining to bearing, or bearing or carrying.
SPERMOLYTIC (spĕr-mō-LĬT-ĭk) Pertaining to destruction of sperm cells – Noun suffixes ending in -sis, like -lysis, form adjectives by dropping the -sis and adding -tic. OLIGOSPERMIA (ŏl-ĭ-gō-SPĔR-mē-ă) Scanty [less than the normal number of sperm in semen] sperm count. ASPERMIA (ā-SPĔR-mē-ă) Failure in a male of production of sperm cells [spermatozoa] as well as ejaculation of semen [fluid and sperm cells], One cause of aspermia is retrograde ejaculation [sperm flows backward into the urinary bladder] as a result of prostate surgery.
TERATOMA (tĕr-ă-TŌ-mă) Malignant tumor of a testis or ovary; composed of embryonic cells that develop into different types of tissue, such as bone, hair, cartilage, and skin cells. Teratomas in the testes are malignant.
TESTICULAR (tĕs-TĬK-ū-lăr) Pertaining to a testis or testicle – The term testis originates from a Latin term meaning witness. In ancient times men would take an oath with one hand on their testes, swearing by their manhood to tell the truth.
VARICOCELE (VĀR-ĭ-kō-sēl) A collection of varicose [enlarged, dilated/swollen, twisted] veins above the testis.
VASECTOMY (vă-SĔK-tō-mē) Removing a piece of each vas deferens and tying off each end – Remember: In this term, vas/o refers to the vas deferens, and not to any other vessel or duct.
AZOOSPERMIA (ā-zō-ō-SPĔR-mē-ă) Lack of live spermatozoa in the semen
CAUSE: testicular dysfunction, chemotherapy, blockage of the epididymis, and vasectomy

6. Suffixes Page 319 -genesis -one -pexy -stomy formation hormone
Meaning Examples
-genesis -one -pexy -stomy
formation
hormone
fixation, put in place
new opening
spermatogenesis
testosterone
orchiopexy
vasovasostomy
SPERMATOGENESIS (spĕr-mă-tō-JĔN-ĕ-sĭs) Formation of sperm cells
TESTOSTERONE (tĕs-TŎS-tĕ-rōn) Male hormone secreted by the interstitial cells of the testes; responsible for male sex characteristics – Ster/o indicates that this is a type of steroid compound. Examples of other steroids are estrogen, cortisol, and progesterone.
ORCHIPEXY (ŏr-kē-ō-PĔK-sē) Surgical fixation of an undescended testis in the scrotum.
VASOVASOSTOMY (vă-zō-vă-ZŎS-tō-mē) New opening (anastomosis) of the ends of a severed vas deferens; this surgical procedure reverses a vasectomy
METHOD: a urologist rejoins the cut ends of the vas deferens.

7. Pathology: Testes Pages 319 – 324
carcinoma of the testes (testicular cancer)
cryptorchidism (cryptorchism)
hydrocele
testicular torsion
varicocele
CARCINOMA OF THE TESTES (kăr-sĭ-NŌ-mă of the TĔS-tēz) Malignant tumor of the testicles; rare except in the 15- to 35-year-old age group.
TYPES: a seminoma (sĕ-mĭ-NŌ-mă), arises from embryonic cells in the testes [most common type], embryonal carcinoma (ĕm-brē-ŌN-ăl kăr-sĭ-NŌ-mă), teratoma, choriocarcinoma, yolk sac tumor, and Teratomas. TREATMENT: If detected early, testicular cancers  can be treated and cured with surgery (orchiectomy), radiotherapy, and chemotherapy.
DIAGNOSIS: Serum levels of human chorionic gonadotropin (hCG) and alpha-fetoprotein (AFP) proteins are used as tumor markers to determine success of treatment.
CRYPTORCHIDISM (krĭp-TŎR-kĭdĭzm) Undescended testicles
TREATMENT: Orchiopexy is performed to bring the testes into the scrotum, if they do not descend on their own by the age of 1 or 2 years.
COMPLICATIONS: Undescended testicles are associated with a high risk for sterility and increased risk of developing testicular cancer.
HYDROCELE (HĪ-drō-sēl) Hernia within the scrotum.
CAUSES: congenital or occur as a response to infection or tumors, Often idiopathic
DIAGNOSIS: ultrasound imaging
TREATMENT: If it does not resolve on its own, the sac is aspirated using a needle and syringe, or hydrocelectomy, may be necessary, the sac is surgically removed through an incision in the scrotum.
TESTICULAR TORSION (tĕs-TĬK-ū-lăr TŎR-shŭn) Twisting of the spermatic cord and blood vessels of the testes – cuts off blood supply to the testis. Torsion occurs most frequently in childhood.
TREATMENT: Surgical correction within hours of onset of symptoms can save the testis.
VARICOCELE (VĀR-ĭ-kō-sēl) A collection of varicose [enlarged, dilated/swollen, twisted] veins above the testis.
COMPLICATIONS: oligospermia and azoospermia.
TREATMENT: varicocelectomy, the internal spermatic vein is ligated (the affected segment is cut out and the ends are tied off).
COMPLICATIONS: On occasion, this leads to an increase in fertility.

8. Pathology: Prostate Gland
Pages 319 – 324
Pathology: Prostate Gland
Benign prostatic hyperplasia
Carcinoma of the prostate
BENIGN PROSTATIC HYPERLASIA (bē-NĪN-prŏs-TĂT-ĭkhī-pĕr-PLĀ-zē-ă) [BPH] Increased growth of the prostate gland in numbers of cells; common condition in men older than 60 years of age.
SYMPTOMS: Urinary obstruction, inability to empty the bladder completely. 
TREATMENT:
transurethral resection of the prostate (TURP), but overgrowth of cells may recur over several years,
Medications – Finasteride (Proscar) inhibits production of a potent testosterone that promotes enlargement of the prostate, tamsulosin (Flomax) [alpha blockers] act by relaxing the smooth muscle of the prostate and the neck of the bladder or
laser TURP or GreenLight PVP – used to destroy prostatic tissue and relieve obstruction.
PICTURE - shows the prostate gland with BPH and with carcinoma.
CARCINOMA OF THE PROSTATE (kăr-sĭ-NŌ-mă of the PRŎS-tāt) Malignant tumor (adenocarcinoma) of the prostate gland; Also known as prostate cancer; commonly occurs in men who are older than 50 years. 
DIAGNOSIS: Digital rectal examination (DRE) (Figure 9-10) can detect the tumor at a later stage, but early detection depends on a prostate-specific antigen (PSA) blood test, and biopsies, CT can detect if it has metastasis to the lymph nodes. TREATMENT: prostatectomy [surgery], radiation therapy, and/or hormonal chemotherapy.
PICTURE - Digital rectal examination (DRE) of the prostate gland.

9. Pathology: Penis Pages 319 – 324 hypospadias phimosis
HYPOSPADIAS (hī-pō-SPĀ-dē-ăs) Congenital abnormality in which the male urethral opening is on the undersurface of the penis, instead of its tip;
OCCURS: in 1 in every 300 live male births and can be corrected surgically.
TREATMENT: Surgical repair – involves elongating the urethra by using surrounding tissue or using a graft from tissue elsewhere in the body and bringing it to the exit at the tip of the penis.
PICTURE
PHIMOSIS (fi-MŌ-sĭs) Narrowing [stricture] of the opening of the prepuce [foreskin] over the glans penis; can interfere with urination and cause secretions to accumulate under the prepuce, leading to infection.
TREATMENT: circumcision (sĭr-kŭm-SĬZH-ŭn) [cutting around the prepuce to remove it]

10. Sexually Transmitted Infections
Pages 319 – 324
Sexually Transmitted Infections
Chlamydial infection
Gonorrhea
Herpes genitalis
Human papilloma virus (HPV)
Syphilis
CHLAMYDIAL INFECTION (klă-MĬD-ē-ăl ĭn-FEK-shŭn) Sexually transmitted bacterial infection that invades the male urethra and female vagina and cervix.
SYMPTOMS: men – may experience a burning sensation on urination and notice a white or clear discharge from the penis. women – may notice a yellowish vaginal discharge (from the endocervix), but often the disease is asymptomatic.
TREATMETN: antibiotics for both partners
COMPLICATIONS: salpingitis, pelvic inflammatory disease [PID], and infertility in women.
GONORRHEA (gŏn-ō-RĒ-ă) Sexually transmitted infection involving inflammation of genital tract mucous membranes and caused by gonococci (berry-shaped bacteria).
Other areas of the body, such as the eye, oral mucosa, rectum, and joints, may be affected as well. Can be acquire anorectal and pharyngeal.
SYMPTOMS: men – dysuria, mucopurulent (PURULENT (PŪR-ū-lĕnt) means pus-filled) discharge from urethra.
women –asymptomatic, or pain, vaginal and urethral discharge, and salpingitis/PID
TREATMENT: antibiotics for both partners
HERPES GENITALIS (HĔR-pēz jĕn-ĭ-TĂL-ĭs) Sexually transmitted infection of the skin and mucosa of the genitals caused by the herpes simplex virus (HSV); Most cases of herpes genitalis are caused by HSV type 2 (although some are caused by HSV type 1, which commonly is associated with oral infections such as cold sores or fever blisters).
SYMPTOMS: reddening of skin with formation of small, fluid-filled blisters and ulcers
Initial episodes also may involve inguinal lymphadenopathy, fever, headache, and malaise. Remissions and relapse periods occur; no drug is known to be effective as a cure.
PREGNANCY: Can jump the placental barrier. Can deliver infants by cesarean section to prevent infection of these babies by HSV.
COMPLICATIONS: Studies suggest there is a higher risk for developing vulvar and cervical cancer.
HUMAN PAPILLOMAVIRUS (HŪ-măn păp-ĭ-LŌ-mă VĪ-rŭs) [HPV] Infection of the skin and mucous membranes in the anogenital region by the human papillomavirus
SYMPTOMS: genital warts and lead to cancer of the cervix as well as cancer in men.
PREVENTION: A vaccine is available for young girls and boys that protects against four types of HPV.
SYPHILIS (SĬF-ĭ-lĭs) Sexually transmitted infection caused by bacteria (spirochetes); a chancre (SHĂNG-kĕr) [hard ulcer or sore] on the external genitalia is a a few weeks after bacterial infection. Two to six months after the chancre disappears, secondary syphilis begins. Tertiary syphilis includes damage to the brain, spinal cord, and heart, which may appear years after the earlier symptoms disappear.
PREGNANCY: Syphilis can be transmitted from the mother. (congenital)
TREATMENT: Penicillin

11. Laboratory Test Pages 324 – 326 PSA test semen analysis
PROSTATE-SPECIFIC ANTIGEN (PSA) TEST – Measurement of levels of prostate-specific antigen (PSA) in the blood. PSA is produced by cells within the prostate gland.
DIAGNOSIS: Elevated levels → enlargement of the prostate gland and may be a sign of prostate cancer.
SEMEN ANALYSIS (SĒ-mĕn ă-NĂL-ĭ-sĭs) Microscopic examination of ejaculated fluid
METHOD: Sperm cells are counted and examined for motility and shape.
PURPOSE: fertility studies and is required to establish the effectiveness of vasectomy.
Men with sperm counts of less than 20 million/mL of semen usually are sterile [not fertile] → Sterility can result in an adult male who becomes ill with mumps, an infectious disease affecting the testes (inflammation leads to deterioration of spermatozoa).

12. Clinical Procedures Pages 324 – 326 castration circumcision
digital rectal examination (DRE)
Photoselective vaporization of the prostate (GreenLight PVP)
transurethral resection of the prostate—TURP
vasectomy
CASTRATION (kăs-TRĀ-shŭn) Removal of sex glands [gonads]; ovaries or testes
Castration may be performed to reduce production and secretion of hormones that stimulate growth of malignant cells [in breast cancer and prostate cancer].
CIRCUMCISION (sĭr-kŭm-SĬZH-ŭn) Surgical removal of the foreskin [prepuce] surrounding the end of penis
DIGITAL RECTAL EXAMINATION (DĬJ-ĕ-tăl RĔK-tăl ĕk-ZĂM) [DRE] Finger palpation through the anal canal and rectum to examine the prostate gland
PHOTOSELECTIVE VAPORIZATION OF THE PROSTATE (fō-tō-sĕ-LĔK-tĭv vā-pŏr-ĭ-ZĀ-shŭn of the PRŎS-tāt) [GreenLight PVP] A minimally invasive surgical procedure for treating benign prostatic hyperplasia in which a green laser light is used to remove prostatic tissue.
TRANSURETHRAL RESECTION OF THE PROSTATE (trănz-ū-RĒ-trăl rē-SĔK-shun of the PRŎS-tāt) Excision of benign prostatic hyperplasia using a resectoscope through the urethra
TREATS: benign prostatic hyperplasia (BPH).
METHOD: In this procedure, an endoscope (resectoscope) is inserted into the penis and through the urethra. An electrical hot loop cuts the prostatic tissue; the bits of tissue (chips) are removed through the resectoscope.
PICTURE
VASECTOMY (vă-SĔK-tō-mē) Removing a piece of each vas deferens and ligation (lī-GĀ-shŭn) [Tying off a tube or blood vessel; thread or wire is used] is performed.
METHOD: a local anesthesia and an incision in the scrotal sac. Because spermatozoa cannot leave the body, the vasectomized man is sterile, but not castrated. Normal hormone secretion, sex drive, and potency (ability to have an erection) are intact. The body reabsorbs unexpelled sperm.
In a small number of cases, a vasovasostomy can successfully reverse vasectomy.

13. Abbreviations Page 326 BPH PSA DRE RPR ED STI GU TRUS HPV TUIP HSV
TUMT
PID
TUNA
PIN
TURP
BPH = benign prostatic hyperplasia
DRE = digital rectal examination
ED = erectile dysfunction
GU = genitourinary
HPV = human papilloma virus
HSV = herpes simplex virus
PID = pelvic inflammatory disease
PIN = prostatic intraepithelial neoplasia
PSA = prostate-specific antigen
RPR = rapid plasma reagin
STI = sexually transmitted diseases
TRUS = transrectal ultrasound
TUIP = transurethral incision of the prostate
TUMT = transurethral microwave thermotherapy
TUNA = transurethral needle ablation
TURP = transurethral resection of the prostate