1. Male Genital System 1
Dr. Amitabha Basu MD

2. Penis Mal formations Inflammatory conditions
Premalignant lesions and malignant conditions

3. Mal formations of penis
Hypospadias
Urethral opening below tip of penis on ventral surface.
Epispadias :
Urethral opening above the tip of penis on dorsal surface.

4. Epispadias: Infection and urinary incontinence.

5. Inflammation of penis and prepuce
Banalities & Balanoprosthitis : Hyperemia and exudates.

6. Banalities & Balanoprosthitis Complications : Phimosis and Paraphimosis

7. Genital candidiacis
Etiology: Diabetes Mellitus

8. Penis
Premalignant lesions
Malignant conditions

9. Premalignant lesions
Etiology
Carcinogens in smegma
HPV type 16

10. Types of Premalignant lesions : Penis
Carcinoma in situ ( Following types).
Bowen disease (HPV type 16).
Erythroplasia of Queyrat (HPV type 16)
Bowenoid Papulosis (Etiology = Venerally transmitted diseases)

11. Bowen disease : gross – Solitary plaque like lesion

12. 10 % progress to invasive carcinoma
Bowen disease : micro – in situ carcinoma ; intact basement membrane ; severely dysplastic epithelium
10 % progress to invasive carcinoma

13. Malignant lesion pf Penis
Etiology
Types of malignancy
Morphology
Clinical features
Squamous cell carcinoma
Verrucous carcinoma

14. Etiology of carcinoma penis
Carcinogens in smegma
HPV type 16

15. Squamous cells carcinoma : penis
This is a squamous cell carcinoma of the penis ( penectomy specimen )

16. Keratinized squamous cell carcinoma

17. Verrucous carcinoma : Papillary growth pattern- good prognosis.

18. Scrotun , Testis and epididymis
Cryptorchidism
Inflammatory conditions of testis
Male infertility
Hydrocele
Hematocele, chylocele, elephantiasis
Testicular torsion

19. Cryptorchidism : Definition
Definition: crypto=hidden, orchid= testicle,
Testis fails to descend in the scrotum by age 12 months.
Cause:
Hormonal abnormality
Intrinsic testicular abnormality.
Mechanical obstruction in inguinal canal.

20. Morphology ( Testicular atrophy)
Right testis more commonly involves. Small testis.
Tubular atrophy with hyalinization present.

21. Microscopy of Atrophic Tubules ( diffuse) of testis.

22. Complication ; Cryptorchidism
Infertility
Seminoma ( malignancy) particularly with unilateral undescended testis.

23. Causes of testiculate atrophy and that may lead to Infertility
Cryptoorchitism ( unilateral / bilateral).
Chronic alcoholism ( Bilateral)
Chronic Ischemia ( unilateral / bilateral)
Chemotherapy or radiation ( Bilateral)
Mumps orchitis ( focal atrophy)
Never forget

24. Inflammatory lesion of testis
Epididymitis
Orchitis.

25. Testis : infection Epididymitis Acute:
< 35 yr: N. Gonorrhoea, Chlamydia
>35 yr: E. coli
Chronic: Tuberculosis
Orchitis
Viral: Mumps
Association: parotid and pancreas involvement

26. Orchitis. Etiology Mumps ( mumps orchitis ) : common in adult.
Plasma cells and lymphocytes are present.

27. Focal atrophy of the testis tubules ; Mumps orchitis
NORMAL

28. Laboratory Sperm count will be low BUT not NIL.
Infertility do not occur usually.

29. Tuberculosis
Epithelioid cell granuloma is present with cassation necrosis.

30. Causes of Male Infertility 1 of 2
Mumps (unilateral / Bilateral)- temporary infertility.
Cryptoorchitism ( unilateral / bilateral).
Chronic alcoholism ( Bilateral)
Chronic Ischemia ( unilateral / bilateral)
Chemotherapy or radiation ( Bilateral)
Hydrocele and Varicocele
Never forget

31. Other causes of male infertility 2 of 2
Klienfelter syndrome : patient present with gyenecomastia.
Sertoli cell-only syndrome : No Sperm-Producing Cells, tubules contain only Sertoli cells.

32. Sertoli cell-only syndrome; sperm count NIL.

33. Hydrocele : etiology
Inflammation
Idiopathic

34. Hydrocele : Accumulation of serous fluid in tunica vaginalis.

35. Hematocele, chylocele, elephantiasis
Hematocele : blood in tunica vaginalis ( in trauma)
Chylocele : lymph in tunica vaginalis ( in lymphatic obstruction).
Elephantiasis : in filarial infection ( lymphatic obstruction).

36. Elephantiasis

37. Varicocele : Dilation of the pampiniform plexus
Complication : infertility

38. Testicular torsion : hemorrhagic infarction
Etiology : Trauma or tumor in the testis

39. Testis
Spermatocele
Dilated efferent duct of epididymus , containing sperm

40. Self assessment Premalignant lesion of Penis Causes of infertility
Etiology of testicular atrophy.

41. Self assessment Cryptorchidism and clinical significance
Carcinoma penis: Type: prognosis, microscopy

42. Thank you