male reproductive medicine

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Medical Language, Second Edition Susan Turley

CHAPTER

Medical LanguageSecond Edition

Male Reproductive Medicine

12

Male Reproductive Medicine

The medical specialty that studies the anatomy and physiology of the male genitourinary system and uses diagnostic tests, medical and surgical procedures, and drugs to treat male reproductive diseases.

Anatomy and Physiology

External Genitalia:-Scrotum-Testes-Epididymides-Penis-Urethra

Internal Genitalia:-Vas deferens-Seminal vesicles-Ejaculatory ducts-Prostate gland-Bulbourethral glands

The male genitourinary system shares the urethra with the urinary system and is also known as the urogenital system. (Male video clip)

Figure 12-2 External and internal male genitalia

Anatomy of the Male Genitourinary System

Scrotum-Soft pouch of skin behind the penis and in front of the legs.-Few degrees cooler than the core body temperature.-Muscles in wall of the scrotum contract or relax to move the scrotum closer to, or farther away from, the body to adjust to temperature changes.-contains two testes or gonads (sex glands.)

Anatomy of the Male Genitourinary System

Testis:-Function as part of the male genitourinary system and the endocrine system.-Contains the seminiferous tubules that produce spermatozoa, or sperm.-Acts as a gland and secretes the hormone testosterone.

Epididymis-A long, coiled tube (over 20 feet) that is attached to the outer wall of each testis.-Within the epididymis, the head of each spermatozoon is given a cap-like layer of enzymes that helps it penetrate and fertilize the ovum of the female.-Destroys defective spermatozoa

Figure 12-3 Structures of the testis and penis.

Figure 12-4 Descent of the testes

Vas Deferens, Seminal Vesicles, and Ejaculatory Duct

-The vas deferens is a long duct that receives spermatozoa from the epididymis.-Spermatozoa can be stored in the vas deferens for several months in an inactive state.-The vas deferens merges with a seminal vesicle.

Vas Deferens, Seminal Vesicles, and Ejaculatory Duct

-The seminal vesicles produce seminal fluid, which makes up most of the volume of semen.-The ejaculatory duct is a large collecting duct that holds spermatozoa and seminal fluid. -The ejaculatory duct enters the prostate gland, then joins the urethra within the prostate gland.

Prostate Gland-Round gland at the base of the bladder that produces prostatic fluid.-Prostatic fluid contains an antibiotic substance that kills bacteria and also contains acid phosphatase, an enzyme that breaks the deposit of semen apart and releases the spermatozoa in the woman’s vagina.

Bulbourethral Glands-Small, bulblike glands about the size of peas, located on either side of the urethra just below the prostate gland.-Produce thick mucus that makes up some of the volume of the semen and neutralizes the acidity of any urine remaining in the urethra at the time of ejaculation.

Penis-Functions as an organ of the male genitourinary system and the urinary system.-In uncircumcised males, the urethral meatus is covered by the prepuce, or foreskin, of the penis.-Three columns of erectile tissue fill with blood during sexual arousal, causing the penis to become firm and erect.

Physiology of Spermatogenesis, Sexual Maturity, and Ejaculation

Spermatogenesis:-At the onset of puberty, the anterior pituitary gland in the brain begins to secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH) to stimulate the testes.-FSH stimulates spermatocytes in the testes to begin dividing.-LH stimulates the interstitial cells to begin to secrete testosterone.

Sexual Maturity:-Testosterone causes the male sexual characteristics to develop: 1. enlargement of the external genitalia2. development of large muscles3. deepening of the voice4. growth of body hair on the face, chest axillae,

and genital areas5. development of the sexual drive

Ejaculation-Thoughts or sensations initiate sexual arousal.-Smooth muscle relaxes in the wall of arteries in the penis, and vasodilation increases blood flow within the penis.-The corpora cavernosa and the corpus spongiosum distend with blood and produce an erection.-Muscles at the base of the penis contract-Spermatozoa mix with seminal fluid, move into the urethra, and are mixed with mucus from the bulbourethral glands.-A series of contractions cause semen to be expelled from the penis through the urethral meatus.

Figure 12-5 Testosterone

Diseases and Conditions

Testis and Epididymis:CryptorchidismEpididymitis InfertilityOligospermia Orchitis Testicular cancer Varicocele

Figure 12-6 OligospermiaCustom Medical Stock Photo, Inc.

Diseases and Conditions

Prostate Gland:Benign prostatic hypertrophy (BPH) Cancer of the prostate gland Prostatitis

Diseases and Conditions

PenisBalanitisChordeeDyspareuniaErectile dysfunction (ED) Phimosis Premature ejaculationPriapism Sexually transmitted disease (STD)

Table 12-1 Sexually Transmitted Diseases (STDs)

Table 12-1 (cont’d) Sexually Transmitted Diseases (STDs)

Table 12-1 (cont’d) Sexually Transmitted Diseases (STDs)

Table 12-1 (cont’d) Sexually Transmitted Diseases (STDs)

Table 12-1 (cont’d) Sexually Transmitted Diseases (STDs)

Diseases and Conditions

Male Breast:Gynecomastia

Laboratory and Diagnostic Procedures

Blood Tests:Acid phosphatase Hormone testing Prostate-specific antigen (PSA) Syphilis testing

Laboratory and Diagnostic Procedures

Semen TestsAcid phosphatase DNA analysis Semen analysis

Figure 12-8 SpermatozoaJohn Walsh/Photo Researchers, Inc.

Laboratory and Diagnostic Procedures

Radiologic TestsProstaScint scan Ultrasonography

Medical and Surgical ProceduresSurgical Procedures:

Digital rectal examination (DRE) Newborn genital examination Testicular self-examination (TSE)Biopsy CircumcisionOrchiectomyOrchiopexyPenile implant ProstatectomyTransurethral resection of the prostate (TURP)Vasectomy

Figure 12-10 Transurethral resection of the prostate (TURP)

Drug Categories

These categories of drugs are used to treat male genitourinary Diseases and Conditions:

Androgen drugsAntiviral drugsDrugs for benign prostatic hypertrophyDrugs for erectile dysfunction

Abbreviations