Lower Male GU Tract Pathology Flashcards
Hypospadias vs. Epispadias
What can also occur in pts. with these anomalies?
Which is more common?
Both result from the malformation of the urethral groove, and urethral canal may create an abnormal urethral opening either on the ventral surface of the penis (hypospadias) or dorsal surface of the penis (epispadias).
Failure of testicular descent and urinary malformations.
Hypospadias is more common, approx. 1/300 live births.
What is Phimosis?
A condition noted when the orifice of the prepuce is too small to permit normal retraction.
What areas of the penis are most commonly inflamed?
What is the most common reason for penile inflammation?
Glans and prepuce (Balanoposthitis)
Poor hygiene.
Condyloma Acuminatum
How does it present upon exam?
What does it look like?
Condyloma Acuminatum - benign tumor of the penis transmitted by HPV type 6 and 11.
Moist mucocutaneous surface of the external genitalia.
Single or multi sessile or pedunculated red papillary excrescences.
Peyronie Disease is what? What does it result in?
Benign tumor of the penis.
Results in fibrous bands involving the corpus cavernosum.
What is Bowden disease?
How old are patients that present?
Where does it present on the penis?
A form of genital CIS (M and F) with a high association with HPV type 16.
Over age 35.
Skin of shaft and scrotum.
How is Bowenoid papulosis different than Bowden disease?
How does it look on histology compared to Bowenoid? Does it metastasize?
It presents in slightly younger patients and presents as multiple reddish-brown papular lesions.
It is non-distinguishable from Bowenoid papulosis on histology, but very rarely metastasizes.
Invasive carcinoma (SCC) of the penis is associated with what 2 things?
How old are these pts.?
What confers protection?
What is the survival rate?
HPV infections and poor hygiene
40-70 y/o
Circumcision (more common in Jews and Muslims)
66% survival rate at 5-years without LN mets, 27% if LN mets.
What is Verrucous carcinoma?
An exophytic well-differentiated variant of penile SCC that are locally invasive, but rarely metastasize.
What is Koilocytosis?
Where are they commonly found?
A venereal wart from cytoplasmic vacuolization of squamous cells, characteristic of HPV infection.
Common in Condylomata acuminatum (rarely progresses into CIS or invasive CA).
What us Cryptorchidism?
What does it confer a greater risk for?
How common is it?
Does it occur with other anomalies?
Complete or partial failure of intra-abdominal testes to descend into the scrotum.
It confers a significantly higher risk of testicular cancers.
1% of 1 y/o boys
Usually occurs in isolation, but can occur among other abnormalities.
What are 8 causes of testicular atrophy?
Atherosclerotic narrowing of blood supply End stage inflammatory orchitis Cryptorchidism Hypopituitarism Malnutrition Radiation Androgen use Exhaustion atrophy
What is testicular atrophy referred to?
Regressive changes
How does epididymitis/orchitis occur?
What are common bugs known to cause it in young, sexually active men?
What about in older men (>35 y/o)?
They are urinary infections that reach epididymis and testes through the vas deferens or lymphatics of the spermatic cord.
Chlamydia and Gonorrhea
E coli and Pseudomonas
What is granulomatous orchitis?
What does it look like?
Where is the inflammation?
An autoimmune orchitis of unknown cause (idiopathic) that presents in middle-aged men with sudden fever.
Painless mass that looks tumor-like.
Throughout the testes and confined to the seminiferous tubules.
Tract of a Gonorrheal infection of the testes/epididymis
In severe cases, what can occur?
Comes from posterior urethra to the prostate, SVs and then to epididymis.
Abscesses which leads to destruction and scarring
Mumps can have orchitis in what population?
When does it present?
Post-pubertal males (20-30% of cases)
Approx 1 wk after parotid swelling
What does Tb cause in the testes/epididymis?
Caseating granulomatous inflammation
