Reproductive Pathology: Male Flashcards
Describe features of benign nodular hyperplasia (benign prostatic hypertrophy)
- non-neoplastic and not premalignant
- associated with hormonal imbalance and infection
- nodular hyperplasia of glands and stroma
- treatable
What areas of the urinary system does benign prostatic hypertrophy affect?
- affects the transition zone and peri-urethral glands
- interferes with the urethral sphincter
- compresses and elongates urethra
What are the complications of benign prostatic hypertrophy?
- causes urinary retention
- can dilate the bladder and cause weakness
- can cause diverticulum that can house stones and infection
- expansion of bladder can shut off ureter and cause hydroureter which can cause feedback pressure in the kidney causing hydronephrosis
Contrast BPH and prostate carcinoma
BPH:
- hyperplasia is central
- causes early urinary symptoms due to narrowing of urethra
Carcinoma:
- arises subcapsular and posterior
- can have no urinary symptoms
Describe the features of prostatic carcinoma
- precursor condition: prostatic intraepithelial neoplasia
- adenocarcinoma
How can you chart the spread of prostatic carcinomas?
- Gleason score: differentiation and distribution
- stage TN (direct, via lymphatics, via blood)
What is the presentation of prostatic carcinoma?
- urinary symptoms
- incidental finding on rectal examination
- bone metastases
- lymph node metastases
What are some pathologies that can affect the penis and scrotum?
- venereal infection
- congenital malformations (hypospadias: urethral opening on inferior aspect, epispadias: with abnormal development of bladder)
- inflammation and infections (phimosis, paraphimosis)
- tumours (Bowen’s disease, invasive SSC)
What are some pathologies that can affect the urethra?
- obstruction (congenital valves, rupture, stricture)
- urethritis (gonococcal/non-gonococcal)
- rupture
- tumours (warts, transitional cell carcinoma)
Describe the features of testicular lesions of the testes and orchitis
Developmental and cystic lesions:
- undescended testis (risk factor for cancer)
- hydrocele
- haematocele
Orchitis:
- mumps orchitis
- idiopathic granulomatous orchitis
- syphilitic orchitis
What is the presentation of testicular tumours?
- painless unilateral enlargement of testes
- secondary hydrocele
- retroperitoneal mass
- gynaecomastia
What are the main testicular tumours and their features?
Teratoma (stem cell potential):
- younger
- more aggressive
- beta HCG and AFP good biomarkers
Seminoma (spermatogonia tumours):
- most common
- older men
- malignant
- good prognosis with chemo
What are the causes of male infertility?
- endocrine disorders (GnRH deficiency, oestrogen excess)
- testicular lesions (crytorchidism, abnormal spermatogenesis)
- post-testicular lesions (obstruction of efferent ducts)
What are common abnormalities of the epididymis and spermatic cord?
- congenital abnormalities
- epididymal cysts and spermatocoeles
- varicocoele
- torsion of spermatic cord and testes
- inflammatory lesions
- tumours (rare)
