Male Genital Tract Flashcards
Anatomy of the Male Genital Tract
Prostate is located at base of the bladder and surrounds urethra + vas deferens
Prostate Functions
Has contractile properties
Helps close of bladder neck during climax
Fluid properties of semen
Nutritive role for sperm cells
Buffer vaginal acidity
Prostate Anatomy
The prostate can be divided into biologically distinct regions, the most important of which are the peripheral and transition zones.
The types of proliferative lesions are different in each region.
For example, most hyperplastic lesions arise in the inner transition zone, while most carcinomas arise in the peripheral zones.
Transition zone is responsible for causing problems with urine flow abnormalities due to hyperplasia
Benign Prostatic Hyperplasia
Benign prostatic hyperplasia (BPH) is an extremely common cause of prostatic enlargement resulting from the proliferation of stromal and glandular elements.
Incidence rises rapidly >40y
2-5x normal weight
Transitional zone
Age-related hormone changes
Urinary obstruction
Benign Prostatic Hyperplasia - Complications
Symptoms
- Frequency, urgency, nocturia
- Decreased force of urinary stream
Complications
- Bladder hypertrophy, dilatation
- Urinary stone formation
Benign Prostatic Hyperplasia - Treatment
Medications
- Relax smooth muscle
- Hormonal (anti-androgen)
Surgery
- Trans-urethral procedures
Prostate Cancer
Carcinoma of the prostate is a common cancer of older men between 65 and 75 years of age. Prostate carcinomas range from indolent lesions that will never cause harm to aggressive fatal tumors
Incidence rises rapidly >50y
Most common non-skin cancer in men
Glandular organ → adenocarcinoma
1 in 9 lifetime risk
1 in 39 cause of death
More die with than from (thanks to screening and modern treatment
Prostate Cancer - Risk Factors
Established
* Age
* Family history
* Ethnicity
— Africa > Europe > Asia
* Geography
— NA, Europe, Australia
Maybe
* Obesity
* Diet
— Red meat, dairy
* Industrial
— Diesel fumes
— Pesticides
* Lifestyle
— Sedentary
— Stress
— Shift work
Prostate Cancer - Screening
No specific early warning symptoms
Usually slow growing (chance to catch early)
Rectal exam and blood test
Prostate Specific Antigen (PSA)
- Present normally in secretions
- Elevated serum PSA in cancer
- Screening test, but not specific
- Also useful in post-treatment monitoring
Prostate Cancer - U/S Needle Biopsy
Needle to take tissue biopsy of the area
Prognostic Factors
* Grade
* Stage
* Surgical margins
* PSA level
Outcome
* Confined to prostate?
— 99% 5-year survival
* Tumor beyond prostate?
— ~30% 5-year survival
Inguinal canal and spermatic cord
Testis goes down through inguinal canal and then sits in scrotum - happens in fetus and just after birth
Cryptorchidism
Cryptorchidism is a Failure of testicular descent into the scrotum. Normally, the testes descend from the abdominal cavity into the pelvis by the third month of gestation and then through the inguinal canals into the scrotum during the last 2 months of intrauterine life.
The diagnosis of cryptorchidism is only established with certainty after 1 year of age, particularly in premature infants, because testicular descent into the scrotum is not always complete at birth.
Cryptorchidism - incidence
3% term gestation
10-30% preterm
Cryptorchidism - risk factors
Prematurity
Low birth weight
Family history
Cryptorchidism - Mechanisms
Anatomical
Hormonal
