Cryptorchidism

One or both testes fail to descend into the scrotom, may lie in the inguinal canal, in the abd cavity, in the perineum, or in the femoral canal

Cause unknown but if not corrected by age 2, seminiferous tubules atrophy and become fibrotic

20-40% chance of testicular cancer if untreated

 Hydrocele

Fluid-dilled mass within the scrotom; imbalance between production & reabsortion; tranillumination, not reatement or hydrocelectomy

 Spermatocele

mobile, painless mass containing dead spermatoza that forms in the epididymis; cause thought to be leakage of sperm due to trauma or infection, no treatment or spermatocelectomy

 Varicocele

 Phimosis

Constriction of the foreskin; can not be retarcted over glans penis; uncommon problem; may be congenital or related to chronic infections

Major problems are that it prevents adequate hygiene, which may lead to malignancy & interfere with erections

 Medical Interventions:

Phimosis

Antibiotics and warm soaks n sitz baths; circumcision may be necessary

 Hypospadias

 occurs when the urinary meatus opens onto the ventral surface of the penis

 Epispadias

when the urinary meatis opens onto the dorsal surface of the penis

 Testicular torsion

Twisting of the testes and spermatic cord; potential mediccal emergency

 Testicular torsion

             Causes:             

Congenital abnormalities called bell-clapper deformity; the tunica vaginalis attached too high on spermatic cord, letting the testes move around; occurs between birth and age 30

 Medical Interventions:

Testicular torsion

surgery to untwist the testicle & fixation to scrotom; if the testes is already necrotic, removal is necessary

 Testicular cancer

1% of all cancers;

most common cancer ages 15-35;

cure rate nearly 100% with early detection;

 Testicular cancer

etiology unknown;

suggested risk factors include cryptorchidism, exposure to DES & OC during fetal growth, HX of increased maternal nausea 1st two months, LBW, prematurity, family hx

 Testicular Cancer

Grows within the testicle, eventually replacing normal tissue; local spread to epididymis or spermatic cord; spreads by lymphatic & vascular to other organs

Presents: Painless hard nodule on testicle

Medical Intervention:

Testicular Cancer

Chemotherapy

Surgery

Radiation therapy

 Lab & Diagnostic Tests:

Testicular Cancer

tumor markers

serum lactic acid dehydrogenase (LDH)

liver function test

CT of chest and abdomen

Priapism

sustained, painful erection *minimal 4hrs without arousal; condition unusual

 Causes:

Priapism

Typesarterial high-flow: trauma to perineal area with torn cavernous artery

Veno-occulsive: relataed to certain drugs and conditions; causes obstruction or venospasms of small veins

Medical Intervention:

Priapism

ice and vasoconstrictive drugs for temporary relief

Sugery to create fitulas to drain blood

 Erectile Dysfunction

The inablility to attain & maintain an erection sufficient to permit satisfactory sexual intercourse; high incidence; most over age 65

Diabetes Mellitus leading cause

 Medical Interventions:

Erectile Dysfunction

Mechanical devices: vacuum constrictive devices

Surgery: Revasculariztion, penile implants *semi-rigid; self-contained, and inflatable

 Peyronie's Disease

Often gives penis curved or crooked look when erect. Fibrous bands or plaques form mainly on the dorsal part of the layer of tissue that surrounds on of the corpora cavernosa of the penis

 Peyronie's disease

Caused by injury or inflammation of penile tissue; may be intermittent condition and resolve spontaneously

If curvature is thick enough, erection is painful with difficulty penetrating vagina and often leads to erectile dysfunction

 Prostatitis

 inflammation of prostate gland

      Causes: acute bacterial (lower UTI's, treated with antibiotics); chronic bacterial (chronic UTI's) or non bacterial (unknown)

 Epididymitis

Infection/inflammation

Usually caused by bladder or urethral infection

Early: pain/local edema progress to erythema & scrotal edema

Late: Occlusion of epididymis/infertility

 Medical Interventions:

Epididymitis

IV antibiotics/hospital, bedrest, ice

Orchitis

infection/inflammation

common complication of epididymitis

through lymphatic & vasculat tunnels

trauma

other diseases

pain& edema

abcesses, atrophy, fibrosis, infertility

 Benign Prostatic Hyperplasia

 Most common disorder in aging males

Cause may have relationship with diet, obesity, sexual activity, ethnic origin, family hx

Two preconditions: age of 50 or greater & prescence of testes; higher level of estrogen

 Benign Prostatic Hyperplasia

 Begins as small nodules in transition zone next to the urethra; nodules form mass of hyperplastic tissue that expands; compresses and narrows the urethra

Sx: nocturia, vesicoureteral reflux if left untreated

 Prostate Cancer

Cause unknown: in early stages is androgen dependent. Testosterone converted to DTH; androgen receptors in nuclei bind with DTH and lead to hyperplasia.

No early symptoms but as tumor grows, compresses urethra, obstructing flow

 Lab & Diagnostic test

Prostate Cancer

PSA

Transrectal ultrasonography

tissue bx

grade and stage (1-4 used)

 Medical Interventions;

Prostate Cancer

Hormone therapy: deprive system of androgens

Surgery

Radiation therapy

 Cancer of Penis

Associated with presence of foeskin, irritative effects of smegma, poor hygiene, other infections such as HPV, cigarette smoking, genital warts, multiple sex partners, hx of penile rash

 Cancer of Penis

Originates at distal end of penis, spreads through lymph channe;s to inguinal nodes & spread to other organs

Signs: mass or persistant sore/ulcer (painless), ulceration, bleeding, purulent, foul smelling drainage, enlarged nodes