Male GenitalPenis:

HypoSpadias Ventral Side Failure of Urethral Folds to closeEpispadias Dorsal Side Assoc w/ Bladder ExstrophyCondyloma Acuminatum Cause: HPV 6 or 11 Benign Warts, Koilocytic change “Raisin nuclei”Lymphogranuloma Venereum

Necrotizing Granulomatous Inflamm. of Inguinal Lymph Nodes/Ducts Cause: Chlamydia Leads to: Rectal Stricture due to perianal involvement

Squamous Cell CA Cause: HPV

Precursor Lessions:

Bowen disease – Leukoplakia on Shaft & Scrotum Erythroplasia of Queyrat – Erythroplakia of Glans Bowenoid Papulosis – Mult Reddish Papules

Testicle:Cryptorchidism Testies dont descent Risk of Seminoma Tx: Orchiopexy before 2yrs oldAcute Epididymitis“Orchitis”- Inflamm. of Testies

(<35yrs) Chlamydia or Neisseria G. VS (>35yrs) E.Coli or Pseudomonas (Teenager) Mumps leads to Infertility Tuberculous Orchitis: Epididymis Testies VS Syphilis: Testies Epididymis

Testicular Torsion Twisting of Spermatic Cord lead to Hemorrhagic InfarctVaricocele “Bag of Worms” Dilation of Spermatic cord Absent Cremasteric Rflx

Cause: Failure of Testies to attach to inner lining of ScrotumHydrocele Fluid in Tunica Vaginalis Dx: Transilluminated scrotal swelling

Cause: Incomplete closure of Vaginalis (Child), or Lymphatic Blockage (Adult)

Testicular Tumors:Germ Cell:15-40yrs oldRisk Factors:-Cryptorchidism-Klinefelter

Seminoma -HCGβ Assoc w/ Cryptorchidism “Clear Cytoplasm w/ Central Nuclei” Malignant “Homogenous Mass w/ No Hemorrhage or Necrosis” Good Response to Radiotherpy Tx Resembles Ovarian Dysgerminoma

Embryonal CA -HCG & AFPβ Malignant Immature/Primitve cells produce Glands “Hemorrhagic Mass w/ Necrosis” Hematogenous Metastasis

Yolk Sac AFP “Child w/ Schiller-Duval Bodies“ (Glomerulus-like Structure)Chorio CA -HCGβ Malignant tumor of Syncytiotrophoblasts & Cytotrophoblasts

Hematogenous Metastasis Leads to HyperThyroid & GynecomastiaTeratoma -HCG & AFPβ Malignant in Males but Benign in FemalesMixed

Sex Cord-Stromal:

Leydig Cell Produce Androgen Precocious Puberty (Child) or Gynecomastia (Adult) Reinke Crystals “Golden Brown” Mass Large Polygonal cells w/ Eosinophilic Cyto.

Sertoli Cell Comprised of Tubules, usually clinically silentLymphoma MCC Testicular Mass in Males >60 Bilateral usually Large B-cell Type

Prostate:Acute Prostatitis Cause: (Child) Chlamydia & Neisseria Gonorrhoeae, vs (Adult) E.Coli & Pseudomonas

“Tender Boggy” Prostate Prostatic Secretions w/ WBC’sChronic Prostatitis Clinical: Dysuria w/ Pelvic or Lower-Back PainBPH“Benign Prostatic HyperPlasia”

DHT (Dihydrotestosterone), (5 -Reductase convertes Testosterone to DHT in Stromal Cellsα ) Occurs in Periurethral Zone of Prostate “Prob. Starting & Stopping”, “Dribbling” Tx: 1-Antagα (Terazosin)– Relax Smooth Muscle, 5 -Reductase α Inhibitor(ADR: Gynecomastia)

Prostate AndenoCa Risk Factors: Age, AfricanAmericans, Saturated Fat Diet No Urinary Symps Clinical: PSA & Alk. Phosphatase, Lower Back Pain Results in Osteoblastic Metastasis

Lower Back Pain Occurs in Peripheral, Posterior Region of Prostate “Small Invasive Glands w/ Prominent Nucleoli” Metastasis to Lumbar Spine or

Pelvis Tx: GnRH-analog (Leuprolide) - reduces LH & FSH

Flutamide – Competitive Inhib Androgen Recept