Male Reproductive System Diseases

The male reproductive system with testicles and spermatic duct can be divided into different sections, but are treated as one unit in anatomy. This article is concerned with the anatomy and physiology of the male sexual organs. At the end, final pathology concludes with a general view on the most important dysfunctions.

Testicular tumors are common and potentially annihilating to the male population. With a brief prologue to testicular tumors; this article focuses on the significant, relevant types of testicular tumors such as Germ Cell Tumors (GCTs) and Non-Germ Cell Tumors (NGCT).Various clinical, patho-physiological and prognostic aspects of the same have been expatiated.

Scrotal masses are embarrassing and seemingly exigent trouble for males. Benign scrotal lesions present as testicular masses that transilluminate as against solid testicular tumors which do not transilluminate. This article expounds about benign, relevant, common scrotal masses such as congenital and acquired hydrocele and spermatocele.

Penile disorders are heterogenous and desolating to the male population. This article succinctly expounds Hypospadiasis, Epispadiasis, Phimosis, Paraphimosis, Peyronie’s disease, Priapism, Penile carcinoma in situ and Squamous cell carcinoma.

Varicoceles are defined as abnormal dilations of the spermatic vein or the pampiniform plexus and are more common on the left side. Careful physical examination of the contralateral scrotal side is essential as bilateral varicoceles are common. While the diagnosis of varicoceles can be done clinically especially when seminal fluid analysis is impaired, imaging studies with color-flow Doppler remain an important part of the diagnostic workup. Symptomatic varicoceles or subfertile men with varicoceles should have their varicoceles surgically corrected either by a minimally invasive procedure, or by percutaneous embolization.

Testicular cancer is an uncommon malignancy. Most of testicular cancers are of the germ cell tumor type and they can be classified into seminomas or nonseminomas. The most common presentation of testicular cancer is a painless testicular nodule. Alpha-fetoprotein can be elevated in nonseminomas, while beta-human chorionic gonadotropin is usually elevated in both seminomas and nonseminomas. Radical inguinal orchiectomy along with retroperitoneal lymph node dissection helps in confirming the diagnosis and can be curative in early stages of testicular seminomas.

Testicular torsion is the most common cause of acute testicular and scrotal emergency pain. Patients usually have unilateral testicular torsion and the most common etiology is a high abnormal attachment of the tunica vaginalis. Abnormal attachment of the tunica vaginalis results in spermatic cord increased mobility and predisposes to spermatic cord twisting and subsequent testicular torsion. Testicular infarction and necrosis can ensue if the testis is not detwisted in the first 8 hours and is usually complete by 24 hours of torsion onset. Bilateral testicular fixation to the tunica vaginalis is recommended.

Prostatitis is a term that indicates inflammation of the prostate which can be infectious or non-infectious. Bacterial prostatitis is easier to identify clinically and their management is better established. The main diagnostic tools for prostatitis are clinical history and physical examination. Prostate massage by digital rectal examination is only recommended in patients with chronic prostatitis and not in acute bacterial prostatitis. Broad spectrum antibiotics are the mainstay therapy for bacterial prostatitis, while symptomatic treatment is indicated for chronic pelvic pain syndrome without evidence for uropathogens.

Cryptorchidism is a term used to describe the failure of descent of the testicle into the scrotum. This condition is common among premature boys, 33% of them, and can still be identified in full-term boys in approximately 5%. Ultrasonography can help localize inguinal testicles, while abdominal magnetic resonance imaging or laparoscopy can identify non-palpable intraabdominal testis. Hormonal treatment is indicated at 6 months of life and surgical correction is needed if hormonal therapy failed. Surgical treatment should be attempted before one year of life to achieve better fertility outcome.