Chapter Nine Pathology of the Male Genital System

PATHOLOGY OF THE MALE GENITAL SYSTEM Objectives:  Describe the penile neoplasm.  Identify the histological features of testicular atrophy associated with infertility cases.  Identify the gross appearance of hydrocele and torsion of testis.  Describe the classification and the histogenesis of Testicular tumors.  Identify the gross and histological features of: Benign prostatic hyperplasia. Carcinoma of the prostate. Malformations of the Penis Hypospadias is the most common malformation (1 in 250 live male births). It refers to the abnormal location of the distal urethral orifice along the ventral aspect of the penis. The urethral orifice is sometimes constricted, resulting in urinary tract obstruction. Epispadias: the urethral orifice is situated on the dorsal aspect of the penis. Like hypospadias, epispadias may produce lower urinary tract obstruction or incontinence. Inflammatory Lesions of the penis Balanitis refer to local inflammation of the glans penis; it may be associated with inflammation of the overlying prepuce. Most cases occur due to poor local hygiene in uncircumcised males, with accumulations of smegma (desquamated epithelial cells, sweat, and debris) that acts as a local irritant. The distal penis is typically red, swollen, and tender; a purulent discharge may be present. Phimosis refers to the difficulty of retracting the prepuce over the glans. It may be congenital but most cases are acquired from scarring of the prepuce secondary to previous balanitis. Genital candidiasis is particularly common in patients with diabetes mellitus. Candidiasis presents as a painful, intensely pruritic erosions involving the glans penis, scrotum, and adjacent intertriginous areas. Scrapings or biopsy specimens of the lesions reveal characteristic budding yeast forms & pseudohyphae within the superficial epidermis.