Male Reproductive System and Syphilis

Here are the study notes:

Reproductive System Disorders

Male Reproductive System Disorders

• Cryptorchidism: testis fails to descend into scrotum properly; can cause degeneration of seminiferous tubules and impaired spermatogenesis; increases risk of testicular cancer if not treated by age 5 years
• Hydrocele: excessive fluid collects in space between layers of tunica vaginalis of the scrotum; may occur as congenital defect in newborn or acquired as result of injury, infection, or tumor
• Spermatocele: cyst containing fluid and sperm that develops between testis and epididymis; may be related to developmental abnormality; treated with surgical removal
• Varicocele: dilated vein in spermatic cord; lack of valves leads to backflow and increased pressure, causing impaired blood flow to testes and decreased spermatogenesis; requires surgery
• Torsion of the Testes: testes rotate on spermatic cord, compressing arteries and veins, leading to ischemia and swelling; can occur spontaneously or following trauma; treated manually and surgically

Inflammation and Infections

• Prostatitis: infection or inflammation of the prostate gland; caused by bacterial infection, usually by E. coli; can lead to urinary tract infections, prostate abscesses, and infertility
• Balanitis: fungal infection of the glans penis; caused by Candida albicans; symptoms include itching, burning, and vesicles; treated with topical antifungal medication

Tumors

• Benign Prostatic Hypertrophy: non-cancerous enlargement of the prostate gland; occurs in up to 50% of men > 65 years; can cause urinary obstruction, frequent infections, and distended bladder
• Cancer of the Prostate: most common cancer in men > 50 years; third leading cause of cancer death in men; symptoms include hard nodule on periphery of gland, hesitancy in urination, decreased urine stream, and frequent urination; treated with surgery, radiation, and hormone therapy
• Cancer of the Testes: most testicular tumors are malignant; risk factors include cryptorchidism, family history, and exposure to herbicides; symptoms include enlarged testes, dull aching, and hydrocele or epididymitis; treated with surgical removal and chemotherapy

Female Reproductive System Disorders

• Structural Abnormalities: uterus may be retroflexed, causing back pain, dysmenorrhea, and dyspareunia
• Menstrual Disorders: include amenorrhea, dysmenorrhea, premenstrual syndrome, and abnormal bleeding
• Endometriosis: growth of endometrial tissue outside uterus; causes pelvic pain, dysmenorrhea, and infertility; treated with hormonal suppression and surgical removal of ectopic tissue
• Infections: include candidiasis (yeast infection), pelvic inflammatory disease, and infections of the uterus, fallopian tubes, and ovaries
• Benign Tumors: include leiomyoma (fibroids), ovarian cysts, polycystic ovarian syndrome, and fibrocystic breast disease
• Malignant Tumors: include carcinoma of the breast, cervix, uterus, and ovaries; risk factors include family history, hormonal imbalance, and radiation exposure; symptoms include abnormal bleeding, pelvic pain, and changes in breast tissue.### Breast Cancer
• Tissue biopsy is used to determine the presence of specific growth factors to design drug treatment and chemotherapy.
• Radiation therapy may be done before or after surgery.
• Lumpectomy is a type of breast cancer surgery that removes the tumor and a small amount of surrounding tissue called the margin.

Carcinoma of the Cervix

• Most cases of cervical cancer are caused by human papillomavirus (HPV) infection, a sexually transmitted virus.
• Vaccines now exist against the causative strains of HPV.
• Routine Pap smears of cervical cells are important in identifying early, treatable stages of the disease.
• Pap smears should be done by age 20 years or in the year that sexual intercourse begins, and at intervals as advised by a healthcare worker.

Etiology of Carcinoma of the Cervix

• Risk factors for cervical cancer include:
  • Age < 40 years
  • Strongly linked to HPV viral infection (STD)
  • Multiple partners
  • Sexual intercourse beginning in early teenage years
  • Smoking
  • History of prior STDs

Carcinoma of the Uterus

• Most common in postmenopausal women
• Early indicator is painless vaginal bleeding
• Risk factors for uterine cancer include:
  • Age > 50 years
  • High-dose estrogen hormone treatment without progesterone
  • Obesity
  • Diabetes

Ovarian Cancer

• Ovarian cancer is considered a silent tumor, with few diagnosed in the early stage
• Research is ongoing to identify markers for serum diagnosis
• Different types of ovarian cancer vary in aggressiveness
• Risk factors for ovarian cancer include:
  • Obesity
  • BRCA1 gene
  • Early menarche
  • Nulliparous or late first pregnancy
  • Use of fertility drugs
• Surgery and chemotherapy are usual treatments for ovarian cancer

Infertility

• Cause may be a female condition, male condition, or a combination of both
• Associated with:
  • Hormonal imbalances
  • Age of parents
  • Structural abnormalities
  • Infections
  • Chemotherapy
  • Workplace toxins
  • Other environmental factors
  • Idiopathic (unknown cause)

Sexually Transmitted Diseases

• Bacterial Infections:
  • Chlamydial Infection
  • Gonorrhea
  • Syphilis
• Viral Infections:
  • Genital Herpes
  • Condylomata Acuminata (Genital Warts)
• Protozoan Infection:
  • Trichomoniasis

Bacterial Infections

• Chlamydial Infections:
  • Considered one of the most common STDs
  • Caused by Chlamydia trachomatis
  • Males: urethritis and epididymitis
  • Females: often asymptomatic until PID (pelvic inflammatory disease) or infertility develops
  • Newborns may be infected during birth
• Gonorrhea:
  • Caused by Neisseria gonorrhoeae
  • May infect the eyes of the newborn, causing irreversible damage and blindness
  • May spread systemically to cause septic arthritis
• Syphilis:
  • Caused by Treponema pallidum, a spirochete
  • 4 stages (primary, secondary, latent, tertiary)
  • Tertiary syphilis: irreversible changes, including gummas in organs and major blood vessels, dementia, blindness, and motor disabilities
  • Organism can be transmitted to the fetus in utero
  • Treatment is usually antimicrobial drugs

Syphilis (Cont.)

• History of syphilis:
  • First recorded outbreak in Europe in 1494/1495 in Naples, Italy
  • Known as "French disease"
  • Causative organism, Treponema pallidum, was first identified in 1905
  • First effective treatment, Salvarsan, was developed in 1910
  • Introduction of penicillin in 1943
  • Many well-known figures, including Scott Joplin, Franz Schubert, Friedrich Nietzsche, Al Capone, and Édouard Manet, are believed to have contracted the disease
  • Origin of syphilis is still unknown, with two primary hypotheses:
    • Carried to Europe from the Americas by the crew of Christopher Columbus
    • Previously existed in Europe but went unrecognized

Viral Infections

• Genital Herpes:
  • Caused by HSV-2 or HSV-1
  • Recurrent outbreaks of blister-like vesicles on the genitalia
  • Infectivity greater when symptoms are present
  • Reactivation is common and may be associated with stress, illness, and menstruation
  • Antiviral drugs are used for treatment and prevention of transmission
  • Infection is considered lifelong
• Condylomata Acuminata (Genital Warts):
  • Caused by HPV
  • Incubation period may be up to 6 months
  • Disease may be asymptomatic
  • Warts vary in appearance
  • Warts can appear wherever contact with the virus has occurred
  • Warts can be removed by different methods
  • May predispose to cervical or vulvar cancer