Pathology of Male Reproductive System
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Questions and Answers

What is the characteristic feature of granulomatous prostatitis?

  • Hormonal imbalance
  • Androgen increase
  • Enlarged prostate
  • Variable inflammatory infiltrate (correct)

    • What percentage of men over 70 years old are affected by Benign Prostatic Hyperplasia (BPH)?

  • 75%
  • 50%
  • 80%
  • 95% (correct)

    • What is the main hormone responsible for the proliferation of prostatic gland cells in BPH?

  • Estrogen
  • Testosterone
  • Dihydrotestosterone (DHT) (correct)
  • Androgen

    • What is the symptom of chronic prostatitis that is common to all diseases?

    <p>Pain during urination</p> Signup and view all the answers

    What is the age range where BPH affects approximately 50% of men?

    <p>40-60 years</p> Signup and view all the answers

    What is the mechanism of BPH that leads to hyperplasia?

    <p>Androgen decrease, estrogen increase</p> Signup and view all the answers

    What is the most common cause of urinary problems in men over 60 years old?

    <p>Benign Prostatic Hyperplasia (BPH)</p> Signup and view all the answers

    Which type of prostatitis is caused by colioforms, Staphylococcus or Neisseria gonorrhoea?

    <p>Acute suppurative prostatitis</p> Signup and view all the answers

    What is the first symptom of prostate gland disease?

    <p>No symptoms, often asymptomatic</p> Signup and view all the answers

    What is the term for the inflammation of the prostate gland?

    <p>Prostatitis</p> Signup and view all the answers

    What type of lesion can occur in the testis?

    <p>All of the above</p> Signup and view all the answers

    Which of the following is NOT a common male reproductive organ?

    <p>Ovary</p> Signup and view all the answers

    What is the type of tumor that is commonly associated with BPH?

    <p>Adenocarcinoma</p> Signup and view all the answers

    What is the primary function of the prostate gland?

    <p>To produce semen</p> Signup and view all the answers

    What is the name of the protein that is often used as a marker for prostate cancer?

    <p>PSA</p> Signup and view all the answers

    What is the name of the surgical procedure that is often used to treat BPH?

    <p>TURP</p> Signup and view all the answers

    What is the term for the accumulation of fluid around the testis?

    <p>Hydrocele</p> Signup and view all the answers

    What is the name of the hormone that is involved in the development of BPH?

    <p>Dihydrotestosterone (DHT)</p> Signup and view all the answers

    What is the term for the hard, craggy prostate gland that is often palpated in patients with carcinoma of the prostate?

    <p>Indurated prostate</p> Signup and view all the answers

    What is the term for the backward flow of urine into the kidneys, which can occur in patients with BPH?

    <p>Vesicoureteral reflux</p> Signup and view all the answers

    What is the term for the inability to empty the bladder completely, which can occur in patients with BPH?

    <p>Urinary retention</p> Signup and view all the answers

    What is the term for the treatment of carcinoma of the prostate by removing the testes?

    <p>Orchidectomy</p> Signup and view all the answers

    What is the characteristic feature of a hydrocele?

    <p>Accumulation of serous fluid within the tunica vaginalis of the testis</p> Signup and view all the answers

    What is the most common cause of epididymo-orchitis?

    <p>Bacterial infection</p> Signup and view all the answers

    What is the most common symptom of testicular torsion?

    <p>Pain and swelling of the testis</p> Signup and view all the answers

    What is the main risk factor for developing testicular tumors?

    <p>Undescended testis</p> Signup and view all the answers

    What is the diagnostic test of choice for epididymo-orchitis?

    <p>Ultrasound</p> Signup and view all the answers

    What is the age range where testicular tumors are more common?

    <p>Young men</p> Signup and view all the answers

    What is the symptom of epididymo-orchitis that may come on more gradually?

    <p>Localized area of pain and swelling on the back of the testicle</p> Signup and view all the answers

    What is the complication of undescended testis?

    <p>Testicular tumor</p> Signup and view all the answers

    Study Notes

    Pathology of Male Reproductive System

    • Common male reproductive organs affected by pathology: prostate, testis, and other accessory organs

    Prostate Gland Disease

    • Associated with urinary problems in men > 60 years old
    • Causes of urinary problems: prostatitis, BPH, and prostatic carcinoma

    Prostatitis

    • Inflammation of the prostate
    • Types:
      • Acute suppurative prostatitis: caused by coliforms, Staphylococcus, or Neisseria gonorrhoeae
      • Chronic non-specific prostatitis
      • Granulomatous prostatitis: idiopathic, tuberculous, or following transurethral resection/allergic
    • Symptoms: enlarged prostate, pain during urination, and common symptoms of prostate disease

    Benign Prostatic Hyperplasia (BPH)

    • Non-neoplastic enlargement of the prostate
    • Aetiology:
      • Hormonal imbalance: androgen decline, estrogen increase
      • DHT (dihydrotestosterone) and AR receptor
    • Gross:
      • Solid nodules and cysts with yellowish necrotic areas and haemorrhagic margin
      • Nodules composed of hyperplastic glandular tissue and stromal muscle
    • Histology:
      • Hyperplastic glandular tissue and stromal muscle
      • Larger glands with tall epithelium lining and papillary projections
    • Clinical features:
      • Early stage: few symptoms, bladder muscles strong enough to push urine through a narrowing urethra
      • Late stage: symptoms of urine flow, weak stream, leakage after urination, unable to empty the bladder, nocturia
    • Diagnosis:
      • Digital rectal examination
      • Urinalysis and urine culture
      • Prostate-specific antigen (PSA) test
    • Complications:
      • Urine retention leading to recurrent urinary tract infections
      • Bladder stones and hydronephrosis
      • Gradual bladder and/or kidney damage
    • Treatment:
      • Transurethral Resection of the Prostate (TURP)

    Carcinoma of Prostate

    • Common malignant disease in men, 2nd leading cause of male deaths
    • Rare in men < 50 years old, peak incidence at 60-85 years old
    • Aetiology:
      • Unknown
      • Associated with environmental factors and hormonal influences
    • Pathology:
      • Gross: hard, irregular, and ill-defined gray area
      • Histology: adenocarcinomas in the glandular epithelium
    • Clinical features:
      • Urinary symptoms similar to BPH but more severe
      • Hard, craggy prostate on rectal examination
      • Bone metastases, pain, pathological fracture, and anaemia
      • Lymph node metastasis
    • Diagnosis:
      • Diagnostic imaging: ultrasound, skeletal X-rays, isotope bone scan
      • Cytoscopy: transurethral resection
      • Chemical pathology: serum acid and alkaline phosphatase, PSA
      • Haematology: leukoerythroblastic anaemia
      • Biopsy: transurethral resection, needle biopsy, fine-needle aspiration cytology
    • Clinical Management:
      • Gonadorelin (GnRH)
      • Orchidectomy - Cyproterone (anti-androgenic effects - DHT action)
      • Radiotherapy

    Testicular Lesions

    • Non-neoplastic disorders:
      • Hydrocele: accumulation of fluid around the testis
      • Incidence increasing worldwide

    Developmental and Cystic Lesions

      1. Undescended testis (cryptorchidism)
      1. Hydrocele: accumulation of serous fluid within the tunica vaginalis of the testis
      1. Haematocele
      1. Testicular Torsion

    Orchitis

    • Inflammatory condition of one or both testis
    • Causes: viral or bacterial infection
    • Symptoms:
      • Rapid onset of pain and swelling
      • Fever and chills
      • Nausea and malaise
      • Headache and body aches
      • Pain with urination
    • Epididymo-orchitis: symptoms may come on and progress more gradually
    • Diagnosis:
      • History and physical exam
      • Ultrasound
      • Rectal examination
      • Sample of discharge
      • FBC
      • Urinalysis

    Testicular Tumor

    • Uncommon
    • Occurs in young men
    • Aetiology:
      • Undescended testis
      • Other factors

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