1. 18
Male Reproductive System

2. Learning Outcomes
State the description and primary functions of the organs/structures of the male reproductive system.
Analyze, build, spell, and pronounce medical words.
Comprehend the drugs highlighted in this chapter.

3. Learning Outcomes
Explain the causes, symptoms, and treatments of selected sexually transmitted diseases.
Provide the description of diagnostic and laboratory tests related to the male reproductive system.
Identify and define selected abbreviations.

4. Multimedia Directory Slide 9 Male Reproductive Animation
Slide 26 Spermatogenesis Animation
Slide 46 Circumcision Video
Slide 52 Erectile Dysfunction Video
Slide 54 Gonorrhea Video
Slide 55 Herpes Video
Slide 69 Sperm Formation Animation
Slide 72 Vasectomy Video

5. Anatomy and Physiology Overview
Male reproductive system
Testes
Various ducts
Urethra
Accessory glands:
Bulbourethral
Prostate
Seminal vesicles

6. Anatomy and Physiology Overview
Supporting structures and accessory sex organs
Scrotum
Penis
Vital function of male reproductive system
Provide the sperm cells necessary to fertilize the ovum, thereby perpetuating the species.

7. Figure 18.1
Male reproductive system: seminal vesicles, prostate, urethra, vas deferens, epididymis, and external genitalia.

8. Insert table 18-1

9. Male Reproductive Animation
Click on the screenshot to view an animation of the male reproductive system.
The animation may take a moment to begin playing.
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10. External Organs Scrotum
Pouchlike structure located behind and below the penis.
Suspended from perineal region and divided by a septum into two sacs.
Each sac contains one of the testes along with its connecting tube, the epididymis.

11. External Organs Scrotum
Fibers of smooth muscle contract in the absence of sufficient heat to bring the testes closer to the perineum to maintain the viability of the spermatozoa.
Temperature is a degree or two lower than body temperature in order to produce viable sperm.
If testicles are kept at body temperature or higher for a prolonged period, infertility or sterility can result.

12. External Organs Testes
Two ovoid-shaped organs located within the scrotum.
Interior of each testis is divided into about 250 wedge-shaped lobes by fibrous tissues.
Seminiferous tubules: one to three small tubes coiled within each lobe.
Spermatozoa: male reproductive cells that develop in the seminiferous tubules.

13. External Organs Testes Testosterone:
Male sex hormone produced by cells in the testes.
Responsible for development of secondary male characteristics during puberty and maintaining them through adulthood.

14. Figure 18.2
Sagittal section of the male pelvis, showing the organs of the reproductive system. 14

15. Sagittal view of the testes showing interior anatomy.
Figure 18.3
Sagittal view of the testes showing interior anatomy.

16. Life Span Considerations
Puberty
Period of rapid change in the lives of boys and girls.
In the male, puberty generally begins around age 12 when the genitals increase in size and the shoulders broaden and become muscular.

17. Life Span Considerations
As testosterone is released, secondary sexual characteristics develop:
Pubic and axillary hair
Increase in size of penis and testes
Voice changes (deepening)
Facial hair
Erections
Nocturnal emissions

18. External Organs Testosterone
Essential for normal growth and development of the male accessory sex organs.
Plays a vital role in the erection process of the penis.
Affects facial hair growth, muscular development, and vocal timbre.

19. External Organs Seminiferous tubules
Form a plexus or network called the rete testis from which 15 to 20 small ducts, the efferent ductules, leave the testis and open into the epididymis.

20. External Organs
Penis
Has three longitudinal columns of erectile tissue that are capable of significant enlargement when engorged with blood as is the case during sexual stimulation.
Corpora cavernosa penis
Corpus spongiosum

21. External Organs
Penis
Covered with loose skin folds called the foreskin or prepuce.
Smegma
A lubricating fluid secreted by glands in the foreskin.
Circumcision
The surgical removal of the foreskin.

22. External Organs
Penis
The erectile state results when sexual stimulation causes large quantities of blood from dilated arteries supplying the penis to fill the cavernous spaces in the erectile tissue.
When the arteries constrict, the pressure on the veins in the area is reduced, thus allowing more blood to leave the penis than enters, and the penis returns to its normal state.

23. External Organs Penis Functions of the penis
The male organ of copulation (sexual intercourse).
Site of the orifice for elimination of urine and semen from the body.

24. Life Span Considerations
In the newborn, the scrotum can appear large at birth.
Cryptorchidism
One or both testes fails to descend into the scrotum.
Phimosis
A condition of narrowing of the opening of the prepuce wherein the foreskin cannot be drawn back over the glans penis.

25. Life Span Considerations
Epispadias
A congenital defect in which the urethra opens on the dorsum of the penis.
Hypospadias
A congenital defect in which the urethra opens on the underside of the penis.

26. Spermatogenesis Animation
Click on the screenshot to view an animation showing spermatogenesis.
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27. Internal Organs
In the male, the epididymis, the vas deferens, the seminal vesicles, the prostate gland, the bulbourethral glands, and the urethra are the internal organs of reproduction.

28. Epididymis
Each testis is connected by efferent ductules to an epididymis, a coiled tube laying on the posterior aspect of the testis.
Each epididymis functions as:
a site for the maturation of sperm
the first part of the duct system through which sperm pass on their journey to the urethra.

29. Basic structure of a spermatozoon (sperm).
Figure 18.4
Basic structure of a spermatozoon (sperm).

30. Vas Deferens Also called the ductus deferens.
A slim muscular tube that is a continuation of the epididymis.
Conveys sperm from the epididymis to the ejaculatory duct.

31. Vas Deferens
Between the testis and the part of the abdomen known as the internal inguinal ring, the vas deferens is contained within the spermatic cord.
This cord also contains arteries, veins, lymphatic vessels, and nerves.

32. Seminal Vesicles
The two seminal vesicles are each connected by a narrow duct to a vas deferens, which then forms a short tube, the ejaculatory duct.
The ejaculatory duct penetrates the base of the prostate gland and opens into the prostatic portion of the urethra.

33. Seminal Vesicles
The seminal vesicles produce a slightly alkaline fluid that becomes part of the seminal fluid or semen.

34. Prostate Gland
Composed of glandular, connective, and muscular tissue, it lies behind the urinary bladder.
It surrounds the first 2.5 cm of the urethra and secretes an alkaline fluid that aids in maintaining the viability of spermatozoa.

35. Prostate Gland Benign prostatic hyperplasia (BPH) Prostatectomy
Enlargement of the prostate.
Condition that can occur in older men.
Prostate obstructs the urethra and interferes with normal passage of urine.
Prostatectomy
Removal of part of the prostate gland.
Prostate gland can be a site for cancer in older men.

36. Life Span Considerations
With aging:
the prostate gland enlarges, and its glandular secretions decrease
the testes become smaller and firmer
testosterone production gradually decreases
pubic hair becomes sparser and stiffer.

37. Life Span Considerations
In a healthy, normal male:
spermatogenesis and the ability to have erections last a lifetime
sexual arousal can be slowed with a longer refractory period between erections.
Refractory period: the time span between orgasms when men are not physically able to have another orgasm.
In older men, the refractory time lengthens.

38. Bulbourethral Glands Also called Cowper’s glands.
Two small pea-sized glands located below the prostate and on either side of the urethra.
A duct connects them with the wall of the urethra.
Produce a mucous secretion before ejaculation, which becomes a component of semen.

39. Urethra Divided into three sections:
Prostatic
Membranous
Penile
Extends from the urinary bladder to the external urethral orifice at the head of the penis.
Serves the dual function of transmitting urine and semen out of the body.

40. Figure 18.5
Sagittal view of the male pelvis showing the seminal vesicle, ejaculatory duct, prostate gland, bulbourethral glands, and urethra. 40

41. Audio Pronunications Audio Pronunications Anorchism
Artificial insemination
Aspermia
Azoospermia
Balanitis
Benign prostatic hyperplasia

42. Figure 18.6
Benign prostatic hyperplasia (BPH) showing an enlarged prostate compressing the urethra.

43. Life Span Considerations
By age 60, four out of five men have an enlarged prostate.
Treatment for benign prostatic hyperplasia includes drug therapy, nonsurgical procedures, and/or surgery.

44. Life Span Considerations
Nonsurgical treatments include:
Transurethral microwave thermotherapy (TUMT)
Prostatron employs microwaves to heat and destroy excess prostate tissue
Transurethral needle ablation (TUNA)
Delivers low-level radiofrequency energy through twin needles to burn away well-defined region of enlarged prostate

45. Audio Pronunciations Castrate Circumcision Cloning Coitus Condom
Condyloma
Cryptorchidism
crypt
= hidden
orchid
= testicle
-ism
= condition

46. Click on the screenshot to view a video on the topic of circumcision.
Circumcision Video
Click on the screenshot to view a video on the topic of circumcision.
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47. Figure 18.7
Circumcision using the Plastibell. (A) The bell is fitted over the glans. A suture is tied around the bell’s rim, and then the excess prepuce is cut away. (B) The plastic rim remains in place for 3–4 days until healing occurs.The bell may be allowed to fall off; it is removed if still in place after 8 days.

48. Figure 18.8
Genital warts. (Courtesy of the Centers for Disease Control and Prevention)

49. Figure 18.9
Cryptorchidism showing (A) undescended testes and (B) a partially descended testis.

50. Audio Pronunciations Ejaculation Epididymitis Epispadias
Erectile dysfunction
Eugenics
eu-
= good
-genic(s)
= formation, produce

51. Figure 18.10
Hypospadias and epispadias. (A) In epispadias, the canal is open on the dorsal surface. (B) In hypospadias, the urethral canal is open on the ventral surface of the penis. 51

52. Erectile Dysfunction Video
Click on the screenshot to view a video on the topic of erectile dysfunction.
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53. Audio Pronunciations Gamete Gonorrhea Gynecomastia Herpes genitalis
Heterosexual
Homosexual

54. Click on the screenshot to view a video on the topic of gonorrhea.
Gonorrhea Video
Click on the screenshot to view a video on the topic of gonorrhea.
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55. Click on the screenshot to view a video on the topic of herpes.
Herpes Video
Click on the screenshot to view a video on the topic of herpes.
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56. Audio Pronunciations Hydrocele Hypospadias Infertility Mitosis
Oligospermia
Orchidectomy
mit
= thread
-osis
= condition

57. Audio Pronunciations Orchidotomy Orchiditis Parenchyma Phimosis
Prepuce
Prostate cancer

58. Life Span Considerations
Diagnosis of prostate cancer can be confirmed with:
a medical history.
physical examination, including a rectal exam.
results of a PSA blood test.
A digital rectal exam assesses size and condition (firm, soft, hard) of the prostate gland.

59. Life Span Considerations
Prostate cancer is the second leading cause of cancer death in men, exceeded only by lung cancer.
1 in 6 men will have prostate cancer; 1 in 32 men will die of this disease.

60. Life Span Considerations
Graded and staged for aggressiveness.
CT Scans and bone scans help in staging, but sometimes it becomes clear only at the time of surgery.
Stages A and B – Confined to the prostate gland.
Stage C – Has spread to other tissues near the prostate gland.

61. Life Span Considerations
Stage D – Has spread to lymph nodes or sites a distance away from the prostate.
Depending on the grade and stage of the cancer, some management options are:
Chemotherapy
Cryosurgery to freeze cancer cells
External radiation to the prostate and pelvis
Hormone therapy

62. Life Span Considerations
Depending on the grade and stage of the cancer, some management options are:
Radioactive implants put directly into the prostate, which slowly kill cancer cells.
Surgery to remove part or all of the prostate and surrounding tissue.
Surgical removal of the testicles to block testosterone production.
Watchful waiting and monitoring only.

63. Life Span Considerations
A significant number of prostate cancer patients use complementary and alternative medicines (CAM) as part of their treatment, but many do not tell their doctors about these therapies, which could have a negative effect on their care.

64. Figure 18.12
Prostate cancer showing metastasis to the urinary bladder. Note the large tumor mass. 64

65. Digital rectal exam (DRE) showing palpitation of the prostate gland.
Figure 18.13
Digital rectal exam (DRE) showing palpitation of the prostate gland. 65

66. Audio Pronunciations Prostatectomy Prostatitis Puberty Semen
Spermatoblast
Spermatocele

67. Figure 18.11
Common disorders of the scrotum. Hydroceles and spermatoceles do not usually require treatment unless they become large and cause pain. Varicoceles are usually treated to prevent infertility.

68. Audio Pronunciations Spermatozoon Spermatogenesis Spermicide Syphilis
Testicular
sperm/i
= seed, sperm
-cide
= to kill

69. Sperm Formation Animation
Click the screenshot to view an animation of sperm formation.
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70. Audio Pronunciations
Varicocele
Vasectomy
Vesiculitis

71. Figure 18.14
Vasectomy. (A) The spermatic cords are located as they ascend from the scrotum. (B) The vas deferens are severed. (C) A 1 cm section is removed. (D) The cut ends cannot reconnect thereby preventing the passage of sperm cells and providing surgical sterilization.

72. Click on the screenshot to view a video on the topic of vasectomy.
Vasectomy Video
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73. Sexually Transmitted Diseases
STDs can occur in men, women, and children.
They are passed from person to person through sexual contact or from mother to child.

74. Insert table 18-2

75. Sexually Transmitted Diseases
Table 18.2 (continued)
Sexually Transmitted Diseases 75

76. Sexually Transmitted Diseases
Table 18.2 (continued)
Sexually Transmitted Diseases 76

77. Insert table 18-2 77

78. Sexually Transmitted Diseases
Table 18.2 (continued)
Sexually Transmitted Diseases 78

79. Insert table 18-2 79

80. Sexually Transmitted Diseases
Table 18.2 (continued)
Sexually Transmitted Diseases 80

81. Drug Highlights Testosterone
Responsible for growth, development, and maintenance of the male reproductive system and secondary sex characteristics.
Replacement therapy in primary hypogonadism and to stimulate puberty in carefully selected males.

82. Drug Highlights Testosterone
Can be used to relieve symptoms of the male climacteric due to androgen deficiency, to help stimulate sperm production in oligospermia and impotence due to androgen deficiency.
Can be used with advanced inoperable metastatic breast cancer in women who are 1 to 5 years postmenopausal.

83. Drug Highlights Testosterone Patient teaching Special considerations
Educate patient of possible adverse reactions.
Special considerations
Diabetic patients
Can decrease blood glucose and insulin requirements.
Anticoagulants
Testosterone can decrease the anticoagulant requirements of patients receiving oral anticoagulants.

84. Drug Highlights Testosterone Special considerations Anabolic steroids
Can be abused by individuals who seek to increase muscle mass, strength, and overall athletic ability.
This form is illegal, and there are many signs of abuse that one should look for.

85. Drug Highlights Drugs used to treat benign prostatic hyperplasia
Proscar
Hytrin
Cardura
Flomax

86. Drug Highlights Drugs used to treat erectile dysfunction Viagra
Levitra
Cialis

87. Diagnostic and Lab Tests
Fluorescent treponemal antibody absorption
Test performed on blood serum to detect syphilis.
Paternity
Test to determine whether a certain man is the father of a specific child. The most common and accurate test used is the DNA test.

88. Diagnostic and Lab Tests
Prostate-specific antigen (PSA) immunoassay
Blood test that measures concentrations of PSA. An increased level indicates prostate disease or possibly prostate cancer.
Semen
Test performed on semen that looks at volume, pH, sperm count, sperm motility, and morphology to evaluate infertility in men.

89. Diagnostic and Lab Tests
Testosterone toxicology
Test performed on blood serum to identify the level of testosterone.
Venereal disease research laboratory (VDRL)
Test performed on blood serum to detect syphilis.

90. Abbreviations 90

91. Combining Form Match Up Quiz
balan/o a. cut
cis/o b. glans
crypt/o c. hidden
mast/o d. testicle
orchid/o e. breast