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MALE REPRODUCTIVE

SYSTEM

OBJECTIVESOBJECTIVES

By the end of the lecture, the By the end of the lecture, the student should be able tostudent should be able to::

List the different components of List the different components of the male reproductive system.the male reproductive system.

Describe the anatomy of the Describe the anatomy of the primary & the secondary sex primary & the secondary sex organs regarding (location, organs regarding (location, function, structure, blood supply function, structure, blood supply & lymph drainage).& lymph drainage).

Describe the anatomy of the male Describe the anatomy of the male external genital organs. external genital organs. 2

Components Of Male Reproductive System

I- I- Primary Sex OrganOrgan:: Testis.Testis.

II- II- Reproductive Reproductive TractTract:: EEpididymis.pididymis. VVas Deferens.as Deferens. SSpermatic cord.permatic cord.

III- III- Accessory Sex Accessory Sex GlandsGlands:: Seminal vesicles.Seminal vesicles. Prostate gland.Prostate gland. Bulbourethral Bulbourethral

glands.glands.IV- IV- External GenitaliaExternal Genitalia::

PenisPenis 3

ScrotumScrotum An out pouching of loose An out pouching of loose skin & superficial fascia.skin & superficial fascia.

The Left scrotum is The Left scrotum is slightly lower than the slightly lower than the right.right.

Functions:Functions: Houses & Protects the Houses & Protects the

testistestis Regulates testicular Regulates testicular

temperature (no temperature (no superficial fat )superficial fat )

It has thin skin with It has thin skin with sparse hairs and sweat sparse hairs and sweat glands.glands.

The Dartos The Dartos muscle lies muscle lies within the superficial within the superficial fascia replaces fascia replaces Scarpa’sScarpa’s fascia.fascia.

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TestesTestes Paired almond-shape Paired almond-shape

gonads that suspended in gonads that suspended in the scrotum by the the scrotum by the spermatic cord.spermatic cord.

Its volume is about 20-Its volume is about 20-25 ml.25 ml.

4 - 5 cm long4 - 5 cm long Weigh (10.5 – 14 g.). Weigh (10.5 – 14 g.). Functions:Functions:

Spermatogenesis.Spermatogenesis. Hormone production:Hormone production: (Androgens--(Androgens--

testosterone)testosterone) Testis or Testis or Testicle

(singular), Testes (singular), Testes (plural).(plural).

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Epididymi

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Coverings Of Coverings Of The TestisThe Testis

Tunica Vaginalis:Tunica Vaginalis: Peritoneal covering, Peritoneal covering,

formed of parietal formed of parietal and visceral layers.and visceral layers.

It surrounds testis It surrounds testis & epididymis.& epididymis.

It allows free It allows free movement of testis movement of testis within the scrotum.within the scrotum.

Tunica albugeniaTunica albugenia It is a whitish It is a whitish

fibrous capsule.fibrous capsule.

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TV

Internal Structure Internal Structure of The Testisof The Testis

Fibrous septae extend from the Fibrous septae extend from the capsule, divide the testis into a capsule, divide the testis into a (200-300) -average 250- (200-300) -average 250- lobules.lobules.

Each lobule contains, Each lobule contains, (1-3) (1-3) seminiferous tubules. seminiferous tubules. Seminiferous Tubules: (60 cm Seminiferous Tubules: (60 cm coiled tubule).coiled tubule).They are the site of the They are the site of the spermatogenesis.spermatogenesis.They form the bulk of They form the bulk of testicular tissue.testicular tissue.Interstitial cells of Leydig Interstitial cells of Leydig secret Testosterone.secret Testosterone.Rete testis:Rete testis: A network of tubules.A network of tubules.It is the site of merging of the It is the site of merging of the Seminiferous tubules.Seminiferous tubules. 7

RT

Blood Supply Blood Supply of Testisof Testis

Testicular artery:Testicular artery:

It arises from the abdominal It arises from the abdominal aorta at the level of L 3.aorta at the level of L 3.

Venous drainage : Venous drainage :

(Pampiniform plexus of veins.(Pampiniform plexus of veins.

About dozen of veins which About dozen of veins which forms a network in the forms a network in the spermatic cord. spermatic cord.

They become larger, They become larger, converge as it approached converge as it approached the inguinal canal to form the inguinal canal to form the the Testicular vein.Testicular vein.

Right Vein drains into IVC.Right Vein drains into IVC. Left Vein drains into left Left Vein drains into left

renal vein.renal vein.

Testicular Artery

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Testicular Lymphatics: Follow arteries, veins End in Lumbar (par

aortic) nodes.

Scrotum, Penis and Prepuce: Terminate in Superficial inguinal nodes

Testicular Lymphatics: Follow arteries, veins End in Lumbar (par

aortic) nodes.

Scrotum, Penis and Prepuce: Terminate in Superficial inguinal nodes

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Indication: Evaluation of testicular pain in case of (Testicular Torsion). Technique Examiner strokes or pinches the skin in the upper medial thigh. It causes cremasteric muscle contractionObserve, rise of the Testicle on same side (normal) Interpretation

Normal: It is present with Epididymitis Absent( cremasteric reflex) (no Testicle rise) Is Suggestive of Testicular Torsion.

Also absent in 50% of boys under age Also absent in 50% of boys under age 30 30 months. Do not use this test under age of 30 months. Efficacy.Test Sensitivity for Testicular Torsion: 99%

Assumes age over 30 months Nerve involved: Genitofemoral (GFN), ( L 1, 2)Sensory: femoral branch of (GFN) & Ilioinguinal n. Motor: Genital branch of (GFN).

Cremasteric reflex

EpididymisEpididymisA Single coiled tubuleA Single coiled tubule 6 Meters long.6 Meters long. Located on the superior Located on the superior and posterior margins of and posterior margins of the testis.the testis. It is divided into 3 parts:It is divided into 3 parts:Head, Body and Tail.Head, Body and Tail.

The The HeadHead receives (rete receives (rete testis) efferent ductules testis) efferent ductules from the testis.from the testis.The The TailTail is continuous with is continuous with Vas Deferens. Vas Deferens. Functions:Functions:

1. Secretes/absorbs the 1. Secretes/absorbs the nourishing fluid.nourishing fluid.2. Recycles damaged 2. Recycles damaged spermatozoa.spermatozoa.3. Stores spermatozoa3. Stores spermatozoa Up Up to 2 weeks to allow for to 2 weeks to allow for maturation.maturation.

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Vas DeferensVas Deferens A muscular tube A muscular tube

45 cm 45 cm long.long. Carries sperms Carries sperms

from the from the epididymisepididymis to to pelvic cavity.pelvic cavity.

Passes through the Passes through the inguinal canal. inguinal canal.

It crossesIt crosses the the ureter.ureter.

Its terminal part is Its terminal part is dilated to form the dilated to form the Ampulla of the vasAmpulla of the vas

It joins the duct of It joins the duct of the seminal vesicle the seminal vesicle to form ejaculatory to form ejaculatory duct which opens duct which opens in the prostatic in the prostatic urethra.urethra.

12Prof. Makarem

Accessory Accessory GlandsGlands

Seminal vesicle.Seminal vesicle. Bulbourethral Bulbourethral

or Cooper’s or Cooper’s glands.glands.

Prostate.Prostate. Functions:Functions:

1. Secretion of 1. Secretion of seminal fluid.seminal fluid.

2. Nourishing, 2. Nourishing, activation of activation of sperms.sperms.

3. Protection of 3. Protection of sperms.sperms.

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Seminal Seminal VesiclesVesicles

Paired elongated Paired elongated glands.glands.

Located posterior Located posterior & inferior to the & inferior to the urinary bladderurinary bladder

Secrete (60% of Secrete (60% of Semen)Semen)

SVSV

BASE OF THE

URINARY BLADDER

VD

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Prostate

Ejaculatory Ejaculatory DuctsDucts

Formed by the Formed by the union of theunion of the lower lower end of the vas end of the vas deferens and the deferens and the duct of the seminal duct of the seminal vesicle.vesicle.

Its length is about Its length is about 2.5cm.2.5cm.

The 2 ejaculatory The 2 ejaculatory ducts open into the ducts open into the prostatic urethra on prostatic urethra on both sides of the both sides of the seminal colliculus.seminal colliculus.They drain the They drain the seminal fluid into seminal fluid into the prostatic the prostatic urethra.urethra. 15

Prostate Prostate GlandGland

The Largest male accessory gland. The Largest male accessory gland. It is a fibromuscular glandular It is a fibromuscular glandular

tissue.tissue.Walnut sized.Walnut sized.Located at the neck of bladder.Located at the neck of bladder.Traversed by the prostatic Traversed by the prostatic

urethra.urethra.Secretes (20-30% of semen)Secretes (20-30% of semen)Shape:Shape: Conical, It has: Conical, It has: Base (Superior): Base (Superior): Attached to neck of urinary Attached to neck of urinary

bladderbladder

Apex (Inferior), rests Apex (Inferior), rests on the on the Urogenital diaphragmUrogenital diaphragm..

Four Surfaces: Four Surfaces: Anterior, posterior Anterior, posterior and 2 lateral (Right & Left).and 2 lateral (Right & Left).

It secretes enzymes which It secretes enzymes which has has the following the following functionsfunctions::

Aid in activating sperm motilityAid in activating sperm motility Mucus degradationMucus degradation Neutralize female reproductive Neutralize female reproductive

tract (Alkaline fluid )tract (Alkaline fluid )

PU

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CapsuleCapsule

Internally, it has a dense Internally, it has a dense fibrous capsule (prostatic fibrous capsule (prostatic capsule)capsule), which is , which is surrounded from osurrounded from outside utside by a by a fibrous prostatic fibrous prostatic sheath.sheath.

The later The later is continuous is continuous with the puboprostatic with the puboprostatic part of the levator ani part of the levator ani muscle. (levator prostate).muscle. (levator prostate).

In between the In between the prostatic prostatic capsulecapsule and the prostatic and the prostatic facial sheath lies the facial sheath lies the prostatic venous plexus.prostatic venous plexus.

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RelationsRelationsAnteriorAnterior:: Symphysis pubis Symphysis pubis

(SP).(SP).

SuperiorSuperior : :

Neck of the bladder.Neck of the bladder.

PosteriorPosterior : :

Rectum ® Rectum ® (important for PR (important for PR eexamination)xamination)

InferiorInferior: :

Urogenital Urogenital diaphragmdiaphragm, , (UGD).(UGD).

LateralLateral: : Medial Medial margins of levator margins of levator ani muscles ani muscles (levator prostate).(levator prostate).

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UB

UGD

SP

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UB

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LobesLobes AnatomicallyAnatomically It is divided into It is divided into 5 lobes 5 lobes according to their according to their

relation to the urethra:relation to the urethra: Anterior (isthmusAnterior (isthmus): ): Lies anterior to the urethra, Lies anterior to the urethra, It is fibromuscular.It is fibromuscular. PosteriorPosterior:: Posterior to the urethra and inferior to the Posterior to the urethra and inferior to the

ejaculatory ducts.ejaculatory ducts. Two lateralTwo lateral:: On each side of the urethra.On each side of the urethra. Middle (median)Middle (median): : Between the urethra and ejaculatory ducts & Between the urethra and ejaculatory ducts &

closely related to neck of urinary bladder.closely related to neck of urinary bladder. Usually it projects into lumen of Usually it projects into lumen of

the bladder distorting the the bladder distorting the internal urethral sphincter, after internal urethral sphincter, after the age of 40 years.the age of 40 years.

The median & lateral lobes are The median & lateral lobes are rich in glandular tissue.rich in glandular tissue. 19

Urologists & Urologists & Sonographers, Sonographers, divide divide the prostate into the prostate into central central (internal(internal) & ) & peripheral peripheral zones.zones.

The The central zone central zone is is represented by the represented by the middle lobe.middle lobe.

Within each lobe are Within each lobe are four lobules, which are four lobules, which are defined by the ducts defined by the ducts and connective tissueand connective tissue

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Blood Supply & Lymph Drainage Blood Supply & Lymph Drainage

Arterial Supply:Arterial Supply:

Inferior vesical artery from IIA.Inferior vesical artery from IIA.

Prostatic venous plexusProstatic venous plexus::

Lies between the Lies between the prostatic fibrous prostatic fibrous capsulecapsule and the prostatic sheath. and the prostatic sheath.

It drains into the It drains into the internal iliac internal iliac veinsveins..

It is continuous superiorly with the It is continuous superiorly with the vesical venous plexus and vesical venous plexus and posteriorly to the internal vertebral posteriorly to the internal vertebral venous plexus. venous plexus. Importance? Importance?

Lymph drainage:Lymph drainage:

Internal iliac lymph nodes. Internal iliac lymph nodes. 21

Hypertrophy of the ProstateHypertrophy of the Prostate Benign Benign Common after middle age.Common after middle age. An enlarged prostate projects into the urinary An enlarged prostate projects into the urinary

bladder and bladder and ddistortsistorts the prostatic urethra. the prostatic urethra. The middle lobe often enlarges and obstructs The middle lobe often enlarges and obstructs

the internal urethral orifice, this leads to the internal urethral orifice, this leads to nocturia, dysuria and urgency.nocturia, dysuria and urgency.

MalignantMalignant::

It is common after the age of 55It is common after the age of 55

The malignant prostate is felt hard & irregular in The malignant prostate is felt hard & irregular in Per rectal examination (PR) .Per rectal examination (PR) .

The malignant cells metastasize first to internal The malignant cells metastasize first to internal iliac & sacral lymph nodes (lymphatic spread)iliac & sacral lymph nodes (lymphatic spread)

Later to distant nodes , bone & brain through Later to distant nodes , bone & brain through (IVVP) -venous spread.(IVVP) -venous spread.

It can cause obstruction to urine flow because of It can cause obstruction to urine flow because of its close relationship to the prostatic urethra.its close relationship to the prostatic urethra. 22

Prostatic Prostatic UrethraUrethra

Structures seen on its posterior wall:Structures seen on its posterior wall:

Urethral crest:Urethral crest: A longitudinal elevated ridge.A longitudinal elevated ridge.

Prostatic sinusProstatic sinus::

A groove on each side of the crest.A groove on each side of the crest. The prostatic gland The prostatic gland

opens into the sinuses.opens into the sinuses.

Seminal colliculusSeminal colliculus: : a rounded a rounded eminence that opens intoeminence that opens into the the prostatic utricle.prostatic utricle.

Prostatic utricle Prostatic utricle :: A depression on the summit of A depression on the summit of

the urethral crest.the urethral crest. The ejaculatory ducts open on The ejaculatory ducts open on

the sides of the utricle.the sides of the utricle.

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BulbourethBulbourethral or ral or

Cooper’s Cooper’s Gland Gland

Small paired Small paired glandsglands

Located at the Located at the base of the penis.base of the penis.

Secrete alkaline Secrete alkaline mucus for:mucus for:

Neutralization Neutralization of urinary of urinary acids &acids &

LubricationLubrication

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PenisPenis A Copulatory & A Copulatory &

Excretory organ.Excretory organ. Excretory:Excretory: Penile urethra Penile urethra

transmits urine & transmits urine & sperm.sperm.

Copulatory:Copulatory: Has (3) Has (3)

cylindrical cylindrical masses of erectile masses of erectile tissuetissue Two Two Corpora Corpora

CavernosaCavernosa One One Corpus Corpus

SpongiosumSpongiosum

CCCS

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Corpora Corpora CavernosaCavernosa

Two superior Two superior (right & left) (right & left) masses ofmasses of

((Primary erectile Primary erectile tissue).tissue).They Provide the They Provide the majority of majority of rigidity & length rigidity & length of penis.of penis.Their posterior Their posterior expansions, expansions, forms forms the 2 the 2 CruraeCrurae (anchor” tissue) (anchor” tissue) against pelvic against pelvic bonebone

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Corpus Corpus SpongiosumSpongiosum

The single inferior The single inferior massmass

((Secondary erectile Secondary erectile tissue)tissue)It is traversed by the It is traversed by the penile urethra.penile urethra.Its Anterior expansion Its Anterior expansion forms the forms the Glans penis.Glans penis.Its posterior Its posterior expansion expansion formsforms the the bbulb of the penis.ulb of the penis.Prepuce or Prepuce or foreskinforeskin:: Fold of skin covering Fold of skin covering glans penis (before glans penis (before circumcision)circumcision) 27

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&&GOOD GOOD LUCKLUCK