Reproductive

• Hypospadias


  Abnormal urethral opening is found on the ventral aspect of the penis
• Epispadias


  Abnormal urethral orifice on the dorsal aspect of the penis
• Balanitis and Balanoposthitis


  Local inflammation of glans penis
• Smegma


  Accumulation of desquamated epithelial cells, sweat and debris
• Phimosis


  Prepuce cannot be retracted easily over glans penis
• Penile squamous cell carcinoma


  Uncircumcised males > 40 years old, smoker, HPV 16 and 18, poor hygiene
• Squamous cell carcinoma in situ (Bowen Disease)

  Solitary plaque on the shaft of penis
• Invasive squamous cell carcinoma

  Gray, crusted, popular lesion on glans penis or prepuce
• Hydrocele


  Accumulation of serous fluid within tunica vaginalis; most common cause of scrotal swelling
• Cryptorchidism


  Failure of testicular descent into the scrotum
• Cryptorchidism


  Carries 3- to 5- fold higher risk for testicular cancer
• Nonspecific Epididymitis & Orchitis


  Begin as primary UTI that spreads to the testis through vas deferens or lymphatics
• Torsion


  Twisting of spermatic cord -> obstruction of venous drainage
• 95% of testicular tumors arise from germ cells; malignant

  
• HCG


  Produced by syncytiotrophoblasts; elevated with Choriocarcinoma, Seminoma
• AFP


  Elevated with Yolk Sac Tumor
• Categories of Prostatitis


  • Acute Bacterial Prostatitis
  • Chronic Bacterial Prostatitis
  • Chronic Pelvis Pain Syndrome
• Benign Prostatic Hyperplasia


  Common cause of prostatic enlargement resulting to proliferation of stromal and glandular elements; occurs in inner transition zone of the prostate
• Prostate Adenocarcinoma


  Most common CA of men 65-75 y.o; carcinomas arise most commonly in outer, peripheral zone of gland
• Gleason system


  Grading of prostate cancer
• Serum PSA


  Clear value in monitoring progressive or recurrent prostate cancer
• Syphilis - Primary


  Painless lesions - Chancre on external genitalia
• Syphilis - Secondary


  Generalized lymphadenopathy, mucocutaneous lesions - Condylomata lata
• Syphilis - Tertiary


  Systemic; granulomatous lesions - gummas in multiple organs
• Syphilis - Microscopic


  Proliferative endarteritis with plasma cells
• Syphilis - Diagnostic test

  Nontreponemal antibody tests - VDRL and RPR
• Gonorrhea


  Dysuria and milky purulent urethral discharge; suppurative inflammatory reaction
• 30% of men with gonococcal urethritis also infected with C. trachomatis
• Nongonococcal urethritis and cervicitis

  C. trachomatis, Mycoplasma genitalium, T. vaginalis, Ureaplasma urealyticum; most common forms of STD
• Lymphogranuloma venereum


  Chronic, ulcerative disease; mixed granulomatous and neutrophilic inflammatory response; lymphedema
• Chancroid (soft chancre)


  Acute, ulcerative disease; papule to ulcer in superficial zone of neutrophilic debris and fibrin
• Granuloma inguinale


  Chronic inflammatory disease; genital ulceration + abundant granulation tissue; pseudoepitheliomatous hyperplasia; Donovan bodies
• Human papillomavirus


  Squamous proliferations in the genital tract - condyloma acuminatum; venereal warts - HPV 6 and 11
• Trichomoniasis


  Protozoan frequent cause of vaginitis; pruritus and profuse, frothy, yellow vaginal discharge

  
• Genital herpes simplex


  Primary: asymptomatic or painful, erythematous, intraepithelial vesicles on mucosa and genitalia skin + regional LN enlargement; Recurrent: less painful, less extensive
• Genital herpes simplex - Histologic exam


  Necrotic cells, fused multinucleate giant cells with intranuclear inclusions (Cowdry Type A)
• Lichen Sclerosus


  Atrophic epithelium, subepithelial dermal fibrosis, bandlike chronic inflammation
• Lichen Simplex Chronicus


  Thickened epithelium with dermal inflammatory infiltrate
• Condylomas


  Warty lesion of the vulva; histologic - koilocytosis; HPV subtypes 6 and 11
• Vulvar Squamous Cell Carcinoma

  Histologic - leukoplakia; HPV subtype 16