00:01
Here we’ll take a look at the
male reproductive pathology.
00:03
And just like we have done
in many organ systems,
we shall also approach this
in an organized fashion.
00:09
Let’s begin.
00:13
We’ll begin our discussion by
looking at congenital male
reproductive pathology and here,
you’ll notice just a couple of
topics in which which I’ve
kind of integrated them
so that you can get a good
idea as to what you can expect
in terms of development
of the testis.
00:29
If you notice a picture
on the left --
So this will be embryologically.
00:34
If you notice on the
left that the fetus
and the testis are located
up in the abdomen.
00:40
And at some point in time,
the gubernaculum,
which you see in picture B here
is going to literally pull the
testis down into the scrotum.
00:49
And there’s a
condition in which,
if at any point in the testis do not
properly descend into the scrotum,
we have problems of
undescended testis.
00:59
In other words, cryptorchidism.
01:01
We’ll talk about that in greater detail
when we talk about testicular tumors.
01:05
Anytime there is
cryptorchidism or there is
improper descent of the
testis into the scrotum,
then you’re worried
about cancer developing
in your male, unfortunately.
01:17
Next,
we have a little structure here
called the processus vaginalis.
01:21
Just a quick little
overview of anatomy here.
01:24
And on the bottom,
you’ll notice numbers.
01:27
And number one,
when we get to letter D
here in the illustration,
is what if you had openings
either on the dorsum or the
ventral aspect of the penis.
01:38
You call this either hypo-
which means the bottom,
but more importantly, make sure that
you know the description of it.
01:45
So even though this is bottom of the
penis, you then call this what?
The?
Good.
01:50
Ventral portion.
01:51
Clear?
So now, what is your patient
what is your child
predisposed to?
Infection.
01:57
Infection.
01:58
Hypospadia more common than epispadia
but there are complications
that you want to know for both.
02:04
In hypospadia,
it is once again the ventral
portion of the penis
that is failure to fuse if you
remember from embryology.
02:12
Whereas epispadia, as the
name implies, would be the –
Well, that would be
the top of the penis,
but they’re not going to
say “top of the penis.”
Clinically, they’ll call it what?
The dorsum.
02:20
Same concept.
02:22
What’s the dorsum of your foot?
When you say dorsiflex,
what are you doing?
You’re taking the foot
and you’re moving it towards
your leg, aren’t you?
Well, here, you have
the top of the penis,
which is the epispadia.
02:31
Failure to fusion here, what’s
your complication in a child?
It’s called bladder extrophy.
02:37
E – epispadia. E – extrophy.
02:41
Now the complications as I said,
hypoaspadia is more
common than epispadia.
02:45
Take a look at number
one so that you know
as to where you are
vicinity-wise.
02:49
Number two, as the name
implies, well, bladder exstrophy.
02:52
But in addition to that,
there are a couple of other things
here that you want to know.
02:56
If you have failure of your
lateral fusion of your abdomen,
then you can have what’s
known as an omphalocele.
03:03
And an omphalocele would
mean that you have
herniation of the
abdominal organs in a child.
03:09
And when this happens,
it is still covered
by the peritoneum.
03:12
Keep that in mind.
03:13
Omphalocele, the failure
of lateral fusion.
03:16
In embryology, we’ve also
looked at gastroschisis
and that would mean that the
peritneum is not covered.
03:22
A couple embryologic issues.
03:24
Hydrocele:
Well, with hydrocele (see number 3),
what ends up happening is that
there’s accumulation of
fluid surrounding the testis,
between the visceral and parietal layers of the tunica vaginalis.
03:38
And we’ll talk more about
hydrocele when the time is right
and we’ll compare
hydrocele to varicocele.
03:43
And for us, varicocele will play
more of a role in pathology,
but hydrocele,
just as important.
03:50
A quick little overview
of your embryology
and then some of the associated
pathologies that you’ve seen.
03:55
Let us keep moving.