Male genital system Systema genitalium masculinum Morphology

Male genital systemMale genital systemSystema genitalium Systema genitalium

masculinummasculinum

MorphologyMorphology

Organa genitalia masculina internaOrgana genitalia masculina interna

Testis (Testis (gr. gr. orchis)orchis)EpididymisEpididymisFuniculus spermaticus = spermatic cord Funiculus spermaticus = spermatic cord

including ductus deferens (= vas deferens)including ductus deferens (= vas deferens)

Glandula vesiculosa / seminalis Glandula vesiculosa / seminalis (Vesiculae seminales) = seminal gland / (Vesiculae seminales) = seminal gland / vesiclevesicle

Prostata = prostateProstata = prostateGlandula bulbourethralis = bulbo-urethral Glandula bulbourethralis = bulbo-urethral

glandgland

Organa genitalia masculina externaOrgana genitalia masculina externa

PenisPenis Urethra masculina Urethra masculina

= male urethra= male urethra ScrotumScrotum

TestisTestis ((grgr. orchis). orchis)

Description Description extremitas (pole) sup. + inf, extremitas (pole) sup. + inf,

margo (border) ant. + post. , margo (border) ant. + post. , facies (surface) med. + lat.facies (surface) med. + lat.

CoversCovers tunica vaginalis et albugineatunica vaginalis et albuginea

SectionSection septula, mediastinum, lobuli, septula, mediastinum, lobuli,

reterete Tubuli seminiferti contorti Tubuli seminiferti contorti

recti recti Ligaments Ligaments

gubernaculum testisgubernaculum testis

TestesTestes - - histologyhistology

Tunica albugineaTunica albuginea Lobuli testisLobuli testis Tubuli seminiferiTubuli seminiferi

spermatogennic epithelium (structure )spermatogennic epithelium (structure ) Spermatogennic cells – various stades - takes 64 daysSpermatogennic cells – various stades - takes 64 days Sertoli´s cells (nutrition, testicular fluid, androgen-binding Sertoli´s cells (nutrition, testicular fluid, androgen-binding

protein ABS, anti-müllerian hormone AMH=MIS, zonulae protein ABS, anti-müllerian hormone AMH=MIS, zonulae occludentes: hematotesticular barrier)occludentes: hematotesticular barrier)

Intestitium Intestitium Leydig´s cells Leydig´s cells testosteron testosteron Collagen tissue, fenestrated capillaries, fibroblasta, Collagen tissue, fenestrated capillaries, fibroblasta,

histiocytes, macrophageshistiocytes, macrophages

Excretory genital ductsExcretory genital ducts Tubuli recti Tubuli recti

cuboideal Sertolli´s cellscuboideal Sertolli´s cells Rete testisRete testis

cuboideal Sertolli´s cellscuboideal Sertolli´s cells Ductuli efferentes Ductuli efferentes

columnar epithelium with columnar epithelium with stereocilia and ciliastereocilia and cilia

Ductus epididymidisDuctus epididymidis pseudostratified columnar pseudostratified columnar

epithelium with stereociliaepithelium with stereocilia Inhibition of capacitationInhibition of capacitation

Ductus deferens Ductus deferens thick muscular wallthick muscular wall pseudostratified columnar pseudostratified columnar

epitheliumepithelium Ductus ejaculatorius Ductus ejaculatorius

no muscle layer !no muscle layer !

EpididymisEpididymis

DescriptionDescriptioncaput, corpus, caudacaput, corpus, cauda

Section Section lobuli, ductuslobuli, ductus

Ligaments Ligaments lig. epididymidis sup. + inf.lig. epididymidis sup. + inf.

Testis + epidydimisTestis + epidydimis arterial supplyarterial supply

aorta abdominalis aorta abdominalis a. testicularisa. testicularis

branches enter lobuli from the branches enter lobuli from the periphery, not in the hilum !periphery, not in the hilum !

auxilliary blood supplyauxilliary blood supply a. iliaca interna a. iliaca interna

a. umbilicalisa. umbilicalis a. ductus deferentisa. ductus deferentis

a. iliaca externaa. iliaca externa a. epigastrica inf.a. epigastrica inf.

a . cremastericaa . cremasterica

mutual anastomosismutual anastomosis

Testis and epididymisTestis and epididymis other supply other supply

VeinsVeins: : rete testis rete testis plexus pampiniformisplexus pampiniformis vv. testiculares vv. testiculares

v. cava inf. (dx.), v. renalis (sin.) v. cava inf. (dx.), v. renalis (sin.)

Lymph drainageLymph drainage: : nodi lymphoidei nodi lymphoidei lumbaleslumbales

NervesNerves:: plexus testicularis plexus testicularis

sympatheticsympathetic by plexus coeliacus + intermesentericus, by plexus coeliacus + intermesentericus, parasympathetic parasympathetic by n. vagus !!!by n. vagus !!!

Developmental rudimentsDevelopmental rudiments

from mesonephric from mesonephric canalscanals

paradidymis paradidymis ((Giraldes´Giraldes´ organ) organ)

ductuli aberrantes ductuli aberrantes (sup. + inf.)(sup. + inf.)

appendix appendix epididymidisepididymidis

from Mfrom Müüllerian ductllerian duct appendix testisappendix testis

Ductus Ductus deferensdeferens

(Vas deferens)(Vas deferens)

pars scrotalispars scrotalispars pars

funicularisfunicularispars inguinalispars inguinalispars pelvicapars pelvicaampulla d.dampulla d.d

crossingscrossings

Ductus deferens / Vas deferensDuctus deferens / Vas deferensTunica mucosa – Tunica mucosa – pseudostratified columnar pseudostratified columnar

epithelium with stereociliaepithelium with stereocilia

Tunica muscularis – Tunica muscularis – 3 layers of smooth muscle 3 layers of smooth muscle (L, C, L)(L, C, L)

AdventitiaAdventitia

tough as a goose-quill tough as a goose-quill

folds, very thick muscle layerfolds, very thick muscle layer

EmissionEmission = sperms transport to colliculus = sperms transport to colliculus seminalis prostataeseminalis prostatae

Ductus deferens / Vas deferensDuctus deferens / Vas deferenssupplysupply

Arteries: Arteries: a. iliaca int. a. iliaca int. a. umbilicalis a. umbilicalis a. ductus deferentis a. ductus deferentis

Veins:Veins: plexus pampiniformis, plexus venosus vesicalisplexus pampiniformis, plexus venosus vesicalis

Lymph drainage:Lymph drainage: n.l. iliaci ext. + int.n.l. iliaci ext. + int.

Nerves:Nerves: plexus deferentialisplexus deferentialis

Funiculus spermaticusFuniculus spermaticus(Spermatic cord)(Spermatic cord)

coverscovers

tunica dartostunica dartos fascia spermatica externafascia spermatica externa m. cremaster cum fascia cremastericam. cremaster cum fascia cremasterica fascia spermatica internafascia spermatica interna

derivated from the anterior abdominal wall by derivated from the anterior abdominal wall by descensus testisdescensus testis

Funiculus spermaticusFuniculus spermaticuscontentcontent

a. ductus deferentis (a. ductus deferentis ( a.iliaca int.) a.iliaca int.) a. testicularis (a. testicularis ( aorta abdominalis) aorta abdominalis) plexus pampiniformis (venous plexus) plexus pampiniformis (venous plexus) v. cava v. cava

inf.inf.

ductus deferensductus deferens a. et v. cremasterica (a. et v. cremasterica ( a. epigastrica inf.) a. epigastrica inf.) vestigium processus vaginalis peritoneivestigium processus vaginalis peritonei plexus deferentialis et testicularis (= nervous plexus deferentialis et testicularis (= nervous

plexuses)plexuses) lymph vessels (along veins)lymph vessels (along veins)

Funiculus spermaticus - Funiculus spermaticus - HEHE

Glandula vesiculosa /seminalisGlandula vesiculosa /seminalis (incorrectly Vesiculae seminales)(incorrectly Vesiculae seminales)

= seminal gland / vesicle = seminal gland / vesicle PositionPosition: behind the urinary bladder, : behind the urinary bladder, in in

connection with peritoneum! – excavatio connection with peritoneum! – excavatio rectovesicalisrectovesicalis

Ductus excretorius Ductus excretorius ductus ejaculatorius ductus ejaculatorius cuboideal-to-pseudostratified epithelium, cuboideal-to-pseudostratified epithelium, folded folded

mucosamucosa MusclesMuscles: 2 smooth layer – circular (inner) and : 2 smooth layer – circular (inner) and

longitudinal (outer)longitudinal (outer) FunctionFunction: 70% of seminal fluid, pH 7,2 –7,6 : 70% of seminal fluid, pH 7,2 –7,6

/proteins + fructose + prostaglandins + citrate//proteins + fructose + prostaglandins + citrate/

Glandulae vesiculosae - Glandulae vesiculosae - HEHE

ProstataProstataProstateProstate

SectionSection: lobuli (4), : lobuli (4), ductuli, parenchymaductuli, parenchyma

Pars prostatica Pars prostatica urethraeurethrae colliculus seminaliscolliculus seminalis utriculus prostaticusutriculus prostaticus sinus prostaticussinus prostaticus

Position:Position: m. puboprostaticusm. puboprostaticus under urinary bladderunder urinary bladder subperitoneal organsubperitoneal organ

Outer descriptionOuter description: basis, apex, facies /3/, isthmus: basis, apex, facies /3/, isthmusLobi prostatae:Lobi prostatae: dexter et sinister /4 lobuli each / dexter et sinister /4 lobuli each / (Lobus medius)(Lobus medius)Pars prostatica urethrae + ductus ejaculatoriusPars prostatica urethrae + ductus ejaculatorius

ProstataProstata((Prostate)Prostate)

sectionsection

urethral glandsurethral glands zonezone + + ductuli prostaticiductuli prostatici

Inner Inner (transitory) (transitory) zonezone tuboalveolar glandstuboalveolar glands

outerouter (peripheral) (peripheral) zonezone less glands + less glands +

fibromuscular stroma (= fibromuscular stroma (= substantia muscularis)substantia muscularis)

capsula prostaticacapsula prostatica (plexus venosus (plexus venosus

prostaticus)prostaticus)

Prostata + glandulae vesiculosaeProstata + glandulae vesiculosae supplysupply

arteriesarteries: branches of : branches of a. iliaca int.a. iliaca int. a. ductus deferentisa. ductus deferentis a. vesicalis inferiora. vesicalis inferior a. rectalis mediaa. rectalis media

veinsveins: plexus venosus : plexus venosus prostaticus + vesicalis prostaticus + vesicalis v. iliaca int. v. iliaca int.

lymph drainagelymph drainage:: n. l. iliaci int. + ext.n. l. iliaci int. + ext. n.l. sacralesn.l. sacrales (prostate (prostate

only!)only!) nervesnerves: plexus : plexus

hypograstricus inf. hypograstricus inf. plexus prostaticusplexus prostaticus

Prostata - Prostata - HEHE

Prostata - Prostata - WvGWvG

ProstateProstate – – function and diseasesfunction and diseases

30-50 tuboalveolar glands 30-50 tuboalveolar glands Seminal fluidSeminal fluid: 30%, pH 6,4 /zinc, citrate, : 30%, pH 6,4 /zinc, citrate,

prostaglandins, spermin and spermidin, prostaglandins, spermin and spermidin, proteases, acid phosphatase, Ig, PSA/proteases, acid phosphatase, Ig, PSA/

benign hyperplasiabenign hyperplasia (50% men over 50 years), (50% men over 50 years), symptoms – hyperplasia of glands in the inner zone! symptoms – hyperplasia of glands in the inner zone! outer zone changes into the thin and tough so-outer zone changes into the thin and tough so-

called called surgical capsulesurgical capsule malign tumourrmalign tumourr – 85% arise in outer zone – 85% arise in outer zone

blood level of prostatic phase of acid blood level of prostatic phase of acid phosphatase phosphatase

Glandulae bulbourethrales Glandulae bulbourethrales CowperiCowperi

pairedpaired composed mucinous tuboalveolar glandscomposed mucinous tuboalveolar glands pea-sizedpea-sized from under the m. transversus perinei profundusfrom under the m. transversus perinei profundus short ductus gl. bulbourethralisshort ductus gl. bulbourethralis opens into opens into ampulla ampulla urethrae (widened beggining urethrae (widened beggining

of pars spongiosa)of pars spongiosa) gland productgland product: clear sticky, enables sperm : clear sticky, enables sperm

sliding in urethrasliding in urethra

Male urethraMale urethra ostium urethrae internumostium urethrae internum (accipiens, (accipiens,

evacuans)evacuans) pars intramuralispars intramuralis pars prostaticapars prostatica (pars proximalis x distalis, (pars proximalis x distalis,

colliculus seminalis, utriculus prostaticus, m. colliculus seminalis, utriculus prostaticus, m. sphincter urethrae internus)sphincter urethrae internus)

pars intemediapars intemedia (= membranacea) (= membranacea) pars spongiosapars spongiosa ( (ampullaampulla, , fossa navicularisfossa navicularis + +

valvula, lacunae et glandulae urethrales, valvula, lacunae et glandulae urethrales, ductus paraurethrales)ductus paraurethrales)

ostium urethrae externumostium urethrae externum constrictionsconstrictions (4) and enlargements (3) (4) and enlargements (3) clinicallyclinically: front and hind urethra: front and hind urethra

PenisPenis DescriptionDescription: radix, crura, corpus, dorsum, facies : radix, crura, corpus, dorsum, facies

urethralis, glans /corona, collum/, preputium urethralis, glans /corona, collum/, preputium /frenulum/, raphe/frenulum/, raphe

StructureStructure: corpora cavernosa et corpus : corpora cavernosa et corpus spongiosum /bulbus/, tunica albuginea, septum spongiosum /bulbus/, tunica albuginea, septum ((incomplete)incomplete)

Section:Section: trabeculae, cavernae, glandulae trabeculae, cavernae, glandulae preputiales preputiales TysoniTysoni

CoversCovers: fascia penis superficialis + profunda: fascia penis superficialis + profunda FixationFixation: ligamentum fundiforme et : ligamentum fundiforme et

suspensorium, crura penissuspensorium, crura penis

Penis - Penis - supplysupply arteriesarteries: :

branches of branches of a. pudenda internaa. pudenda interna (a. dorsalis et profunda penis, (a. dorsalis et profunda penis, a. urethralis, a. bulbi penis) a. urethralis, a. bulbi penis) aa. helicinae (+ aa. helicinae (+ Ebner´s Ebner´s pillowspillows) ) vv. cavernosae vv. cavernosae

veinsveins: : v. dors. penis spf. v. dors. penis spf. vv. pudendae ext. vv. pudendae ext. v. femoralisv. femoralis v. dors. p. prof. + v. bulbi penis + v. urethralis v. dors. p. prof. + v. bulbi penis + v. urethralis v. pudenda v. pudenda

int. int. v. iliaca int. v. iliaca int. lymph drainagelymph drainage: :

n.l. n.l. inguinales superficialesinguinales superficiales ( (skinskin), ), profundi profundi ((glansglans) et ) et iliaci iliaci interniinterni (cavernous and spongious bodies, urethra) (cavernous and spongious bodies, urethra)

nervesnerves: : n. pudendus (n. pudendus (sympathetic - sympathetic - plexus hypogastricus inf., plexus hypogastricus inf.,

parasympatheticparasympathetic- nn. splanchnici pelvici S2-4)- nn. splanchnici pelvici S2-4) glans penis is the best innervated skin area in the body!glans penis is the best innervated skin area in the body!

Penis - Penis - HEHE

ScrotumScrotumDescriptionDescription: raphe, septum /: raphe, septum /complete!complete!//Wall structureWall structure: anterior abdominal wall : anterior abdominal wall

derivates + tunica dartosderivates + tunica dartos

ArteriesArteries: : a. femoralisa. femoralis aa. pudendae ext., aa. pudendae ext., a. iliaca int. a. iliaca int. a. pudenda int.a. pudenda int., a. , a. cremasterica pro obalycremasterica pro obaly

VeinsVeins: vv. scrotales ant. : vv. scrotales ant. v. femoralisv. femoralis

vv. scrotales post. vv. scrotales post. v. pudenda int.v. pudenda int.

Scrotum - Scrotum - supplysupply

lymph drainagelymph drainage: : n.l. inguinales n.l. inguinales superficialessuperficiales

No testis puncture because of possible No testis puncture because of possible tumour cells spreadingtumour cells spreading

nervesnerves: : anterior 1/3 (n. ilioinguinalis + r. genitalis n. anterior 1/3 (n. ilioinguinalis + r. genitalis n.

genitofemoralis)genitofemoralis)posterior 2/3 – (n. pudendus + n. cutaneus posterior 2/3 – (n. pudendus + n. cutaneus

femoris post.)femoris post.)

Abdominal wall x Scrotal wallAbdominal wall x Scrotal wall

skinskin Camper´s layerCamper´s layer fascia abd. subcutanea fascia abd. subcutanea

//ScarpaeScarpae// fascia abd. superficialisfascia abd. superficialis mm. abdominismm. abdominis

fascia transversalisfascia transversalis peritoneumperitoneum

skinskin

tunica dartostunica dartos

fascia spermatica ext.fascia spermatica ext. m. cremater + f. m. cremater + f.

cremastericacremasterica fascia spermatica int.fascia spermatica int. tunica vaginalis testistunica vaginalis testis

lamina parietalis = periorchiumlamina parietalis = periorchium lamina visceralis = epiorchiumlamina visceralis = epiorchium