Reproductive: Male Genital Tract System

Front 1

What is the most common etilogy of male infertility?

Back 1

varicocele

Front 2

2 primary functions of testes.

Back 2

spermatogenesis
production of testosterone

Front 3

Endocrine cause of male infertility.

hypothalamus

Back 3

- high prolactin: feedback inhibition on hypothalamus -> decrease release of GnRH
- congenital hypothalamic defect
- Kallman syndrome: anosmia (lack of smell), no GnRH production, facial asymmetry. X linked KAL-1 deletion

Front 4

What is this disease?

- anosmia (lack of smell)
- no GnRH production
- facial asymmetry

Back 4

kallman syndrome
- X linked KAL-1 deletion

Front 5

Endocrine cause of male infertility.

primary pituitary disease

Back 5

- adenoma: visual change, headache
- congenital FSH/LH production problem

Front 6

Endocrine cause of male infertility.

secondary pituitary disease

Back 6

- malnutrition/systemic disease
- androgen or estrogen excess (negative feedback to pituitary)

Front 7

Endocrine cause of male infertility.

testicles

Back 7

- idiopathic hypoandrogenism
- obesity
- liver disease (lack of aromatase)
- medication: nitrofurantoin, tetracyclin, testosterone, sulfasalazine, cimetidine, cyclosporin, colchicine

Front 8

What is this congenital disease that cause male infertility?

- absent abdominal wall muscles
- undescended tesetes
- megaureters

Back 8

prune belly syndrome

Front 9

What is this congenital disease that cause male infertility?

- malfunction of dynein arm in the sperm tail

Back 9

Kartagener's syndrome

Front 10

What are some genetic causes of male infertility.

Back 10

- Kleinfelter's (47, XXY)
- Y microdeletion
- prune belly syndrome: absent abdominal wall muscles, undescended testes, megaureters
- Kartagener syndrome: malfunction of sperm's dynein arm

Front 11

Give some social substances that can cause male infertility.

Back 11

- alcohol
- anabolic steroid
- cocaine
- marijuana
- tobacco

Front 12

Give some enviromental toxins that can cause male infertility.

Back 12

- pesticides
- solvents

Front 13

Give some causes of male infertility by the mechanism of heat.

Back 13

- hot tub/saunas
- fever
- varicoceles: dilation of pampiniform plexus, more common on the left side

Front 14

What is this cause if male infertility?

- dilation of pampiniform plexus
- usually on the left side
- leads to testicular atrophy, decreased sperm counts

Back 14

varicoceles

Front 15

How to treat varicoceles?

Back 15

embolization
surgical ligation
- microscopic inguinal
- retroperitoneal
- laparoscopic retroperitoneal: usually reserved for children and adolescents

Front 16

What is this cause of male infertility?

- collection of fluid between parietal and visceral layers of tunica vaginalis.

Back 16

hydrocele

Front 17

Name some tumors of epidydimis.

Back 17

adenomatoid tumor
malignant tumor (very rare)

Front 18

Cause of male infertility: epidydimis.

- cystic fluid collection connected to epidydimus
- contain dead sperms

Back 18

spermatocele

Front 19

Function of epidydimis.

Back 19

sperm maturation

Front 20

Causes of male infertility: vas deferens.

Back 20

- CBAVD: congenital bilateral absence of vas deferens
- blcokage by surgeries (inguinal hernia repair, hydrocele/spermatocele repair)
- infectious stricture
- vasectomy

Front 21

Function of vas deferens.

Back 21

- propels sperm forward into posterior urethra

Front 22

What are some treatment options for blocked vas deferens caused by surgeries?

Back 22

- vasovasostomy
- vasoepididymostomy
- surgical sperm extraction(MESA or TESE) and IVF

Front 23

A men was surgically treated for hytroceole, but still unable to produce sperm. What might be the problem?

Back 23

blockage of vas deferens by the surgery

Front 24

Function of seminal vesicle.

Back 24

- secrete alkaline rich fluid high in fructose

Front 25

Function of ejaculate duct.

Back 25

prevent reflux of fluid back intto vas deferens and seminal vesicles

Front 26

What is the treatment for obstruction of ejaculartory duct?

Back 26

TURED: transurethral resection of ejaculatory duct

Front 27

What are some medications for BPH?

Back 27

- alpha blockers: fast onset
- 5-alpha-reductase blocker: slow onset (6 month)

Front 28

Give 2 alpha blockers that can be used to treat BPH.

Back 28

- Flomax
- Uroxatral

Front 29

What are some surgical options for treating BPH?

Back 29

microwave
TURP (gold standard)

Front 30

What are the two radiation therapy of prostate cancer?

Back 30

- external bean radiation
- brachytherapy (seeds)

Front 31

Give a medication that can be used to treat prostate cancer.

Back 31

GnRH agonist: no more cyclic release of GnRH

Front 32

Causes of male infertility: urethra/penis

narrowing of urethra caused by scarring due to infection or instrumentation.

Back 32

urethral stricture disase

Front 33

Give an oral medication for erectile dysfunction.

Back 33

- PDE5 inhibitors: prevent cGMP to GMP

Front 34

Give some non-oral medication for erectile dysfunction.

Back 34

- intraurethral pellet: increase cAMP
- intracavernosal injection
- vaccume erection device
- inflatable penile prosthesis

Front 35

What are some causes of retrograde ejaculation?

Back 35

- spinal cord injury
- DM
- prinor surgery of bladder/prostate
- medications: alpha blockers, psch meds

Front 36

How to treat anejaculation?

Back 36

electroejaculation
sperm extraction + IVF

Front 37

How to treat retrograde ejaculation?

Back 37

stop meds
alpha agonist (sudafed)
sperm retrieval + IVF

Front 38

What is the normal density of semen analysis?

Back 38

> 20 million/cc
> 50% motile

Front 39

What test can be used to diagnose retrograde ejaculation?

Back 39

post-ejaculatory urinanalysis

Front 40

What is the risk of testis cancer in infertile men?

Back 40

33x higher