Prof Dermatology STDs amp Andrology ElMinya University Introduction Andros Male Greek word Andrology Diagnosis amp Treatment of Male Fertility Problems Introduction ID: 1035839
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1. AndrologyByTarek El-AmmawiProf. Dermatology, STDs & AndrologyEl-Minya University
2. Introduction Andros = Male (Greek word) Andrology: (Diagnosis & Treatment of Male Fertility Problems)
3. Introduction Andros = Male (Greek word) Andrology: (Diagnosis & Treatment of Male Fertility Problems) It also includes: Sexual and Erectile Disorders Reproductive Tract Infection Accessory Sex Gland Disorders Male Puberty Disorders Aging Male Male Contraception
4. Lecture Plan Male Infertility Human Sexuality
5. Infertility When a couple fails to induce a pregnancy within one year of regular unprotected intercourse Prevalence of infertility in couples within reproductive age is variable (about 15%) It may be primary or secondary
6. Causes of InfertilityBoth (26%)Female (39%)Obscured Cause (15%)Male (20%)
7. Male Infertility (contents) Anatomy of the Male Genital Tract Physiology of the Reproductive System Male Infertility Sheet Semen Analysis Causes & Diagnosis of Male Infertility Treatment of Male Infertility Miscellaneous Topics
8. Anatomy of Male Genital System
9. Male Genital SystemPrimary Sex Organ (Testis)Male Genital Duct System (Efferent Ducts, Epididymis, VD, ED)Accessory Sex Glands (Prostate, SV, Bulbo-urethral Gl.)Spermatic CordMale UrethraExternal Genitalia (Penis, Scrotum)
10. TestisSpermatic CordEpididymisExternal Inguinal Ring
11. TestisOval, average 4.5 X 3 cm (3.6 - 5.5 X 2.5 - 3.2 cm)Medium-hard and elasticVolume, 15 - 25 mlWeight, approximately 32 gmTemperature, 2 - 4oC lower than rectal temperature
12. SkinTunica VasculosaTunica Vaginalis(Parietal Layer)Tunica AlbugineaDartos FasciaDartos MCoverings of The TestisTestisRete TestisMedian Scrotal SeptumEpididymisTunica Vaginalis(Visceral Layer)Cremaster M
13. Median Scrotum Septum
14. Cremaster MInternal Spermatic FasciaExternal Spermatic Fascia
15. TestisDivided by fibrous trabeculae into 250 – 300 lobules, each contains 1 – 3 seminiferous tubulesAll tubules drain into rete testis
16. Vas DeferensEpididymisSeminiferous TubuleEfferent Ducts (6 - 12)Rete TestisFibrous Trabeculae(250 -300 lobules each has 1 – 3 tubule)
17. TestisHistologically, it is divided into 2 compartments; tubular and interstitial compartments
18. Tubular CompartmentInterstitial CompartmentTestis Histology
19. TestisSeminiferous tubules (60 – 80% of volume) contain Sertoli cells, germ cells and peitubular cells
20. TestisSeminiferous tubules (60 – 80% of volume) contain Sertoli cells, germ cells and peitubular cellsInterstitial compartment (20 – 40%) contains Leydig cells, CT fibers and fibroblasts, BVs, lymphatics and leukocyte immune cells (e.g. macrophages, lymphocytes and mast cells)
21. Seminiferous Tubule (Sertoli cells & Germ cells)
22. Seminiferous Tubule (Sertoli cells & Germ cells) PrimarySpermatocyteRound SpermatidSperm
23. PrimarySpermatocyteRound SpermatidSpermatogoniaSCBVLCSeminiferous Tubule (Sertoli cells & Germ cells)
24. SeminiferousTubuleBasement MembraneCollagen LayerMyo-epithelial LayerLining of Seminiferous Tubules
25. SpermRound Spermatid
26. Sperm
27. Leydig Cells
28. Measurement of Testis VolumeOrchidometerUltrasonographyCT ScanFluid Displacement (after excision)
29. Orchidometer
30. Orchidometer
31. Blood Supply of Testis Arterial Supply :Testicular AA to Vas DeferensCremasteric A
32. AortaTesticular As(From Aorta)Testicular VIVCRenal VPampiniform PlexusRenal AA of Vas Deferens(From Inf. Vesical A)Cremasteric A(From Inf. Epig. A)Blood Supply of the TestisSpermatic Cord
33. Blood Supply of Testis Arterial Supply :Testicular AA to Vas DeferensCremasteric AVenous Drainage :Pampiniform Plexus Testicular V
34. AortaTesticular As(From Aorta)Testicular VIVCRenal VPampiniform PlexusRenal AA of Vas Deferens(From Inf. Vesical A)Cremasteric A(From Inf. Epig. A)Blood Supply of the TestisSpermatic Cord
35. Blood Supply of Testis Arterial Supply :Testicular AA to Vas DeferensCremasteric AVenous Drainage :Pampiniform Plexus Testicular V Lymphatic Drainage :Lumbar LN Mediastinal LN
36. Innervation of the testisT10 – L1(Sympathetic)S2 – S4(Parasympathetic)
37. Nerve Supply of GenitaliaSuperior Hypogastric PlexusGenito-femoral NPelvic (Inf. Hypogastric) PlexusVas Deferens & N PlexusTesticular A & N PlexusDorsal Ns of PenisHypogastric NsTesticular A & N PlexusAnt. Scrotal NGenital Branch of Genito-femoral N
38. Duct SystemEfferent DuctsEpididymisVas DeferensEjaculatory Duct
39. Duct SystemEfferent Ducts (6 – 12)Epididymis (Head, Body & Tail) * Head is made from ED & Body and Tail are a single tubule * It is about 6 meters long
40. Vas DeferensEpididymisSeminiferous TubuleEfferent DuctsRete TestisBodyTailHead
41. Epididymis
42. TestisRectumProstateUrinary BladderBulbo-urethral GlandEpididymisVas DeferensUrethraUreter
43.
44. Duct SystemVas Deferens (30 – 35 cm) * Thick walled tube * Five parts : Within T Vaginalis Scrotal Inguinal Pelvic Ampulla
45. Testis &EpididymisSpermatic CordVas DeferensSeminal VesicleAmpulla of VDProstate
46. Vas Deferens (VD)
47. TestisRectumProstateUrinary BladderBulbo-urethral GlandEpididymisVas DeferensUrethraUreter
48. Duct SystemEjaculatory Duct (2 cm) * Within prostate gland * It is the termination of VD when joins the duct of Seminal Vesicle
49. Ejaculatory DuctSeminal VesicleBladderProstatic urethraEjaculatory DuctProstateVerumontanumMembranous urethra
50. Accessory Sex GlandsProstate (about 18 gm) * A musculo-glandular organ * It has Ant., post. and lateral lobes
51. Accessory Sex GlandsProstate (about 18 gm) * A musculo-glandular organ * It has Ant., post. and lateral lobesSeminal Vesicles (5 X 1 cm) * Highly convoluted gland * Less muscular
52. Accessory Sex GlandsProstate (about 18 gm) * A musculo-glandular organ * It has Ant., post. and lateral lobesSeminal Vesicles (5 X 1 cm) * Highly convoluted gland * Less muscularBulbo-urethral Glands of Cowper * Lie on each side of membranous urethra, ducts open in bulbous urethra
53. Spermatic Cord * It is about 10 cm long that extends from upper back of testis to deep inguinal ring. Left is slight longer * Coverings : skin, tunica dartos, ext. spermatic fascia, cremaster muscle and int. spermatic fascia
54. Cremaster MuscleLateral OriginMedial OriginCremaster Muscle
55. Spermatic Cord * Contents : VD, arteries (testicular, cremasteric and vasal arteries), pampiniform plexus of veins, lymphatics and nerves within an areolar tissue
56. TestisSpermatic CordEpididymisExternal Inguinal Ring
57. Lining of Male Reproductive SystemSeminiferous T (germ cells, Sertoli cells)Terminal part of ST (only Sertoli cells)Rete Testis (cuboidal or columnar epithelium)Efferent Ducts (columnar epithelium of different heights)Epididymis (pseudo-stratified ciliated columnar epithelium)
58. Lining of Male Reproductive SystemVas Deferens (pseudo-stratified columnar epithelium)Seminal Vesicle (1 – 2 layers of columnar epithelium)Prostate (2 layers; basal cells and cuboidal to columnar epithelial layer)Ejaculatory Duct (columnar epithelium)
59. ProstateProstatic UrethraMembranous UrethraExternal MeatsCavernous UrethraUrinary BladderCorps SpongiosumVas DeferensUreter
60. Roof of urethraFloor of urethraProstatic u.Membranous u. Penile u.Bulbous u.Cavernous u.Intramural u.
61. Roof of urethraFloor of urethraBulbCrusC. Cavern.C. Spong.ProstateCowper’s GlandLittré GlandsMembranous u.Penile u.Bulbous u.External MeatsNavecular FossaOpenings of Ejaculatory DuctsOpenings of Cowper’s Gland DuctsCavernous u.Prostatic u.Intramural u.
62. Lining of Male Reproductive SystemUrethraIntramural (like urinary bladder)Prostatic Membranous (pseudo-stratified columnar)PenileFossa Navicularis (cuboidal)
63. Capsule Summary Andrology deals with diagnosis & treatment of male fertility problems Male shares with a significant percentage among infertile couples Male genital system consists of : Primary Sex Organ Male Genital Duct System Accessory Sex Glands Spermatic Cord External Genitalia
64. Thank You
65. Male Genital SystemPrimary Sex Organ (Testis)Male Genital Duct System (Efferent Ducts, Epididymis, VD, ED)Accessory Sex Glands (Prostate, SV, Bulbo-urethral Gl.)Spermatic CordMale UrethraExternal Genitalia (Penis, Scrotum)