Diseases of the male genital tract

Andrology is dealing with diseases and dysfunctions of the male reproductive organs. First, the external genitalia (testes, scrotum, penis, prepuce) are inspected and palpated, later (for evaluation of the prostate), a rectal and sonographic examination will be performed. In some cases an endocrinological examination (hormone blood measurement) may be useful.

Diseases of the male genital tract include (examples):

•    diseases of the testicles, e.g. testicular tumor, cryptorchidism, orchitis
•    diseases of the prostate, e.g. benign enlargement, cysts, tumor
•    diseases of the penis and prepuce, e.g. preputial catarrh, frenulum persistens, para-/phimosis/penile prolapse
•    disorders of sexual development, e.g. Pseudo-/Hermaphrodism, hypospadia, uterus masculinus

Incomplete testicular descent (cryptorchidism)

Under normal conditions, the descent of both testicles into the scrotum takes place shortly after birth and can usually be palpated at the time of weaning. From time to time, a delayed descent is described. An incomplete testicular descent can finally be diagnosed at the age of six months. At this point of time, the outer inguinal ring is closed. The incidence of cryptorchidism is around 0.8 - 15% and is inherited by an autosomal recessive trait carried by males and females. A distinction is made between inguinal and abdominal cryptorchidism, with the missing testicle lying in the inguinal region or in the abdomen, respectively. Retained testicles should be surgically removed as the risk of tumor development is majorly increased. Furthermore, a possible risk of torsion for abdominal testicles is described. Hormonal treatment is not recommended for ethical reasons.

Benign prostatic hyperplasia

The prostate is an accessory male sex gland controlled by sex hormones and therefore gets atrophic in castrated animals. In contrast, the benign enlargement of the prostate in uncastrated males is a physiological process that begins at the age of 2-3 years and progresses further. Due to changes in the androgen-estrogen ratio, prostatic cysts may develop, which is often noticeable by serosanguineous urethral discharge. Defecation can be complicated by organ enlargement and pressure on the rectum. Untreated, secondary diseases such as prostatitis and abscesses may develop. A sonographic examination allows visualization and assessment of the prostate. A size reduction of the organ can be achieved by medical therapy or castration.

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