Include: the testes, the epididymis, the vas deferens, the seminal vesicles, the prostate gland, and the Cowper’s glands. The testes, (To Testify) the paired, oval-shaped organs that produce sperm and male sex hormones, are located in the scrotum. They are highly innervated and sensitive to touch and pressure. The testes produce testosterone, which is responsible for the development of male sexual characteristics and sex drive (libido).

1. Dr. NDAYISABA CORNEILLE
CEO of CHG
MBChB,DCM,BCSIT,CCNA
Supported BY
Dr Ndayisaba Corneille 1

2. Contents
Vas Deferens
Seminal vesicles
Ejaculatory Ducts
Prostate
Clinical notes
Dr Ndayisaba Corneille 2

3. Internal Male Sexual Organs
• Include:
• the testes, the epididymis, the
vas deferens, the seminal
vesicles, the prostate gland, and
the Cowper’s glands.
• The testes, (To Testify) the
paired, oval-shaped organs that
produce sperm and male sex
hormones, are located in the
scrotum.
• They are highly innervated and
sensitive to touch and pressure.
• The testes produce testosterone,
which is responsible for the
development of male sexual
characteristics and sex drive
(libido).
Dr Ndayisaba Corneille 3

4. Dr Ndayisaba Corneille 4

5. Ejaculatory Duct
• Ejaculatory duct ejects semen and sperm
into the urethra
• Formed from the fusion of terminal portion
of the ductus deferens and the duct of the
seminal vesicles
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6. Ejaculatory Ducts
• The two ejaculatory ducts are each less than 1
inch (2.5 cm) long and are formed by the union of
the vas deferens and the duct of the seminal
vesicle
• The ejaculatory ducts pierce the posterior surface
of the prostate and open into the prostatic part
of the urethra, close to the margins of the
prostatic utricle; their function is to drain the
seminal fluid into the prostatic urethra.
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7. Vas Deferens
• Is a thick-walled tube about 18 inches (45 cm)
long that conveys mature sperm from the
epididymis to the ejaculatory duct and the
urethra.
• Arises from the lower end or tail of the
epididymis and passes through the inguinal
canal. It emerges from the deep inguinal ring
and passes around the lateral margin of the
inferior epigastric artery
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8. Contd
• Passes downward and backward on the lateral
wall of the pelvis and crosses the ureter in the
region of the ischial spine.
• Runs medially and downward on the posterior
surface of the bladder
• Its terminal part is dilated to form the ampulla .
The inferior end of the ampulla narrows down
and joins the duct of the seminal vesicle to form
the ejaculatory duct.
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9. Dr Ndayisaba Corneille 9

10. Dr Ndayisaba Corneille 10

11. SEMINAL VESICLES
• Are two lobulated organs about 2 inches. (5 cm)
long lying on the posterior surface of the bladder
• On the medial side of each vesicle lies the
terminal part of the vas deferens.
• Posteriorly, the seminal vesicles are related to
the rectum.
• Inferiorly, each seminal vesicle narrows and joins
the vas deferens of the same side to form the
ejaculatory duct.
• Each seminal vesicle consists of a much-coiled
tube embedded in connective tissue.
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12. Blood Supply
Arteries
• The inferior vesicle and middle rectal arteries.
Veins
• The veins drain into the internal iliac veins.
Lymph Drainage
• The internal iliac nodes.
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13. Function
• The function of the seminal vesicles is to
produce a secretion that is added to the
seminal fluid.
• The secretions nourish the spermatozoa.
• During ejaculation the seminal vesicles
contract and expel their contents into the
ejaculatory ducts, thus washing the
spermatozoa out of the urethra.
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14. Accessory Structures
• Bulbourethral glands - produces fluid that
lubricates penis and neutralizes urinary acids;
located at the base of the penis
–Cowper’s gland
• Semen - composed of 60% seminal vesicle
fluid, 30% prostatic fluid, 10 % sperm and
various secretions
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15. Semen
• The whitish fluid expelled through the opening of
the penis (urethra) during ejaculation.
• Most of the ejaculate is made up of the fluid that
supports the sperm.
• Besides sperm, (1%) semen is made up of fluids;
65% from the seminal vesicles, 30 to 35% from the
prostate and 5% from the vasa.
• The amount of ejaculate you produce can vary,
from just a few drops to about a teaspoon full (2 to
6 ml).
• One amount of ejaculate may contain between 40
million to 600 million sperm depending on the
volume and the length of time stored before
ejaculating.
• Yet, the quantity of sperm produced will only cover
the head of a pin.
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16. Journey of the Sperm
interstitial
cells-
testosterone

17. Journey of the Sperm
sperm
production
in the
seminferous
tubules

18. Journey of the Sperm
sperm
storage
in the
epididymis

19. Journey of the Sperm
transport
in the
vas
deferens

20. Journey of the Sperm
ampulla -
storage

21. Journey of the Sperm
fluid from
the
seminal
vessicles
ejaculatory
duct

22. Journey of the Sperm
fluid from
the
prostate
gland

23. Journey of the Sperm
cowper’s
gland

24. Journey of the Sperm
ejaculation

25. Erectile and Ejaculatory
Abnormalities
Peyronie’s disease:
• An abnormal condition
characterized by an
excessive curvature of the
penis that can make
erection quite painful
• Etiology: buildup of fibrous
tissue in the penile shaft.
• It usually requires medical
attention.
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26. Phimosis
• Phimosis is a medical condition in which the
foreskin of the penis of an uncircumcised male
cannot be fully retracted.
• The word derives from the Greek phimos
("muzzle").
• In the United States, circumcision is the surgical
treatment of choice for correction of phimosis
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27. Retrograde ejaculation:
• Ejaculation in which the
ejaculate empties into the
bladder.
• The external sphincter
remains closed 
preventing the expulsion of
the seminal fluid; the
internal sphincter remains
open  allowing the
ejaculate to empty into the
bladder.
• The result is a dry orgasm.
• Etiology: possible (earlier
types of ) prostate surgery,
tranquilizers, illness, and
accidents.
• Harmless  discharged with
urine.
• Infertility may be the result.
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28. Priapism:
• Painful erections that persist for hours or days.
• Etiology: mechanisms that drain the blood that
erects the penis are damaged and so cannot
return the blood to the circulatory system.
• Caused by the following medical conditions:
leukemia, sickle cell anemia, or diseases of the
spinal cord.
• Treatment: may become a medical emergency,
since prolonged erections beyond six hours can
starve the penile tissues of oxygen, leading to
permanent tissue deterioration.
• Surgery or drugs are sometimes used.
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29. Prostate
• Location and Description
• It is a fibromuscular glandular organ that surrounds the
prostatic urethra
• It is about 1.25 inches (3 cm) long and lies between the
neck of the bladder above and the urogenital diaphragm
below
• The prostate is surrounded by a fibrous capsule
• It has a somewhat conical shape and has a base, which lies
against the bladder neck above, and an apex, which lies
against the urogenital diaphragm below.
• The two ejaculatory ducts pierce the upper part of the
posterior surface of the prostate to open into the prostatic
urethra at the lateral margins of the prostatic utricle
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30. Prostate in coronal section (A), sagittal section (B), and horizontal section (C). In the coronal
section, note the openings of the ejaculatory ducts on the margin of the prostatic utricle
Dr Ndayisaba Corneille 30

31. Relations
• Superiorly: The base of the prostate is
continuous with the neck of the bladder, the
smooth muscle passing without interruption
from one organ to the other. The urethra
enters the center of the base of the prostate.
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32. Contd
• Inferiorly: The apex of the prostate lies on the
upper surface of the urogenital diaphragm.
The urethra leaves the prostate just above the
apex on the anterior surface
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33. Contd
• Anteriorly: The prostate is related to the
symphysis pubis, separated from it by the
extraperitoneal fat in the retropubic space
(cave of Retzius). The prostate is connected to
the posterior aspect of the pubic bones by the
fascial puboprostatic ligaments
Dr Ndayisaba Corneille 33

34. Contd
• Posteriorly: The prostate is closely related to
the anterior surface of the rectal ampulla and
is separated from it by the rectovesical
septum (fascia of Denonvilliers). This septum
is formed in fetal life by the fusion of the walls
of the lower end of the rectovesical pouch of
peritoneum, which originally extended down
to the perineal body.
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35. Contd
• Laterally: The prostate is embraced by the
anterior fibers of the levator ani as they run
posteriorly from the pubis
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36. Structure the Prostate
• The numerous glands of the prostate are
embedded in a mixture of smooth muscle and
connective tissue, and their ducts open into
the prostatic urethra.
• The prostate is incompletely divided into five
lobes The anterior lobe lies in front of the
urethra and is devoid of glandular tissue.
Dr Ndayisaba Corneille 36

37. Contd
• The median, or middle, lobe is the wedge of
gland situated between the urethra and the
ejaculatory ducts. Its upper surface is related
to the trigone of the bladder; it is rich in
glands.
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38. Contd
• The posterior lobe is situated behind the
urethra and below the ejaculatory ducts and
also contains glandular tissue. The right and
left lateral lobes lie on either side of the
urethra and are separated from one another
by a shallow vertical groove on the posterior
surface of the prostate. The lateral lobes
contain many glands.
Dr Ndayisaba Corneille 38

39. PROSTATE LOBES
• Inferioposterior lobe – it lies to the posterior
to the urethra and inferior to the ejaculatory
duct
• Inferiolateral lobe- it lies directly to the
urethra
• Superiomedial lobe- inferior to the ejaculatory
duct
• Anteriomedial lobe- lateral to the prostatic
urethra
Dr Ndayisaba Corneille 39

40. Function of the Prostate
• The prostate produces a thin, milky fluid
containing citric acid and acid phosphatase
that is added to the seminal fluid at the time
of ejaculation.
• The smooth muscle, which surrounds the
glands, squeezes the secretion into the
prostatic urethra. The prostatic secretion is
alkaline and helps neutralize the acidity in the
vagina.
Dr Ndayisaba Corneille 40

41. Blood Supply
• Arteries
• Branches of the inferior vesical and middle rectal
arteries.
• Veins
• The veins form the prostatic venous plexus,
which lies outside the capsule of the prostate .
The prostatic plexus receives the deep dorsal vein
of the penis and numerous vesical veins and
drains into the internal iliac veins.
• .
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42. • Lymph Drainage
Internal iliac nodes.
• Nerve Supply
Inferior hypogastric plexuses. The sympathetic
nerves stimulate the smooth muscle of the
prostate during ejaculation
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43. Dr Ndayisaba Corneille 43

44. Prostate Cancer
The Facts*
• About 70% of all diagnosed cancers: men aged 65 years or
older.
Over the past 20 years, the survival rate increased from 67%
to 97%.
Studies have found the following risk factors for prostate cancer:
• Age: Age is the main risk factor for prostate cancer. This disease
is rare in men younger than 45. The chance of getting it goes up
sharply as a man gets older.
• Family history: A man's risk is higher if there is family history
• Race: Prostate cancer is more common in African American
• Diet: Some studies suggest that men who eat a diet high in
animal fat or meat may be at increased risk for prostate cancer.
Screening:
• Digital Rectal Exam: The doctor inserts a lubricated, gloved
finger into the rectum and feels the prostate through the rectal
wall. The prostate is checked for hard or lumpy areas.
• Blood test for PSA: A lab checks the level of PSA in a man's
blood sample. Prostate cancer may also cause a high PSA level.
• The digital rectal exam and PSA test can detect a problem in the
prostate. They cannot show whether the problem is cancer or a
less serious condition.
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45. Symptoms
• A man with prostate cancer may not have any
symptoms. For men who have symptoms of prostate
cancer, common symptoms include:
• Urinary problems
– Not being able to urinate
– Having a hard time starting or stopping the urine
flow
– Needing to urinate often, especially at night
– Weak flow of urine
– Urine flow that starts and stops
– Pain or burning during urination
• Difficulty having an erection
• Blood in the urine or semen
• Frequent pain in the lower back, hips, or upper thighs
• Sometimes symptoms are not due to cancer.
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46. Enlarged Prostrate
An enlarged prostate means the gland has grown
bigger. Prostate enlargement happens to almost
all men as they get older. As the gland grows, it
can press on the urethra and cause urination and
bladder
Symptoms
• Slowed or delayed flow of urine
• Weak urine stream
• Dribbling after urinating
• Straining to urinate
• Strong and sudden need to urinate
• Incomplete emptying of your bladder
• Incontinence
• Pain and bloody urine
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47. Clinical Notes
Prostate Examination
• The prostate can be examined clinically by
palpation by performing a rectal examination.
• The examiner's gloved finger can feel the
posterior surface of the prostate through the
anterior rectal wall.
Dr Ndayisaba Corneille 47

48. Prostate Activity and Disease
• It has been shown that trace amounts of
proteins produced specifically by prostatic
epithelial cells are found in peripheral blood.
• In certain prostatic diseases, notably cancer of
the prostate, these proteins appear in the
blood in increased amounts.
• The specific protein level can be measured by
a simple laboratory test called the PSA
(prostate-specific antigen) test.
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49. Benign Enlargement of the Prostate (BPH)
• Benign enlargement of the prostate is common in
men older than 50 years.
• The median lobe of the gland enlarges upward
and encroaches within the sphincter vesicae,
located at the neck of the bladder.
• The leakage of urine into the prostatic urethra
causes an intense reflex desire to micturate.
• The patient experiences difficulty in passing
urine and the stream is weak.
• Back-pressure effects on the ureters and both
kidneys are a common complication.
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50. Dr Ndayisaba Corneille 50

51. END
END
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By
DR NDAYISABA CORNEILLE
MBChB,DCM,BCSIT,CCNA
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Dr Ndayisaba Corneille 51