The male genital system includes both internal and external structures. The external genitalia are the penis and scrotum. The internal genitalia include the testes, epididymis, vas deferens, seminal vesicles, prostate, and urethra. The penis has three erectile tissues (corpora cavernosa and corpus spongiosum) and is covered in skin. The urethra pierces through the penis. The testes produce sperm and testosterone. During ejaculation, seminal fluid is secreted by the seminal vesicles and prostate to transport sperm through the urethra. Common clinical issues involving the male genital structures include inflammation, infections, tumors and congenital anomalies.

1. Male genital systemMale genital system
References:
1.V.K.SHARMA
2.IADVL
3.GRAYS ANATOMY
4.B D CHAURASIA

2. Includes internal and external genitalia
External genitalia includes:
Penis
Scrotum
Internal genitalia includes:
Testes
Epididymis, vas, ejaculatory duct
Spermatic cords
Glands – prostate, cowper’s.
Urethra.

3. Penis:Penis:
Root
Body
Root:
Superficial perineal pouch.
3 masses of erectile tissue – 2 crura and one
bulb.
Crura – attached to pubic arch – covered by
ischiocavernosus.

5. Bulb – attached to perineal membrane in b/n
crura – covered by bulbospongiosus.
Pierced by urethra.
Body:
Completely enveloped by skin.
Composed of 3 elongated masses of erectile
tissue – 2 ‘corpora cavernosa’ (continuation of
crura) and a median ‘corpus spongiosum’
(contin. Of bulb).
Terminal part of c.spongiosum expanded –
‘glans penis’.

6. Rim like raised surface at its proximal end –
‘corona glandis’.
Circular groove, ‘coronal sulcus’ runs along
corona glandis and seperates it from the
shaft of penis – k/a ‘neck’ of the penis.
At the neck, the skin covering the penis is
folded to form the ‘prepuce’ or ‘foreskin’ –
retracted backwards to expose the glans.
Space b/n glans and prepuce – ‘preputial sac’.

8. prepuce is attached to
the glans at its ventral
surface – ‘frenulum’.
On the corona and
neck of the penis –
numerous small
preputial or sebaceous
glands – secrete
smegma – collected in
the sac.

9. Lymphatic supply:
External pudendal
lymph vessels 
superficial inguinal
nodes.
Glans  deep inguinal
nodes called ‘gland of
cloquet’.

10. Applied anatomy:Applied anatomy:
1. PPP – Small pin head sized
projections studded over corona
in one r two rows.
confused with condyloma
acuminata.
2. Preputial sac – due to
occlusive effect over the glans –
vulnerable for inflammation-
‘balanoposthitis’.
3. Tight frenulum – predisposes
to trauma during sexual
intercourse – serves as another

11. Scrotum:Scrotum:
Cutaneous fibromuscular sac, which contains
testes, epididymis, vas deferens and loose
areolar tissue.
Layers: (o  i)
Skin
Dartos muscle – is prolonged into a median
vertical septum b/n the 2 halves of the
scrotum.
External spermatic fascia.
Cremasteric muscle and fascia.

12. Internal spermatic fascia.
Divided into right and left halves by a
cutaneous raphe – indicates b/l origin of the
scrotum from the genital swellings.
Left side of the scrotum is usually lower
because the left spermatic cord is longer.

14. Skin – thin, pigmented and rugous.
Has hairs, sebaceous glands (charac. Odor)
and also sweat glands, pigment cells and
nerve endings.
No subcutaneous adipose tissue.
Drained into superficial inguinal nodes.

15. Applied anatomy:
Abundance of hair and sebaceous glands –
site of sebaceous cysts.
Vulnerablility to genital ulcer ds. Due to
proximity with penis.
Ulcers over penoscrotal junction and
scrotum are seen in behcet’s ds.
Phthirus pubis (pubic louse) enjoys the
habitat of scrotal and pubic hair.
S.skin can be predisposed to develop nodular
scabies and persistent pruritic nodules of
scabies.

17. Male urethra:Male urethra:
long membranous canal for discharging
urine and seminal fluid.
extends from bladder neck to external
urinary meatus.
divided into:
Prostatic post.
Membranous urethra
 spongy or penile --- ant. Urethra.

19. Prostatic urethra:
Tunnels through the subs. of prostate.
3-4 cms is length
Lined by transitional epithelium
Widest and most dilatable part of male
urethra.
Post. Wall has a midline ridge called as
‘urethral crest’.
On each side of crest – shallow depression
called ‘prostatic sinus’ – perforated by orifices
of 15-20 prostatic ducts.

21. Elevation in the middle
of urethral crest –
‘verumontanum’ (a/k
colliculus seminalis) –
contains slit like orifice
of prostatic utricle.
Openings of
ejaculatory ducts are
present on either side
of this orifice.

22. Membranous urethra:
1.5 cms – shortest, least dilatable.
Part which passes through the perineal
membrane.
Lined by transitional epithelium.
The wall consists of thin layer of smooth
muscle and prominent outer circular straited
muscle fibers (rhabdosphincter) – form
external urethral sphincter.

24. Spongy urethra:
16 cms long.
Extends from membranous urethra to
external urethral orifice.
Lined by pseudostratified columnar epi.
2 parts:
Bulbar urethra – surrounded by
bulbospongiosus – widest part.
Penile urethra – dilated part within the glans
– navicular fossa – lined by stratified
squamous epithelium.

25. Transitional epi.
Transitional epi.
Pseudo. Columnar epi.
Pseudo. columnar
Stratified Squamous epi.

26. Lymphatic drainage:
Posterior urethra -
internal iliac nodes;
few end in external
iliac nodes.
Anterior urethra +
glans penis – deep
inguinal nodes.

27. Applied anatomy:Applied anatomy:
Commonly involved structure in urethral
syndromes of gonococcal and non-
gonococcal origin.
Gonococci have predilection for columnar
epithelium.
Inflammation of urethra is known as
‘urethritis’ – regarded as sexually transmitted
unless proven otherwise.
Urethritis often presents with urethral
discharge and dysuria.
Lab: increased PMNL in urethral dis. Smear.

29. Gonococcal urethritis: Neisseria gonorrhea.
Non-gonococcal:
Chlamydia trachomatis
Ureaplasma urealyticum
Mycoplasma genitalium
Trichomonas vaginalis
Non-infective causes:
Strictures
Traumatic
Neoplastic
Foreign body – catheterisation.

30. Urethral strictures:
narrowing of the urethra caused by injury or
disease such as UTI.
can occur as complication of gonococcal
(hard strictures) and non gonococcal
urethritis ( soft strictures).
Early Syphilis, chancroid, herpes, TB,
bilharzia.
Trauma - can be physical (eg catheterization,
urethroscopy); Chemical (burns from
podophyllin ,TCA or diathermy).

31. Rupture Of Urethra:
commonly ruptured beneath the pubis by a
fall astride a sharp object leading to
extravasation of urine into peritoneum.
Hypospadias:
common anamoly in which urethra opens on
the undersurface of penis.
Epispadias:
rare condition in which urethra opens on the
dorsum of penis.
associated with ectopia vesicae

32. Spermatic cord:Spermatic cord:
As the testis traverses the abdominal wall
into the scrotum during early life, it carries
its vessels, nerves and vas deferens with it.
These meet at the deep inguinal ring to form
the ‘spermatic cord’.
In the canal, the cord acquires coverings
from abd. Wall layers.
Suspends the testis in scrotum and extends
from deep inguinal canal to the posterior
aspect of the testis.

34. Contents of spermatic cord:
1. ductus deferens
2.testicular and cremasteric arteies and
artery of the ductus deferens.
3. pampiniform plexus of veins.
4. lymph vessels from the testis.
5. ilioinguinal nerve, genital branch of the
genitofemoral nerve, and the plexus of
sympathetic nerves around the artery to
ductus deferens and visceral afferent nerve
fibers.
6.remains of the processus vaginalis.

36. Testes:Testes:
Primary reproductive organs or gonads.
Covered by 3 coats ( o  i)
Tunica vaginalis
Tunica albuginea
Tunica vasculosa.
Produce sperm and testosterone.
Sperms – produced by seminiferous tubules.
Testosterone – by leydig cells located b/n the
tubules.

38. 400-600 seminiferous tubules in each testes –
contain spermatogenic cells and supporting
sertoli cells.
Tubules join to form ‘rete testis’
Excretory duct system – 5 elements.
Testis
Efferent ducts
Epididymis
Vas
Ejaculatory duct and urethra.

40. Applied anatomy:Applied anatomy:
Absence of testis:
u/l – monorchism
b/l – anorchism.
Undescended testis or cryptorchidism: may
lie in lumbar, iliac, inguinal, or upper scrotal
region.
May complete after birth.
Spermatogenesis may fail to occur in it.
More prone for malignancy.
Condition is surgically corrected.

41. Hermaphroditism:
Individual shows some features of male and
some of a female.
True – both testis+ ovary
Pseudo – gonad is of one sex while the
external or internal genitalia are of opposite
sex.
Carcinomas and infections: may be palpated
to check any nodules, or any irregularity or
size or consistency.
Varicocele: dilatation of pampiniform plexus
on veins.

42. Epididymis:Epididymis:
lies postero-lateral to
the testis.
Has:
1. head or globus
major superiorly,
2. body – corpus
3. tail – cauda or
globus minor.

43. Vas deferens:Vas deferens:
Distal continuation of
epididymis.
45 cms long.
At prostate base, vas
joins duct of seminal
vessel to form
ejaculatory duct.
Conveys sperm to the
ejaculatory ducts.
Applied anatomy: –
vasectomy - removing a
part under LA for family
planning.

44. Ejaculatory duct:Ejaculatory duct:
2 cms in length.
Starts from the base of the prostate and
ends on the verumontanum or within
the utricular opening.

46. Seminal vesicles:Seminal vesicles:
Sacculated tubes located b/n the bladder
and the rectum.
Single coiled tube with irregular
diverticula.
Secrete alkaline, slightly yellowish viscid
fluid which constitutes 60-70% of the
ejaculatory volume.

48. Prostate:Prostate:
Located b/n bladder neck and the urogenital
diaphragm.
Encircles the urethra completely.
Zones: 3
1. Periurethral zone – surrounding urethra.
2. central zone – wedge-shaped; bounded by
ejaculatory duct, urethra, and base of the
bladder.
Less susceptible to inflammatory,
hyperplastic, or neoplastic ds.

49. 3. peripheral/outer zone – the portion that is
palpable on rectal exmn.
Most frequently involved in carcinoma and
inflammation.

50. Secretions:
Thin, slightly opaque fluid.
Contributes to 30% of ejaculate volume.
Protects the male lower urinary tract against
infections.
Provides enzymes for ‘liquefying’ the semen
after ejaculation.

51. Applied anatomyApplied anatomy
Benign prostate hypertrophy:
senile enlargement after 50 years.
Occurs in periurethral zone.
Causes retention of urine due to distortion
of urethra.
Rx: prostatectomy – transvesical
transvesical/
retropubic/
transurethral
resection.

52. Prostatitis:
Acute or chronic inflammation.
Acute – sec. to gonococcal urethritis.
Chronic – tuberculous infection of
epididymis, seminal vesicles and the bladder.
Ca.prostate:
Occurs after the age of 50-55 years.
Symptoms are urinary obstruction, low
backpain or sciatica.
Rectal exmn – irregular hard prostate.
Mets spread to vertebral column.

53. Bulbourethral (cowper’s)glands:Bulbourethral (cowper’s)glands:
Paired, pea-sized glands located in urogenital
diaphragm.
Excretory ducts drain into posterior
urethra.
Secrete a thin, mucoid material during the
excitatory stage of sexual response.
Contribute a minimal amount to the
ejaculate.
Immune to hyperplastic and neoplastic ds.