TRASTORNOS REPRODUCTIVOS

T.M. REINALDO FIGUEROA

FISIOPATOLOGÍA 2019
Cryptorchidism and possible positions of the undescended testis
DIFFERENTIATING HYPOSPADIAS AND EPISPADIAS
Hypospadias and epispadias
Abnormalities of the scrotum
 Varicocele

A, Dilation of veins within the spermatic cord. B, Varicocele on physical examination

HYDROCELE
Depiction of a Hydrocele

A, Accumulation of clear fluid between the

visceral (inner) and parietal (outer) layers of
the tunica vaginalis

B, The appearance of a hydrocele on

ultrasound examination
 Testicular torsion

Twisting of the spermatic cord that suspends the testis and the
spermatic vessels that supply the testis with blood
The causes and reasons for scrotal or testicular torsion
Testicular torsion
The signs and symptoms and related rationales of scrotal or testicular torsion
 Torsion of the Testes

A, Left testicular torsion in an adolescent with acute scrotum; the testis is necrotic
B, Late phase torsion in an adolescent with severe testicular pain 1 month previously. Note
the absence of inflammation and high position of testis in scrotum
C, The testes appear dark red and partially necrotic owing to hemorrhagic infarction
The causes and background related to epididymis
The causes and explanations for epididymo-orchitis
The signs and symptoms and rationales for epididymo-orchitis
 Acute epididymitis caused by gonococcal infection

Left, the epididymis is necrotic and replaced by an abscess. Normal testis is seen on the
right
Testicular Tumor
The causes and background for testicular cancer
The signs and symptoms and rationales of testicular cancer
Staging testicular cancer
Semen analysis: normal values and definitions
PROSTATIC INFLAMMATION
The causes and related rationales of prostatitis
The signs and symptoms and why associated with acute bacterial prostatitis, chronic
bacterial prostatitis, and inflammatory and noninflammatory prostatitis
PROSTATIC ENLARGEMENT
The causes of BPH, and why these causes occur
PALPATING THE PROSTATE GLAND
 Nodular hyperplasia of the prostate

Cut surface of a prostate enlarged by nodular hyperplasia shows numerous, well

circumscribed nodules of prostatic tissue. The prostatic urethra (paper clip) has been
compressed to a narrow slit
Nodular hyperplasia of the prostate
Nodular hyperplasia of the prostate
Mechanism of androgen action on prostatic stromal and epithelial cells

Testosterone (T), dihydrotestosterone (DHT)

The symptoms of BPH and
why these symptoms occur
Transurethral resection of the prostate (TURP)
Complications of benign prostatic hypertrophy
PROSTATE CANCER
Selected World Population Age-Standardized Incidence Rates of Prostate Cancer
The causes and reasons for prostate cancer
The signs and symptoms and background of prostate cancer
Carcinoma of the Prostate

A, Schematic of carcinoma of
the prostate

B, Carcinoma of the prostate extending into

the rectum and urinary bladder
Structural abnormalities of the uterus
Anatomic anomalies of the uterus
Cervix Is Lined by Two Types of Epithelial Cells: Squamous Cells and
Columnar Glandular Cells
Location of the squamocolumnar junction (transformation zone) in menarchial,
menstruating, menopausal, and postmenopausal women

A, menarchial; B, menstruating; C, menopausal; D, postmenopausal

 Cervical Intraepithelial Neoplasia

Diagram of cervical endothelium showing progressive degrees of CIN

 Cervical Intraepithelial Neoplasia

B, Normal multiparous cervix. C, CIN stage 1. Note the white appearance of part of the
anterior lip of the cervix associated with neoplastic changes. D, CIN stage 2. Lesions
reflected in distant capillaries. E, CIN stage 3. Lesion predominantly around the external os
Interrelations of naming systems for premalignant cervical disease
Cervical Intraepithelial Neoplasia (CIN)
 Cervical Intraepithelial Neoplasia (CIN)

Normal epithelium, HPV infection progressing to CIN stage I, and then with more time persistent
HPV infections progressing to precancerous lesions CIN II and CIN III and eventually cervical
cancer. Most cervical lesions do not progress to cervical cancer
Development of carcinoma of the cervix
CERVICAL CANCER
The causes and background for cervical cancer
The signs and symptoms and associated rationales for cervical cancer
Cancer of the cervix

A, Positive Pap smear indicative of cervical

cancer
B, Early invasion (microscopic) occurring in a
cervical neoplasm (stage I)
C, Carcinoma well advanced, the neoplastic
mass projecting above the mucosa
 PAP SMEAR FINDINGS

Normal Mild dysplasia

 PAP SMEAR FINDINGS

Severe dysplasia, carcinoma in situ Invasive carcinoma

The cause and explanation for PMS
The signs and symptoms and associated rationales for PMS
Categories of dysmenorrhea
The cause and background of dysmenorrhea
The signs and symptoms and associated rationales for dysmenorrhea
 Endometriosis

Common locations of endometriosis in the

pelvis and abdomen

Endometriosis. Implants of endometrium on

the ovary appear as red-blue nodules
The signs and symptoms and
reasons for endometriosis
Endometriosis. Possible ectopic sites
PELVIC ENDOMETRIOSIS
COMMON SITES OF ENDOMETRIOSIS
 Endometriosis

Endometriosis involving the right ovary (chocolate cyst) and left ovary showing the inner
lining of a large cyst with excrescences
 Leiomyoma of the uterus

(A) The leiomyomas are intramural, submucosal (a pedunculated one appearing in the
form of an endometrial polyp) and subserosal (one compressing the bladder and the other
the rectum). (B) Bisected uterus displays a prominent, circumscribed, fleshy tumor
Etiology of Uterine Leiomyomas
The signs and symptoms and explanations for fibroids
Leiomyomas

A, Uterine section showing whorl-like

appearance and locations of leiomyomas,
which are also called uterine fibroids

B, Multiple leiomyomas in sagittal section.

Typical, well-circumscribed, solid, light gray
nodules distort uterus
Causes and mechanisms of chronic anovulation
Polycystic ovarian syndrome
Polycystic Ovary
The causes and reasons for PCOS
Clinical consequences of chronic anovulation in
polycystic ovary syndrome
Manifestations of polycystic ovary syndrome1
The signs and symptoms and rationales for PCOS
Insulin Resistance and Hyperinsulinemia in Polycystic Ovary Syndrome (PCOS)
 Pathogenesis of the various clinical manifestations of the polycystic ovary syndrome

SHBG, steroid hormone-binding globulin; IGFBP-1, insulin-like growth factor binding protein-1;
IGF, insulin-like growth factor; FSH, follicle-stimulating hormone; LH, luteinizing hormone.
(Redrawn, with permission, from Barnes HV. Clinical Medicine: Selected Problems with Pathophysiologic
Correlations. Year Book Medical Publishers, 1988)