SISTEM REPRODUKSI PRIA

( ANDROLOGY )
Related to male reproductive health
and urology
JOHN. W.H. SITOHANG
LABORATORIUM HISTOLOGI
FK-UKI
ANDROLOGY
 SISTEM REPRODUKSI PRIA
• REPRODUCTIVE ORGANS
• SEMEN PRODUCTION
• SPERMATOGENESIS
• ACCESORY GLANDS
• HYPOTHALAMUS-HYPOPHYSIS-TESTICULAR AXIS
• BLOOD TESTIS BARRIERAUTOIMMUN INFERTILITY
• BASIC SEMEN ANALYSIS
• THE MECHANISM OF ERECTION
• DEFECT OF ORGANS ( LIMITED)
• ANDROPAUSE
• PRIAPISM
 ORGAN REPRODUKSI
@ EKSTERNAL
@ INTERNAL
PENIS
1.TESTIS
SCROTUM
2.SALURAN KELUAR
3. KELENJAR PELENGKAP
GLD.PROSTAT,VESIKULOSA
BULBOURETHRALIS
PARA URETHRALIS
MALE REPRODUCTIVE ORGAN
 TESTIS
• SEPASANG , OVAL
• DIBUNGKUS SCROTUM
• P : 4-5 CM, T: 2,5 CM, BRT : 14 GR.
• TEMPAT PEMBENTUKAN SPERMATOZOA
• EMBRIOLOGIS : MESODERM  GENITAL RIDGE
• TUNIKA ALBUGINEA  MEDIASTINUM TESTIS
SEPTULA LOBULUS TESTIStubulus seminiferus
REPRODUKSI PRIA
 TUBULUS SEMINIFERUS
• LAP.LUAR: SEL FIBROELASTIK,MYOID CELL
• LAP.TENGAH : LAMINA BASALIS
• LAP.DALAM : 4-5 LAPIS BERUPA EPITEL SPERMATOGENIK
@ SEL SERTOLI  PHAGOSITOSIS,SUPPORT
MEKANIK,NUTRISI
@ SEL LEYDIG TESTOSTERON
TUBULUS SEMINIFERUS
TUB.SEMINIFERUS
 TUB.SEMINIFERUS
1.SEL SERTOLI
@BENTUK COLUMNAR
@ INTI ELLIPS/TIGA SUDUT
@ SITOPLASMA IRREGULER
@ SEL SITOSKELETON
@BADAN INKLUSI  CRYSTALOID
C.B
FS; NUTRITIF DAN SUPPORT
MEKANIK SPERMATOZOA
2. SEL LEYDIG
@ POLIHEDRAL/OVOID
@INTI BULAT,TENGAH
@LETAK : ANT/ JAR.INTERTITIUM
@ FUNGSI ENDOKRIN
(TESTOSTERON)
TUBULUS SEMINIFERUS
LEYDIG CELLS
 SPERMATOGENESIS
• SPERMATOSITOGENESIS
SPERMATOGONIA  SPERMATOSIT 1 &2
• MEIOSIS
SPERMATOSIT  SPERMATID
• SPERMIOGENESIS
SPERMATID  SPERMATOZOA

PERJALANAN SPERMA :
TUB.SEMINIFERUSTUB.RECTUSRETE
TESTISDUCT.EFFERENDUCT.EPIDIDIMIS DUCT
DEFERENT DUCT EJACULATORIUS URETHRA ( OUE)
BALANITIS
 TUBULUS REKTUS
• EPITEL SELAPIS KUBIS
• MIKROVILI
• SEL FLAGELA TUNGGAL
• FUNGSI FLAGELA  BELUM JELAS
 RETE TESTIS
• EPITEL SELAPIS KUBIS
• MIKROVILI
• SEL FLAGELA TUNGGAL
• DILAPISI PENY.KOLAGEN,
PEMB.DARAH, MYOID CELL
• MEMBANTU MOTILITAS SPERMA
 TUBULUS REKTUS +RETE TESTIS

TUBULUS
EPIDIDIMIS

TUBULUS
RECTUS
TUB.SEMINIFERUS

RETE TESTIS
THE ORGANS
 DUKTUS EFERENTES

• TERDAPAT 12 ATAU LEBIH

• PANJANG ± 10 CM
• EPIT. TORAK SELAPIS SILIA + NON SILIA
• DILINGKARI OTOT POLOS
• MEMBANTU PROPULSI SPERMA
DUKTUS EFFEREN
 DUKTUS EPIDIDIMIS

• CAPUT,CORPUS, CAUDA
• EPITEL TORAK PSEUDOSTRATIFIED
TDD: SEL BASAL & PRINCIPAL
• MIKROVILI STEREOSILIA
• OTOT POLOS PROX KE DISTALTEBAL
• FS: AKUMULASI,MATURASI,STORAGE
Cauda epididimis
 DUKTUS DEFEREN ( VAS DEFEREN)

• EPITEL TORAK PSEUDOSTRATIFIED

• OTOT POLOS 3 LAPIS : LONG-SIR-LONG
TEBAL  VASEKTOMI
• BERSAMA:
A/V/N SPERMATIKUS SPERMATIC

PLEKSUS PAMPINIFORMIS CORD

DUKTUS DEFEREN

OTOT POLOS LONGITUDINAL

OTOT POLOS
SIRKULAR
 DUKTUS EJACULATORIUS
• EPITEL TORAK PSEUDOSTRATIFIED
• MUKOSA MEMBENTUK LIPATAN
• MENEMBUS PROSTAT  POST URETRA 
COLLICULUS SEMINALIS
( Veromentanum)
 BASIC SEMEN ANALYSIS
NORMAL SEMEN PARAMETERS

• VOLUME ( ml) : 2-6 ml

• JUMLAH ( x 10ⁿ / ml) : ≥ 20 juta / ml
• MOTILITAS ( % motile) : ≥ 40%
• PROGRESIFITAS : ≥ 30%
• MORFOLOGY ( % normal ) : ≥ 40%
• WARNA : opaque
• BAU : “flowers of the chestnut”
• Ph :7,2 – 7,8
• Koagulasi o/k proteinkinase
• Liquefaksi : 10 – 20 menit o/k enzim fibrinolisin( > 20 ‘  prostat
disturb)
• Viskositas.
 KESIMPULAN PEMERIKSAAN
• JUMLAH SPERMA OLIGOZOOSPERMIA
/AZOOSPERMIA
• MOTILITAS  ASTHENOZOOSPERMIA /
NECROZOOSPERMIA
• MORFOLOGY  TERATOZOOSPERMIA
• VIABILITAS  BAIK/SEDANG/BURUK
• VISKOSITAS  NORMAL/ABNORMAL
 PROSTAT

• P:3CM, T:2CM, L:4CM, BRT: 20 GR

• T.MUK: EPITEL BERTINGKAT TORAK
KEL.TUBULO ALVEOLAR
MEMBENTUK 30-40 KELENJAR
• T.SUBM: OTOT POLOS ( MAIN GLAND)
• T.MUSK: OTOT POLOS
• T.ADV: KOLAGEN,FIBROSA,OTOT POLOS
 PROSTAT

• LUMEN : CORPORA AMYLACEA

( STARCHING BODIES)KONKREMEN KALSIFIKASI
SUMBATAN HYPERPLASI
( BPH)DEPRESI URETRA PARS PROSTATICA
SUSAH MIKSI
• FUNGSI: SEKRESI ( SEL EPITEL)
AMILASE,ACID POSPATASE,FIBRINOLISIN
• CA.PROSTAT  BAG.PERIFER
KELENJAR PROSTAT
 VESIKULA SEMINALIS
• ORGAN BERPASANGAN
• TM : EP.BERTINGKAT TORAK,LIPATAN
MUKOSA,MIKROVILI,FLAGEL TUNGGAL
• TSM: JAR.PENY.JARANG
• TMUSK:OTOT POLOS 2 LAPIS ( SIR-LONG)
• T.AD: JAR.FIBROELASTIK
• FUNGSI : HSL.PROTEIN, m/ 70% SEKRET SEMEN
• TESTOSTERON DEPENDENT
VESIC.SEMINALIS
 BULBO URETRALIS
( COWPER )
• BENTUK TUBULO ALVEOLAR
• EPITEL VARIASI : ALVEOLUS :KUBIS
DUKTUS:TORAK RENDAH
• VILI IRREGULER
• LETAK : TIAP SISI URETRA PARS CAVERNOSA
• ANTARA LOBULUS : PENY.KOLAGEN,SERAT
ELASTIN,OTOT POLOS,OTOT RANGKA
• FUNGSI SEKRET : PELUMAS URETRA SAAT EJAKULASI
 SCROTUM
• MEMBUNGKUS TESTIS
• KULIT TIPIS BERKERUT
• OTOT POLOS  M.DARTOS
• OTOT BERCORAK  M. CREMASTER
• SENSITIF TERHADAP TEMPERATUR
• FS: MENJAGA SUHU TESTIS
 CORPORA CAVERNOSA PENIS DAN C.C URETHRA

TUNIKA ALBUGINEA

A.PROFUNDA PENIS

A./V/N DORSALIS PENIS

CORPUS
CAVERNOSUM PENIS

CORPUS CAVERNOSUM
URETHRA URETHRA
 PENIS
• TIGA BADAN SILINDER ( CAVERNOSA)
C C PENIS  JAR. EREKTIL
C C URETRA  NON EREKTIL
• DISTAL TBTK GLANS PENIS
PROKSIMAL TBTK BULBUS URETRA
• PEMBUNGKUS SUBCUTAN + OTOT POLOS
• PREPUTIUM  CIRCUMSISI
• KELENJAR TYSON  SMEGMA
CORPUS SPONGIOSUM URETHRA

URETHRA PARS CAVERNOSA

 EREKSI

• PSIKIS,TAKTIL  STIMULASI COMPLEX

NEURAL PATHWAY ( N.PUDENDUS 
PLEKSUS SAKRALIS  CEREBRUM 
SYMPATIS  NEUROTRANSMITTER
VASODILATASI ARTERI PENIS  OTOT
POLOS CCP RELAKSASI, VENA TERTEKAN 
PENIS RIGID ( FASE TUMESCENSE )
 DYSFUNGSI EREKSI (IMPOTENSI)
• CAUSAL :
PSIKOGENIK FACTOR
ENDOCRINOLOGIC FACTOR
NEUROLOGIC FACTOR
ARTERIOGENIC FACTOR
DRUGS EFFECTS
 PRIAPISM
• EREKSI BERLANGSUNG 6-8 JAM
• CAUSAL:
ANAK SIKLE SEL ANEMIA
DWS UNKNOWN  MAYBE :
DRUGS,ALKOHOLISM,DISEASE
• TERAPI  ASPIRASI CCP ADRENALIN
RETRACTED GLANS PENIS

GLANS PENIS

PREPUTIUM
 METABOLISME TESTOSTERON
LIPOPROTEIN

CHOLESTEROL PREGNENOLON PROGESTERON

ACETAT

17ά HIDROXYPREGNENOLON 17ά HIDROXYPROGESTERON

DEHIDROEPIANDROSTERON ANDROSTENEDION ESTRONE

ESTRADIOL
TESTOSTERON
ANDROSTENEDIOL

5ά REDUCTASE
AROMATASE

DEHIDROTESTOSTERON
 MALE INFERTILITY
FIVE ETIOLOGICAL GROUPS
• 1.PRETESTICULAR CAUSES ( HYPOTALAMUS-HYPOPHISIS
DISORDERS)
• 2. TESTICULAR CAUSES ( FACTOR AFFECTING
SPERMATOGENESIS)
• 3.POST TESTICULAR CAUSES ( DUCTAL FACTOR AND
SEXUAL DYSFUNCTION)
• 4. GENITOURINARY INFECTION
• 5. IMMUNOLOGICAL CAUSES
 FEMALE INFERTILITY
• 1.DISORDERS IN MENSTRUAL RHYTHMS
PRIMARY OVARIAN FAILURE
OVULATORY FAILURE
HYPERANDROGENISM ( P.C.O.D )
LUTEAL PHASE DEFECT
• 2. DISORDERS IN FEMALE REPRODUCTIVE TRACT
TUBAL DEFECT
PERITONEAL FACTORS
UTERINE FACTORS
ENDOMETRIOSIS
CERVICAL MUCUS HOSTILITY
INFECTION ( P.I.D)
• 3. LIFE STYLE
DIET,MEROKOK,ALKOHOLISM,EXERCISE,
FACTOR LINGKUNGAN,PEKERJAAN,AGE
 CLINICAL APPLICATION
• ANDROPAUSE
• EJACULATION
• ORGASM
• PRIAPISM
• ERECTION
• DYSFUNGSI EREKSI ( IMPOTENCE )
• BENIGN PROSTATE HYPERFLASI ( BPH )
• SPERM ANALYSIS
• HERNIA SCROTALIS
• INFERTILITY
 CLINICAL APPLICATION
• CIRCUMSISI – PREPUTIUM
• DORSUMSISI
• KEL.TYSON  SMEGMA  BALANITIS PHIMOSIS  CIRCUMSISI
• VASEKTOMI
• UNDESCENCUS TESTICULORUM
(= CRYPTORCHYSMUS)
• AUTOIMMUN INFERTILITY
• STD
• ASSISTED REPRODUCTIVE TECHNOLOGY
IUI ( INTRA UTERINE INSEMINATION)
TESA / MESA ( MICRO EPIDIDIMAL SPERM ASPIRATION)
IVF, ICSI
 CLINICAL APPLICATION
• VARICOCELE
• HYDROCELE
• ORCHITIS
• EPISPADIA
• HYPOSPADIA
 MALE CONTRACEPTIONS
• CONDOM
• VASECTOMY
• INJECTION MPA
• POLYESTER SLING – CELANA DALAM KETAT
• PEMANASAN SCROTUM – BERENDAM AIR PANAS
• GOSSIPOL
 TERIMA KASIH
“SCIENCE GIVE US KNOWLEDGE BUT
ONLY PHYLOSOPHY CAN GIVE US
WISDOM”