Urinary System

and
Male Genitalia
I Nyoman Mangku Karmaya
 Urogenital System
Terdiri dari:
1. Urinary system :
A. Kidney
B. Sistem saluran :
– Ureter, vesica urinaria, urethra
2. Genital system :
A. Male genital system : - interna
- externa
B.Female genital system : - interna
- externa

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URINARY
SYSTEM

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Embryology of the Kidney at glance
• Berasal dari mesoderm, akhir minggu 3
 Embryology of the Kidney at glance

Tahapan-
tahapan
1. Pronephros
2. Mesonephros
3. Metanephros
Embryology of the Kidney at glance
 Embryology
of the Kidney
at glance
Embryology of the Kidney at glance
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Pria Dewasa
130 – 150 gram

Perempuan
lebih ringan

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 Kidneys :
retroperitoneal

Ureter :
retroperitoneal

Urinary bladder :
subperitoneal

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 (Fascia
Gerota)

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 Columna
Renalis Bertin

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RENAL ARTERY
AND ITS
SEGMENTATION

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 BLOOD
SUPPLY

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 Arteriole eferen
Arteriole aferen

Interlobular a.

Arcuate a.

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 Epith parietal
TCD Bowman space
Epith visceral

TCP

Loop of
Henle

NEPHRON (cortical and

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Yuxtamedullary)
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 CLINICAL CONSIDERATION

• GLOMERULONEPHRITIS
• HYDRONEPHROSIS
• KIDNEY STONES
• RENAL FAILURE
• DEVELOPMENTAL ANOMALIES:
– POLYSTIC KIDNEY
– HORSESHOE KIDNEY
– LOBATED KIDNEY
– ECTOPIC KIDNEY
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Ureter
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 Kelainan Uereter
• Duplication of the ureter: a congenital (from
birth) condition in which two ureters form on the
same kidney.
• Ureteropelvic junction obstruction: this occurs
when the connection between the kidney and
ureter is blocked, preventing urine from exiting
the kidney.
• Ureterovesical junction obstruction: When the
connection between the ureter and bladder is
blocked.
Urethra laki-laki
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 Vagina

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27.16
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Catheter
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URETHRA

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 Male Genital System

1. Internal genitalia :
a. Testis (jamak: testes)
b. Epididymis
c. Ductus deferens
d. Seminal gland
e. Ejaculatory ducts
f. Prostate
g. Bulbourethral glands
2. External genitalia :
a. Scrotum
b. Penis
 Male Genital System
• Primary sex organ : testes
• Secondary sex organ:
– a. Epididymis.
– b. Ductus (Vas) Deferens.
– c. Seminal Vesicles.
– d. Ejaculatory Duct.
– e. Prostate Gland.
– f. Penis.
Testis manufacturing
sperm and anfrogen
Testis
Gubernaculum = pita jaringan ikat yang menghubungkan testis janin
dengan bagian bawah skrotum. Tidak bisa meregang (panjang tetap)
sehingga ketika bayi memanjang testes seolah tertarik menyebabkan
turunnya testis.
Spermatic cord
1. a. spermatica, a.
cremasterica, a.vas
defferens
2. Vena: v.spermatica
(plexus
pampiniformis)
3. Pembuluh lymphe
4. Syaraf: plexus
spermaticus
(simpathis)
 The spermatic cord covered by:
• Internal spermatic fascia :
derived from an
extension of the
transversalis fascia
• Cremasteric fascia :
derived from the fascia
covering the superficial
and deep aspect of
the internal oblique
• External spermatic fascia
derived from the
external oblique aponeurosis
 Prostate gland

Location
 low level in lesser pelvis

behind the inferior border

of the symphysis pubis and pubic arch

 anterior to rectal ampulla

Structure – 2 (Lobation)
anterior urethra  fibromuscular -
continuation of the urethral
sphincter muscle little glandular
tissue
Anterior Lobe

Inferolateral lobe
major part of prostate

Inferoposterior lobe Posterior urethra & inferior ejaculatory

duct  palpated by DRE
 Ducts, Vascularization, & Innervation
• Prostatic ducts  prostatic fluid  20% of the semen
volume open into prostatic sinuses
• Artery (branches of the internal illiac artery)
– inferior vesical artery
– internal pudendal artery
– middle rectal artery.
• The prostatic veins  prostatic venous plexus 
drains into internal iliac veins
• lymphatic vessel chiefly in the internal iliac lymph
node others pass to sacral node
• Innervated by sympathetic nerve from inferior
hypogastric plexus
• The prostatic capsule  periprostatic nerve plexus
The ridged band contains more Meissner's corpuscles and exhibits
features of specialized sensory mucosa
The frenulum
is the most
sensitive part
of the penis,
containing a
huge number
of nerve
endings.
Meissner’s corpuscle
The skin sliding up and down the shaft of the
penis acts as a lubricant for masturbation or
intercourse
 GLIDING
MECHANISM
 Fungsi preputium penis
• to cover and bond with the synechia so as to
permit the development of the mucosal surface of
the glans and inner foreskin.
• to protect the infant's glans from feces and
ammonia in diapers.
• to protect the glans penis from friction and
abrasion throughout life.
• to keep the glans moisturized and soft with
emollient oils.
• to lubricate the glans.
• to coat the glans with a waxy protective substance.
 Fungsi preputium penis
• to provide sufficient skin to cover an erection by
unfolding.
• to provide an aid to masturbation and foreplay.
• to serve as an aid to penetration.
• to reduce friction and chafing during intercourse.
• to serve as erogenous tissue because of its rich
supply of erogenous receptors.
• to contact and stimulate the G-spot of the female
partner
Vagina
Gliding
mechanism
during
sexual
intercourse
Erectile tissue
 KELAINAN
• Testis: hidrokel, varikokel, infeksi
• Ductus deferens: sumbatan
• Prostat: tumor, kanker, infeksi
• Vesicula seminalis: infeksi
• Urethra: infeksi, tersumbat batu, hipospadia,
epispadia
• Penis: kanker, infeksi, kelainan bawaan
• Kelainan fungsi : DE
Hypospadia

Epispadia
Varicocele

Left testis >

right testis
FUNGSI ALAT REPRODUKSI

• MAU
• MAMPU
• BERHASIL
• AMAN
• MEMUASKAN