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Male Genital System and Pathology (*Sertoli / Leydig Cells / Hormones /…

- - - - Erections and
        Erectile Dysfunction
        
        Erectile dysfunction case study:
        
        Notes:
        
        sildenifil is a PDE-5 inhibitor
        
        PDE-5 breaks down cGMP, which is downstream from NO (a SM vasodilator)
        --> NO released during sexual stimulation
        
        in the above, corpus cavernosum is the main tissue that maintains the erection through
        --> NO / cGMP / vasodilation and engorgement
        
        note that the corpus spongiosum is not meant to maintain the erection
        --> even though it also fills with venous blood
        --> its main purpose through the same NO / cGMP / PDE5 inhibition pathway is to actually close off the urethra to prevent urination during erection and promote a smaller space for ejaculation to shoot further into the woman's vagina
      - *PDE5 Inhibitors
        
        sildenafil = Viagra
        
        note that PDE inhibiotrs were actually developed from caffeine
        
        theophylline (use for bronchodilation in asthma as final agent)
        --> variant of caffeine
        
        how do these PDE inhibiotrs fit in with sildenafil
        --> same principle and method of action for increasing cGMP and increasing muscle relaxation
  - - - *Penis Anatomy
        
        Notes:
        
        the frenulum and prepuce = foreskin are removed during circumcision
        
        these have been shown to have higher sensitivity
        --> more stimulation during sex
        
        Notes:
        
        "In the BODY of the penis (= COPRUS), The CAVES fill with blood and the SPONGE soaks up the urethra pee."
        
        corpus cavernosum x 2
        --> meant to maintain the erection
        --> fill with blood from NO / cGMP / PDE5 inhibition
        
        corpus spongiosum
        --> meant to close off the urethra during sex
        --> also fill with blood from NO / cGMP / PDE5 inhibition
      - *Urethra Anatomy of male urethra
        -
- - - - Testosterone and ABPs
        (Androgen-binding proteins)
        
        Notes:
        
        sertoli cells make ABPs needed for high concentrations of test. in seminiferous tubules and epididymis
        --> spermatogenesis + sperm maturation
        
        the ABPs line the semiferous tubule that bring the testosterone and DHT into the tubule
        
        Clinical Case:
- - - - Testicular Cancer Until Proven otherwise
        
        Notes:
        
        note that testicular cancer is only seen in YOUNG males, NOT older males
        --> age 15 -35
        
        Clinical Cases
        
        Clinical Case
        
        Notes:
        
        note that
        
        Clinical Case