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Androgen insensitivity syndrome
Hypospadias and epispadias
Benign prostatic hyperplasia
Male hypoactive sexual desire disorder
Premature ovarian failure
Polycystic ovary syndrome
Sex cord-gonadal stromal tumor
Surface epithelial-stromal tumor
Germ cell ovarian tumor
Pelvic inflammatory disease
Female sexual interest and arousal disorder
Genito-pelvic pain and penetration disorder
Fibrocystic breast changes
Paget disease of the breast
Preeclampsia & eclampsia
Intrauterine growth restriction
Congenital cytomegalovirus (NORD)
Neonatal herpes simplex
Congenital rubella syndrome
Gestational trophoblastic disease
Fetal hydantoin syndrome
Fetal alcohol syndrome
Disorders of sex chromosomes: Pathology review
Prostate disorders and cancer: Pathology review
Testicular tumors: Pathology review
Uterine disorders: Pathology review
Ovarian cysts and tumors: Pathology review
Cervical cancer: Pathology review
Vaginal and vulvar disorders: Pathology review
Benign breast conditions: Pathology review
Breast cancer: Pathology review
Complications during pregnancy: Pathology review
Congenital TORCH infections: Pathology review
Disorders of sexual development and sex hormones: Pathology review
Amenorrhea: Pathology Review
Testicular and scrotal conditions: Pathology review
Sexually transmitted infections: Warts and ulcers: Pathology review
Sexually transmitted infections: Vaginitis and cervicitis: Pathology review
HIV and AIDS: Pathology review
Penile conditions: Pathology review
Penile conditions: Pathology review
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Antonia Syrnioti, MD
Aileen Lin, MScBMC
Jacob is a 32 year old male who comes to the emergency department because of a painful, sustained erection, which has lasted five hours now. Upon further questioning, Jacob tells you that he takes antidepressant medications. You immediately order a penile arterial blood gas analysis, which reveals decreased concentration of oxygen, increased concentration of carbon dioxide, and decreased arterial pH.
Next you see Tafari, a 55 year old male of African descent. Tafari is worried because he developed a lesion on the glans penis about six months ago, and it won’t go away. Upon physical examination, you notice that the lesion looks bright red and has well-defined borders. Finally, you decide to perform an excisional biopsy to remove and analyze the lesion.
Okay, based on the initial presentation, both Jacob and Tafari seem to have some form of penile condition.
Now, the penis is made of three long cylindrical bodies: the corpus spongiosum that surrounds the penile urethra, and the two corpora cavernosa that are made of erectile tissue. The corpora cavernosa are wrapped in a fibrous coat called the tunica albuginea, and each corpus cavernosum is made up of blood-filled spaces called the cavernosal spaces. These spaces are lined with endothelial cells surrounded by smooth muscle. Running down the center of each corpus cavernosum is a large artery called the deep artery, which gives off smaller arteries that supply the cavernosal spaces. Next, blood gets drained from these spaces by small emissary veins, which drain into the deep dorsal vein. This vein then carries the blood back into the systemic circulation.
Now, for your exams, some high yield penile conditions you must absolutely remember include Peyronie disease, priapism, and squamous cell carcinoma of the penis.
Let’s start with Peyronie disease, which refers to an abnormal curvature of the penis. For your exams, make sure you don’t confuse this disease with a penile fracture, where penile injury may result in rupture of the corpora cavernosa, leading to an abnormal penile curvature. In contrast, the cause of Peyronie disease is not fully understood, however, it’s thought to be associated with repeated microtrauma during sexual intercourse. This is followed by local inflammation and collagen deposition creating a fibrous plaque in the tunica albuginea.
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