DEVELOPMENT DEVELOPMENT OF OF

MALE GENITAL SYSTEMMALE GENITAL SYSTEM

Prof. Ahmed Fathalla Prof. Ahmed Fathalla IbrahimIbrahimDr.Sanaa AlshaarawyDr.Sanaa Alshaarawy

OBJECTIVESOBJECTIVES

At the end of the lecture, students should be able At the end of the lecture, students should be able to:to:

List the causes of differentiation of genitalia into the male type.

Describe the origin of each part of the male internal & external genitalia.

List the causes & describe the events of descent of testis.

List the common anomalies of male genital system & describe the causes of each of them.

Gonad : Testis. Genital Ducts: Epididymis. Vas deferens. Urethra. Genital Glands: Seminale vesicle. Prostate. Bulbourethral

Glands.

DEVELOPMENT OF DEVELOPMENT OF GONADSGONADS

During 5During 5thth week: week: gonadal development occurs.

Until 7Until 7thth week: week: gonads are similarsimilar in both sexes

Gonads are derived from 3 sources:3 sources:

1. Mesothelium (mesodermal epithelium lining the coelomic cavity)

2. Underlying mesenchyme3. Primordial germ cells

INDIFFERENT GONADSINDIFFERENT GONADS Gonadal ridge: Gonadal ridge: a bulge on the medial side of mesonephros

produced by:1. Proliferation of mesothelium

(cortex)(cortex)2. Proliferation of mesenchyme

(medulla)(medulla) Gonadal (primary sex) cords: Gonadal (primary sex) cords: The proliferating mesothelial

cells fuse and penetrate the underlying mesenchyme to form gonadal cords.

Primordial germ cells:Primordial germ cells: endodermal cells endodermal cells of the yolk sac migrate along dorsal mesentery of hindgut to gonadal ridges & become incorporated into gonadal cords.

In Medulla

Germ cells

Mesothelial cells

DEVELOPMENT OF DEVELOPMENT OF TESTISTESTIS

The Y chromosome has a has a testis-determining factor testis-determining factor (TDS)(TDS) that differentiates gonad into testis.

At 7At 7thth week: week: Regression of cortex &

differentiation of medulla differentiation of medulla into testis.into testis.

Gonadal cords condense & extend into medulla to extend into medulla to form form seminiferous cords.seminiferous cords.

The characteristic feature is the development of a thick fibrous capsule (tunica albuginea) (tunica albuginea) that separates the enlarging testis from mesonephros.

DEVELOPMENT OF DEVELOPMENT OF TESTISTESTIS

Seminiferous cords Seminiferous cords develop into: semineferous tubulessemineferous tubules

Semineferous tubules remain solid until pubertyuntil puberty. Its walls are composed of:

1.1. Sertoli cells: Sertoli cells: derived from surface epithelium of testis (mesothelial (mesothelial cells)cells)

2.2. Spermatogonia: Spermatogonia: derived from primordial germ cellsprimordial germ cells

By eighth week, By eighth week, mesenchymemesenchyme surrounding semineferous cords gives rise to interstitial cells (of interstitial cells (of Leydig)Leydig) secreting testosterone.

Germ cells Mesothelial

CellsMesenchymal cells

DEVELOPMENT OF MALE GENITAL DUCTSDEVELOPMENT OF MALE GENITAL DUCTS

Leydig’s cellsLeydig’s cells Sertoli cellsSertoli cells

Testosterone Testosterone (8(8thth week) week) Müllerian inhibiting substanceMüllerian inhibiting substance(Anti- Müllerian hormone) (Anti- Müllerian hormone) (7(7thth week) week)

1)1) Masculine differentiation ofMasculine differentiation ofmesonephric ductmesonephric duct: : epididymis,epididymis,vas deferens, seminal glands, vas deferens, seminal glands,

ejaculatory duct.ejaculatory duct.2) 2) Masculine differentiation ofMasculine differentiation of

external genitaliaexternal genitalia

Suppression of developmentSuppression of developmentof paramesonephric of paramesonephric

(Müllerian) duct(Müllerian) duct

DEVELOPMENT OF MALE DEVELOPMENT OF MALE GENITAL GLANDSGENITAL GLANDS

1. SEMINAL GLAND: mesodermal outgrowth from mesonephric duct.

2. PROSTATE GLAND: endodermal outgrowth from prostatic urethra.

3. BULBOURETHRAL GLAND: endodermal outgrowth from spongy urethra.Stroma & smooth muscles in 2 & 3 are derived from surrounding mesenchyme

Genital tubercle: produced from mesenchyme at the cranial end of cloacal membrane. It elongates to form a primordial phallusUrogenital folds: develop on each side of cloacal membraneLabioscrotal swellings: develop on each side of urogenital folds

INDIFFERENT INDIFFERENT STAGESTAGE

OFOFEXTERNAL EXTERNAL GENITALIAGENITALIA

(from 4(from 4thth to 7 to 7thth week)week)

DEVELOPMENT OF MALE EXTERNAL DEVELOPMENT OF MALE EXTERNAL GENITALIAGENITALIA

(stimulated by testosterone)(stimulated by testosterone) Begins Begins at 99thth week week Complete Complete

differentiation differentiation at 1212thth weekweek:

1.1. The phallus The phallus enlarges to form the the penispenis

2.2. The urogenital folds The urogenital folds fuse to form the the spongy (penile) spongy (penile) urethraurethra

3.3. The labioscrotal folds The labioscrotal folds (swellings) (swellings) fuse to form the scrotumthe scrotum

DESCENT OF TESTISDESCENT OF TESTIS

Labioscrotal fold

Scrotum

Inguinal canal

Internal descent

External descent

DESCENT OF TESTISDESCENT OF TESTIS

Gubernaculum:Gubernaculum: a mesenchymal band extending from inferior pole of gonad to labioscrotal fold.

Inguinal canal: Inguinal canal: a pathway formed by gubernaculum through layers of anterior abdominal wall.

Processus vaginalis: Processus vaginalis: a peritoneal fold passing through inguinal canal before testis to facilitate its descent.

INTERNAL DESCENT OF INTERNAL DESCENT OF TESTISTESTIS

Definition:Definition: Descent of testis from posterior abdominal wall to deep inguinal ring.

Time:Time: During 1212thth week week Cause: Cause: a relative relative

movement movement resulting from elongation of cranial part of abdomen away from its caudal part (future pelvic cavity).

Inguinal canal

EXTERNAL DESCENT OF EXTERNAL DESCENT OF TESTISTESTIS

Definition: Definition: Descent of testis from deep inguinal ring, through inguinal canal, to scrotum

Time:Time: Begins in 77thth month month and takes 2 to 3 daystakes 2 to 3 days

Causes: Causes: 1. Controlled by androgens.androgens.2. Guided by gubernaculum. gubernaculum. 3. Facilitated by processus processus

vaginalis.vaginalis.4. Helped by increased increased

intra-abdominal pressure intra-abdominal pressure resulting from growth of abdominal viscera.

EXTERNAL DESCENT OF EXTERNAL DESCENT OF TESTISTESTIS

1. More than 97% of full-termfull-term new born males have both testes in scrotum.

2. During first 3 months after birthfirst 3 months after birth, most undescended testes descend into scrotum.

3. No spontaneous descent occurs after the age of 1 yearafter the age of 1 year.

EXTERNAL DESCENT OF EXTERNAL DESCENT OF TESTISTESTIS

Complete descent of testis Complete descent of testis is associated by:is associated by:

Degeneration of gubernaculum

Obliteration of stalk of processus vaginalis

Persistence of part of processus vaginalis surrounding the testis in the scrotum to form “tunica vaginalis”

CRYPTORCHIDISMCRYPTORCHIDISM(UNDESCENDED TESTIS)(UNDESCENDED TESTIS)

Incidence: Incidence: in up to 30% of premature & 3-4% of full term males

Cause:Cause: deficiency of androgens.

Common sites: Common sites: look to figurelook to figure Complications:Complications:

1. Sterility, if bilateral.

2. Testicular cancer (20-44%).

CONGENITAL INGUINAL CONGENITAL INGUINAL HERNIAHERNIA

Definition:Definition: Herniation of a loop of intestine through a non-obliterated processus vaginalis.

A:A: incomplete incomplete B: B: complete (in scrotum)complete (in scrotum)

Cause: Cause: The processus vaginalis does not obliterate & remains in open communication with the peritoneal cavity.

HYDROCELE OF SPERMATIC CORDHYDROCELE OF SPERMATIC CORDAccumulation of fluid in spermatic

cord due to a non-obliterated portion of stalk of processus vaginalis

HYDROCELE OF TESTISHYDROCELE OF TESTISAccumulation of fluid in tunica vaginalis

(in scrotum) due to non-obliteration of the whole stalk of Processus vaginalis

THANK YOU

1.Which of the following is the characteristic feature of the testicular development ?a. Rete testis.b. Seminiferous cords.c. Tunica albuginea.d. Testis- determining factor (TDF).

2. Which structure gives rise the seminal gland ?a. Genital tubercle.b. Mesonephric duct.c. Paramesonephric duct.d. Urogenital sinus.

3. Which one of the following contributes in accumulation of fluid in scrotum?a.Cryptorchidism.b.Congenital inguinal hernia.c.Hydrocele of spermatic cord.d.Hydrocele of testis.