Page From G-K-Pal-Comprehensive-Textbook-of-Medical-Physiology

Chapter 67: Male Reproductive System 603
TESTICULAR ABNORMALITIES Male Hypogonadism

There are mainly two types: Hypergonadotropic hypog-
Cryptorchidism onadism and hypogonadotropic hypogonadism.
The failure of migration of testis from abdominal cavity
into the scrotum during fetal development is called unde- Hypergonadotropic Hypogonadism
scended testis or cryptorchidism. The usual site of unde- If this occurs due to testicular dysfunctions, plasma level
scended testis is inguinal rings. of gonadotropin is increased.
1. From posterior wall of the abdomen testis first
descends into the inguinal region and then from there Hypogonadotropic Hypogonadism
into the scrotum. This ocurs mainly due to tumor of hypothalamus or pitui-
2. The descent from abdomen into the inguinal region tary. Gonadotropin level in plasma is depressed.
depends on MIS. 1. If hypogonadism occurs after puberty, the secondary
3. The descent from inguinal region to scrotum depends sex characteristics regress slowly as androgenic main-
on testosterone and other factors. tenance of these features is less essential. However,
4. Descent of testis normally completes in few days loss of libido is common.
before the birth. 2. If loss of Leydig cells occurs from childhood, eunu-
choidism results.
Treatment −− Enuchoids are usually tall, with narrow shoulders
Treatment with gonadotropin hormones facilitates the and less muscular development.
descent of testis. Surgical correction is required when the −− The genitalia are small.
hormonal treatment fails. −− Though pubic hairs are present they are usually sparse
and exhibit female pattern, i.e. triangle with base up.
Complications
Androgen Secreting Tumors
Undescended testis decreases sperm production, as
temperature is high in the abdomen. The incidence of Hypersecretion of testis is usually due to a tumor in the
malignant tumors is significantly more in undescended testis. Leydig cell tumors secrete androgen and result in
testis. precocious puberty in prepubertal boys.
CHAPTER SUMMARY
Key Concepts
1. In males, gametogenesis is a continuous process. Gametes (sperms) are produced in millions every day, and the process continues
throughout life starting from puberty, though the rate of production decreases in old age.
2. Sertoli cells provide support to the germ cells in the process of spermatogenesis. The tight junctions between Sertoli cells from the
blood-testis barrier that provides protection to developing sperms from harmful blood born toxins.
3. Leydig cells secrete testosterone that provides hormonal stimulation for spermatogenesis.
Important to Know (Must Read)
1. In examination, ‘Describe the steps of spermatogenesis and factors controlling spermatogenesis, may be asked as a Long Question.
2. Spermatogenesis, Factors controlling spermatogenesis, Functions of Sertoli cells, Leydig cells, Blood-testis barrier, Spermiogenesis,
Semen analysis, Physiological actions of testosterone, Testicular abnormalities, are usual Short Questions in exam.
3. In Viva, examiner may ask… List the steps of spermatogenesis, List the factors controlling spermatogenesis, What is the duration of
spermatogenesis, What is the rate of production of sperms, List the functions of testis, Why the scrotal temperature is lower than core
body temperature, What is blood-testis barrier and what are its functions, What is the structure of a spermatozoa, What is the fate of
stored spermatozoa, What is the composition of normal semen, How do you assess male infertility, What is the source of testosterone,
List the physiological actions of testosterone, What are the secondary sex characteristics in male, List the functions of Sertoli cells, What
are the functions of Leydig cells, What is the fate of testosterone secreted from Leydig cells, What is cryptorchidism and what is its
treatment and complications, What is spermiogenesis and what are the changes that occur during this period, What is spermiation,
What is capacitation, What is acrosomal reaction, What are the function of prostate glands, Why is the prostate specific antigen (PSA) a
marker of prostate cancer, What is the use of 5α -reductase inhibitors in prostate hypertrophy, What is penis-at-14 syndrome, What is the
source of estrogen in males, What are the causes of gynecomastia in males, What are the types and causes of male hypogonadism, What
is eunuchoidism, What are the other testicular hormones and what are their functions, How is the testicular functions regulated, What is
the mechanism of action of testosterone, What is CatSper protein and what is its function, , List the differences between spermatogenesis
and oogenesis, What is the structure and function of epididymis, How do the Leydig cells and Sertoli cells interact, What are the function
of vas deferens, What are the function of bulbourethral glands, What is the effect of androgen secreting tumors.

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Chapter 67: Male Reproductive System 603

TESTICULAR ABNORMALITIES Male Hypogonadism

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