Male-reproductive-organ-copy-2.pdf

THE MALE

REPRODUCTIVE SYSTEM

Table of Contents • Functions of Male Reproductive system • Pictures • Scrotum •Definition •Parts •Function •Health Issues • Testes •Function •External Characteristics •Blood Supply and Lymphatic Drainage •Blood Testis Barrier •Development •Health Issues •Spermatogenesis •Process •Purpose •Location •Spermatocytogenesis •Spermatidogenesis

•Spermiogenesis •Influencing Factors •Hormonal Control • Duct System • Penis •Parts •Disorders • Glands • Secretions • Physiology of Male Reproduction • Puberty • Effects of Testosterone • Major Reproductive Hormones in Male • Male Pattern Baldness • Male Sexual Behavior and Male Sex Act • Sensory Impulses and Integration • Erection, Emission, and Ejaculation • Treatment of Erectile Dysfunction • Infertility in Male

MALE REPRODUCTIVE FUNTIONS: - Production of Sperm Cells The reproductive system produces male sex cells, or sperm cells, in the testes

- Sustaining and Transfer of the Sperm Cells to the Female - the duct system provides nutrients for the sperm cells produced in the testes - provides an environment in which the sperm cells mature - provides secretion that form most of the volume of the semen transferred to the female

MALE REPRODUCTIVE FUNTIONS:

- transports the sperm cells from the testes through the penis

- Production of Male Sex Hormone - Hormones produced by the male reproductive system control the development of the reproductive system itself and of the male body form. - Hormones are also essential for the normal function of the reproductive system and reproductive behavior

Scrotum - Introduction • In some male mammals, the scrotum is a protuberance of skin and muscle containing the testicles. • It is an extension of the abdomen, and is located between the penis and anus. In humans, and some other mammals, the base of the scrotum becomes covered with pubic hair at puberty. • In common speech, the scrotum is often improperly referred to as the testicles, which actually refer to organs encased inside the scrotum. The scrotum is homologous to the labia majora in females. In slang, the scrotum is often referred to as the "nut sack."

The Scrotum

Scrotum • The Scrotum is a cutaneous pouch which contains the testes and parts of the spermatic cords. It is divided on its surface into two lateral portions by a ridge or raphé, which is continued forward to the under surface of the penis, and backward, along the middle line of the perineum to the anus. Of these two lateral portions the left hangs lower than the right, to correspond with the greater length of the left spermatic cord. Its external aspect varies under different circumstances: thus, under the influence of warmth, and in old and debilitated persons, it becomes elongated and flaccid; but, under the influence of cold, and in the young and robust, it is short, corrugated, and closely applied to the testes.

Parts of the Scrotum • The scrotum consists of two layers, the integument and the dartos tunic. •

The Integument is very thin, of a brownish color, and generally thrown into folds or rugæ. It is provided with sebaceous follicles, the secretion of which has a peculiar odor, and is beset with thinly scattered, crisp hairs, the roots of which are seen through the skin.

• The Dartos Tunic (tunica dartos) is a thin layer of non-striped muscular fibers, continuous, around the base of the scrotum, with the two layers of the superficial fascia of the groin and the perineum; it sends inward a septum, which divides the scrotal pouch into two cavities for the testes, and extends between the raphé and the under surface of the penis, as far as its root.

Parts of the Scrotum

Function of the Scrotum •

The function of the scrotum appears to be to keep the testes at a temperature slightly lower than that of the rest of the body. For the human, a temperature around 34.4 degrees Celsius seems to be ideal; 36.7 degrees Celsius may be damaging to sperm count.

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The temperature is controlled by moving the testicles closer to the abdomen when it is cold, and away when hot. This is done by the contracting and relaxing of the cremaster muscle in the abdomen and the dartos fascia (muscular tissue under the skin) in the scrotum. However, this may not be the main function.

Function of the Scrotum •

The volume of sperm produced by the testes is small, (0.1-0.2ml). It has been suggested that if testes were situated within the abdominal cavity that they would be subjected to the regular changes in abdominal pressure that is exerted by the abdominal muscles. This squeezing and relaxing would result in the more rapid emptying of the testes and epididymes of sperm before the spermatozoa were matured sufficiently for fertilization.

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Some mammals do keep their testes within the abdomen and there may be mechanisms to prevent this inadvertent emptying e.g. elephants, sea mammals.

Health Issues of the Scrotum • Sebaceous Cyst (Epidermal Cyst) • Hydrocele (Elephantiasis) • Hematocele • Spermatocele • Varicocele

Other Scrotum Health Issues • Contact Dermatitis • Inguinal Hernia • Candidiasis (Yeast Infection) • Heart Failure • Kidney or Liver Disease

Sample of a Male Scrotum

Testes - Introduction •

The testicle (from Latin testis, meaning "witness", plural testes) or ballock is the male generative gland in animals. This article will concentrate on mammalian testicles unless otherwise noted.

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The gonad is the organ that makes gametes. The gonads in males are the testes and the gonads in females are the ovaries. The product, gametes, are haploid germ cells. For example, sperm and egg cells are gametes. Although medically the gonad term can refer to either male gonads (testicles) or female gonads (ovaries), the vernacular, or slang use of "gonads" (or "nads") usually only refers to the testicles.

Function of the Testes • The respective functions of the testicles are: • producing sperm (spermatozoa) • producing male sex hormones, of which testosterone is the best-known. • Both functions of the testicle, sperm-forming and endocrine, are under control of gonadotropic hormones produced by the anterior pituitary: • luteinizing hormone (LH) • follicle-stimulating hormone (FSH)

Testes – External Characteristics • Male mammals have two testicles, which are often contained within an extension of the abdomen called the scrotum. In mammals with external testicles it is most common for one testis to hang lower than the other. • It is estimated that in about 85% of men the lower hanging testicle is the left one. This is due to differences in the vascular anatomical structure on the right and left sides.

Testes – External Characteristics • In normal adult human males, testicular size ranges from the lower end of around 14 cm³ to the upper end larger than 35 cm³. Measurement in the living adult is done in two basic ways: • comparing the testicle with ellipsoids of known sizes (orchidometer). • measuring the length, depth and width with a ruler, a pair of calipers or ultrasound imaging.

Testes – External Characteristics •

To some extent, it is possible to change testicular size. Short of direct injury or subjecting them to adverse conditions, e.g., higher temperature than they are normally accustomed to, they can be shrunk by competing against their intrinsic hormonal function through the use of externally administered steroidal hormones.

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Steroids taken for muscle enhancement often have the undesired side effect of testicular shrinkage. Similarly, stimulation of testicular functions via gonadotropic like hormones may enlarge their size.

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Testicles may shrink or atrophy during hormone replacement therapy.

Testes – Blood Supply • The paired testicular arteries arise directly from the abdominal aorta and descend through the inguinal canal, while the scrotum and the rest of the external genitalia is supplied by the internal pudendal artery (itself a branch of the internal iliac artery).

Testes - Lymphatic Drainage • Lymphatic drainage of the testes follows the testicular arteries back to the paraaortic lymph nodes, while lymph from the scrotum drains to the inguinal lymph nodes.

Parts of the Testes

The Blood-Testis Barrier • Large molecules cannot pass from the blood into the lumen of a seminiferous tubule due to the presence of tight junctions between adjacent Sertoli cells. • The spermatogonia are in the basal compartment (deep to the level of the tight junctions) and the more mature forms such as primary and secondary spermatocytes and spermatids are in the adluminal compartment.

The Blood-Testis Barrier • The function of the blood-testis barrier may be to prevent an auto-immune reaction. Mature sperm (and their antigens) arise long after immune tolerance is established in infancy. Therefore, since sperm are antigenically different from self tissue, a male animal can react immunologically to his own sperm. In fact, he is capable of making antibodies against them. • Injection of sperm antigens causes inflammation of the testis (autoimmune orchitis) and reduced fertility. Thus, the blood-testis barrier may reduce the likelihood that sperm proteins will induce an immune response, reducing fertility and so progeny.

Health Issues of the Testes • • • • • • • •

Testicular Cancer Neoplasm Hydrocele Testis Orchitis Epididymitis Spermatic Cord Torsion (Testicular Torsion) Varicocele Anorchidism

Spermatogenesis - Introduction • is the process by which male spermatogonia develop into mature spermatozoa. • Spermatozoa are the mature male gametes, in many sexually reproducing organisms. Thus, spermatogenesis is the male version of gametogenesis. In mammals it occurs in the male testes and epididymis in a stepwise fashion, and for humans takes approximately 64 days.

Spermatogenesis • is highly dependent upon optimal conditions for the process to occur correctly, and is essential for sexual reproduction. • It starts at puberty and usually continues uninterrupted until death, although a slight decrease can be discerned in the quantity of produced sperm with increase in age.

Spermatogenesis - Process

Cell type spermatogonium (types A and B) primary spermatocyte

ploidy/ chromatids chromosomes

Process

diploid/46

2N

spermatocyto genesis (mitosis)

4N

spermatidoge nesis (meiosis 1)

diploid/46

secondary spermatocyte

haploid/23

2N

spermatidoge nesis (meiosis 2)

spermatid

haploid/23

1N

spermiogenesi s

spermatozoon

haploid/23

1N

spermiation

Epithelium of a Seminiferous Tubule

Spermatozoon

Spermatogenesis - Purpose • Spermatogenesis produces mature male gametes, commonly called sperm but specifically known as spermatozoa, which are able to fertilize the counterpart female gamete, the oocyte, during conception to produce a single-celled individual known as a zygote. • This is the cornerstone of sexual reproduction and involves the two gametes both contributing half the normal set of chromosomes (haploid) to result in a chromosomally normal (diploid) zygote.

Spermatogenesis - Location •

Spermatogenesis takes place within several structures of the male reproductive system. The initial stages occur within the testes and progress to the epididymis where the developing gametes mature and are stored until ejaculation.

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The seminiferous tubules of the testes are the starting point for the process, where stem cells adjacent to the inner tubule wall divide in a centripetal direction beginning at the walls and proceeding into the innermost part, or lumen to produce immature sperm. Maturation occurs in the epididymis and involves the acquisition of a tail and hence motility.

Spermatocytogenesis • Spermatocytogenesis is the male form of gametocytogenesis and results in the formation of spermatocytes possessing half the normal complement of genetic material. In spermatocytogenesis, a diploid spermatogonium divides mitotically to produce a diploid intermediate cell called a primary spermatocyte. • Each primary spermatocyte duplicates its DNA and subsequently undergoes meiosis I to produce two haploid secondary spermatocytes. This division implicates sources of genetic variation, such as random inclusion of either parental chromosomes, and chromosomal crossover, to increase the genetic variability of the gamete.

Spermatocytogenesis • Each cell division from a spermatogonium to a spermatid is incomplete; the cells remain connected to one another by bridges of cytoplasm to allow synchronous development. • It should also be noted that not all spermatogonia divide to produce spermatocytes, otherwise the supply would run out. Instead, certain types of spermatogonia divide to produce copies of themselves, thereby ensuring a constant supply of gametogonia to fuel spermatogenesis.

Spermatidogenesis • Spermatidogenesis is the creation of spermatids from secondary spermatocytes. • Secondary spermatocytes produced earlier rapidly enter meiosis II and divide to produce haploid spermatids. The brevity of this stage means that secondary spermatocytes are rarely seen in histological preparations.

Spermiogenesis • During spermiogenesis, the spermatids begin to grow a tail, and develop a thickened mid-piece, where the mitochondria gather and form an axoneme. • Spermatid DNA also undergoes packaging, becoming highly condensed. The DNA is packaged firstly with specific nuclear basic proteins, which are subsequently replaced with protamines during spermatid elongation. The resultant tightly packed chromatin is transcriptionally inactive. The Golgi apparatus surrounds the now condensed nucleus, becoming the acrosome. One of the centrioles of the cell elongates to become the tail of the sperm.

Spermiogenesis • Maturation then takes place, which removes the remaining unnecessary cytoplasm and organelles. • The excess cytoplasm, known as residual bodies, is phagocytosed by surrounding Sertoli cells in the testes. The resulting spermatozoa are now mature but lack motility, rendering them sterile. The mature spermatozoa are released from the protective Sertoli cells into the lumen of the seminiferous tubule in a process called spermiation.

Spermiogenesis • The non-motile spermatozoa are transported to the epididymis in testicular fluid secreted by the Sertoli cells with the aid of peristaltic contraction. Whilst in the epididymis they acquire motility and become capable of fertilization. • However, transport of the mature spermatozoa through the remainder of the male reproductive system is achieved via muscle contraction rather than the spermatozoon's recently acquired motility.

Influencing Factors • The process of spermatogenesis is highly sensitive to fluctuations in the environment, particularly hormones and temperature. • Testosterone is required in large local concentrations to maintain the process, which is achieved via the binding of testosterone by androgen binding protein present in the seminiferous tubules. Testosterone is also produced by interstitial cells, also known as Leydig cells, which preside adjacent to the seminiferous tubules.

Influencing Factors •

Seminiferous epithelium is sensitive to elevated temperature in humans and some other species, and will be adversely affected by temperatures exceeding 4°C - 5°C less than normal body temperature. Consequently, the testes are located outside the body in a sack of skin called the scrotum. Optimal temperature is maintained by the retraction and relaxation of the scrotum towards and away from the heat of the body depending on the environmental temperature.

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Dietary deficiencies (such as vitamins B, E and A), anabolic steroids, metals (cadmium and lead), x-ray exposure, dioxin, alcohol, and infectious diseases will also adversely affect the rate of spermatogenesis.

DUCT SYSTEM Sperm cells pass through a series of ducts to reach the outside of the body. After they leave the testes, the sperm passes through the epididymis, ductus deferens, ejaculatory duct, and urethra. • Epididymis . Sperm leave the testes through a series of efferent ducts that enter the epididymis. Each epididymis is a long (about 6 meters) tube that is tightly coiled to form a commashaped organ located along the superior and posterior margins of the testes. When the sperm leave the testes, they are immature and incapable of fertilizing ova. They complete their maturation process and become fertile as they move through the epididymis. Mature sperm are stored in the lower portion, or tail, of the epididymis

Duct System •

Ductus Deferens also called vas deferens, is a fibromuscular tube that is continuous with the epididymis. It begins at the bottom (tail) of the epididymis then turns sharply upward along the posterior margin of the testes. The ductus deferens enters the abdominopelvic cavity through the inguinal canal and passes along the lateral pelvic wall. It crosses over the ureter and posterior portion of the urinary bladder, and then descends along the posterior wall of the bladder toward the prostate gland. Just before it reaches the prostate gland, each ductus deferens enlarges to form an ampulla. Sperm are stored in the proximal portion of the ductus deferens, near the epididymis, and peristaltic movements propel the sperm through the tube.

DUCT SYSTEM •

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Ductus Deferens The proximal portion of the ductus deferens is a component of the spermatic cord, which contains vascular and neural structures that supply the testes. The spermatic cord contains the ductus deferens, testicular artery and veins, lymph vessels, testicular nerve, cremaster muscle that elevates the testes for warmth and at times of sexual stimulation, and a connective tissue covering. Ejaculatory Duct Each ductus deferens, at the ampulla, joins the duct from the adjacent seminal vesicle (one of the accessory glands) to form a short ejaculatory duct. Each ejaculatory duct passes through the prostate gland and empties into the urethra.

DUCT SYSTEM •

Urethra The urethra extends from the urinary bladder to the external urethral orifice at the tip of the penis. It is a passageway for sperm and fluids from the reproductive system and urine from the urinary system. While reproductive fluids are passing through the urethra, sphincters contract tightly to keep urine from entering the urethra. The male urethra is divided into three regions: - The prostatic urethra is the proximal portion that passes through the prostate gland. It receives the ejaculatory duct, which contains sperm and secretions from the seminal vesicles, and numerous ducts from the prostate glands. -the membranous urethra, is a short region that passes through the pelvic floor. -The longest portion is the spongy urethra which extends the length of the penis and opens to the outside at the external urethral orifice. The ducts from the bulbourethral glands open into the penile urethra.

PENIS • copulatory organ of the male • contains 3 columns of erectile tissue • ROOT – attach to the wall of abdomen

• BODY or SHAFT – attach to the wall of abdomen • GLANS – cone-shaped end of the penis

ERECTION – engorgement of the erectile tissue with blood causes penis to enlarge and become firm

PENIS CORPORA CAVERNOSA – dorsal potion and sides of penis

CORPUS SPONGIOSUM – 3rd and smaller erectile column occupies the ventral portion of penis

GLANS PENIS – distal end and cap of penis

PREPUCE or FORESKIN – loose fold of skin which covers the glans penis

Penis Disorders Inflammation of the penis. Symptoms of penile inflammation include redness, itching, swelling, and pain. Balanitis occurs when the glans (the head of the penis) becomes inflamed. Posthitis is foreskin inflammation, which is usually due to a yeast or bacterial infection. Hypospadias. This is a disorder in which the urethra opens on the underside of the penis, not at the tip. Phimosis. This is a tightness of the foreskin of the penis and is common in newborns and young children. It usually resolves itself without treatment. If it interferes with urination, circumcision (removal of the foreskin) may be recommended. Paraphimosis. This may develop when a boy's uncircumcised penis is retracted but doesn't return to the unretracted position. As a result, blood flow to the penis may be impaired, and your child may experience pain and swelling. A doctor may try to use lubricant to make a small incision so the foreskin can be pulled forward. If that doesn't work, circumcision may be recommended.

Ambiguous genitalia. This occurs when a child is born with genitals that aren't clearly male or female. In most boys born with this disorder, the penis may be very small or nonexistent, but testicular tissue is present. In a small number of cases, the child may have both testicular and ovarian tissue. Micropenis. This is a disorder in which the penis, although normally formed, is well below the average size, as determined by standard measurements. Sexually transmitted diseases. Sexually transmitted diseases (STDs) that can affect boys include human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), human papillomavirus (HPV, or genital warts), syphilis, chlamydia, gonorrhea, genital herpes, and hepatitis B. They are spread from 1 person to another mainly through sexual intercourse.

GLANDS SEMINAL VESICLES - Glands consisting of many saclike structures located next to the ampulla of the ductus deferens – total no: 2 – 5 cm long, tapers into short duct that joins the ampulla to form the ejaculation duct

GLANDS PROSTATE GLAND • consists of glandular and muscular tissue • about the size and shape of walnut • surrounds the urethra and the ejaculatory ducts • consists of capsule and numerous partitions • the cells lining the partition secretes prostatic fluid

GLANDS BULBOURETHRAL GLANDS or COWPER’S GLAND • pair of small mucus-secreting glands located near the base of penis • about the size of pea in adult, but decrease in size with age

SECRETIONS SEMEN – is a mixture of sperm cells and secretions from male reproductive gland 60% - produced by seminal vesicles 30% - produced by prostate gland 5% - contributed by testes 5% - contributed by bulbourethral glands

SECRETIONS Bulbourethral Glands & Mucous Glands Secretion - produce mucous secretion - which lubricates the urethra - helps neutralize the contents of the normally acidic urethra - provides a small amount of lubrication during intercourse - helps reduce acidity in the vagina

SECRETIONS Testicular Secretion - secretes sperm cells and small amount of fluid

Seminal Vesicles - Its thick, mucuslike secretion contains: - fructose and other nutrients that provide nourishment to sperm cells - proteins that weakly coagulate after ejaculation - enzymes that are thought to help destroy abnormal sperm cells - prostaglandins (present in high concentration) which stimulates smooth muscle contraction and can cause contraction of female reproductive tract, which help transport sperm cells through female reproductive tract

SECRETIONS Prostate Secretion - milky secretion - alkaline pH - help neutralize the acidic urethra and testes secretions, seminal vesicle and vagina - contains proteolytic enzymes that break down the coagulated proteins of the seminal vesicle and make the semen more liquid

PHYSIOLOGY OF MALE REPRODUCTION Regulation of Sex Hormone Secretion Gonadotropin-releasing hormone (GnRH) -released from neurons in the hypothalamus and passes to anterior pituitary gland. -causes cells in the anterior pituitary gland to secrete two hormones. TWO HORMONES LUTEINIZING Hormone (LH) -binds to the interstitial cells in the testes and causes them to secrete testosterone. -once referred to as interstitial cell-stimulating hormone (ICSH) FOLLICLE-STIMULATING Hormone (FSH) -binds primarily to Sertoli Cells in the seminiferous tubulues and promotes sperm cell development. -increases the secretion of a hormone called INHIBIN.

PUBERTY Puberty is the sequence of events by which a child is transformed into young adult. IN BOYS, puberty commonly begins at ages 12-14 and completed by age of 18. Beginning just before puberty and continuing throughout puberty, development changes in the hypothalamus cause the hypothalamus and the anterior pituitary gland to become less sensitive to the inhibitory effect of testosterone. Testosterone still has a negative-feedback effect on the hypothalamus and pituitary gland BUT GnRH, LH and FSH secretion occur at substantially higher levels.

Effects of Testosterone •

Testosterone is the major male hormone secreted by the testes. During Puberty, testosterone causes the enlargement and differentiation of the male genitals and reproductive duct system. It is necessary for Spermatogenesis and development of SECONDARY SEXUAL CHARACTERISTICS.

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Secondary Sexual Characteristics are those structural and behavioral changes, other than on the reproductive organs, that develop at puberty and distinguish males from females.

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IN MALES, it includes hair distribution and growth, skin texture, fat distribution, skeletal muscle growth and changes in the larynx.

MAJOR REPRODUCTIVE HORMONE IN MALES
 HORMONE

SOURCE

TARGET TISSUE

RESPONSE

Gonadotropin- Releasing Hormone

Hypothalamus

Anterior Pituitary

Stimulates secretion of LH and FSH

Luteinizing Hromone

Anterior Pituitary

Interstitial Cell of Testes

Stimulates synthesis and secretion of testosterone.

Follicle- Stimulating Hormone

Anterior Pituitary

Seminiferous Tubules

Support spermatogenesis and inhibin secretion.

Testosterone

Interstitial Cell of testes

Testes; Body Tissues

Development and maintenance of reproductive organs; maintenance of secondary sexual characteristics.

Inhibin

Sertoli cells

Anterior Pituitary and Hypothalamus Anterior Pituitary

Inhibits GnRH, LH and FSH secretion through negative feedback. Inhibits FSH secretion through negative feedback.

MAJOR REPRODUCTIVE HORMONE IN MALES
 TARGET TISSUE Penis and Scrotum Hair Follicles

Skin

Larynx Most Tissues Red Blood Cell Kidney

Skeletal Muscle Bone

RESPONSE Enlargement and Differentiation Hair growth and coarser hair; male pattern baldness if has appropriate genetic make up.

Coarser of Skin texture; increased secretion of sebaceous gland and sweat gland in axillary region.

Enlargement and deeper masculine voice. Increased rate of metabolism Increased RBC production. Retention of sodium and water to a small degree, resulting in increased extracellular fluid volume.

Increases mass. Increased rate of growth and bone growth.

 
 MALE PATTERN BALDNESS


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It is develop in response to testosterone and other androgens. Baldness usually reaches its maximum rate of development when the individual is in the third or fourth decade of life. MINOXIDIL – is a drug effectively prevents a decrease in hair growth in many men. It causes blood vessels to dilate, including those close to hair follicle.

Male Sexual Behavior and the Male Sex Act
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The blood levels of testosterone remain relatively constant through the lifetime of a male from puberty until about 40 years of age. Thereafter the levels slowly decline to approximately 20% of this value by 80 years of age, causing a slow decrease in sex drive and fertility. The male sexual act is a complex series of reflexes that result in erection of the penis, secretion of mucus into urethra, emission and ejaculation. EMISSION movement of sperm cells, mucus, prostatic secretions and seminal vesicle secretions into the prostatic membranous and spongy urethra. EJACULATION forceful expulsion of the secretions that have accumulate din the urethra to the exterior ORGASM or CLIMAX

the intense sensations.

RESOLUTION occurs after ejaculation.

Sensory Impulses and Integration


Sensory Action Potentials - are carried to sacral region of the spinal cord. - travel from spinal cord to cerebrum to produce conscious sexual sensation. *Rhythmic Massage of Penis. *Engorgement of Prostrate gland and seminal vesicles. *Psychic Stimuli. Nocturnal Emission - ejaculation while sleeping. relatively common event in young males and is thought to be associated with dreaming. IMPOTENCE - the inability to concentrate on sexual sensations. - inability to achieve an erection of the penis.

Erection, Emission, and Ejaculation
 Erection Is the first major component of the male sexual act. Parasympathetic action potentials from sacral region of the spinal cord cause the arteries that supply blood to the erectile to dilate. Blood then fills small venous sinuses called SINUSOIDS, which reduces blood flow from the penis. Emission Is stimulated by sympathetic action potentials. This action potentials cause contraction of reproductive ducts and stimulate the seminal vesicles and prostrate gland to release secretions. Ejaculation Results from the contraction of smooth muscle in the wall of urethra and skeletal muscle that surround the base of penis.

TREATMENT OF ERECTILE DYSFUCNTION
 The inability to achieve erection can be due to reduces testosterone secretion resulting from hypothalamic, pituitary or testicular complications. It can also be due to defective stimulation of the erectile tissue by nerve fibers or reduced response of the blood vessels to neural stimulation. . Erection can be achieved in some people by oral medication, such as Sildenafil (Viagra), Tadalafil (Cialis), or Verdenafil (Livitra) or by the injection of specific drugs into the base of penis.

INFERTILITY IN MALES
 The most common cause of infertility in males is a low sperm count. If the sperm count is below 20 million sperm cell per mL, the male is usually sterile. Decreased in sperm count can occur because of damage to the testes as the result of a trauma, radiation or infection such as mumps, that block the ducts in epididymis. It can also result from poor secretion of Luteinizing Hormone and Follicle Stimulating Hormone. Decreased testosterone secretion also reduces sperm count. Fertility can sometimes be a c h i e v e d b y c o l l e c t i n g s e v e ra l ejaculations, concentrating the sperm cells, and by Artificial Insemination (AI).

Prepared By: GROUP 6 AHSE 2A MIRANDA, Rizza NIETO, Andrea MOLINA, Jessa IGNACIO, Abraham