The Reproductive System
will become “menopausal” afer the surgery. (a) How would you
answer her question and explain away her concerns? (b) Explain
what a tubal ligation is.
Mr. Scanlon, a 76-year-old gentleman, is interested in a much
younger woman. Concerned because oF his age, he asks his urologist
iF he will be able to Father a child. What questions would a physician
ask oF this man, and what diagnostic tests would be ordered?
Lucy had both her lef ovary and her right uterine tube removed
surgically at age 17 because oF a cyst and a tumor in these organs.
Now, at age 32, she remains healthy and is expecting her second child.
How could Lucy conceive a child with just one ovary and one uterine
tube, widely separated on opposite sides oF the pelvis like this?
keloids (masses oF scar tissue). Her history revealed that she was
a member oF a commune located in the nearby mountains that
shunned hospital births (iF at all possible). What do you think
Gina’s problem is and what caused it? (Be anatomically speciﬁc.)
Harry, a sexually active adolescent, appeared in the emergency
room complaining oF a penile “drip” and pain during urination.
An account oF his recent sexual behavior was requested and
recorded. (a) What do you think Harry’s problem is? (b) What
is the causative agent oF this disorder? (c) How is the condition
treated, and what may happen iF it isn’t treated?
A 36-year-old mother oF Four is considering tubal ligation to
ensure that her Family gets no larger. She asks the physician iF she
Related Clinical Terms
month) PainFul menstruation; may reﬂect abnormally high
prostaglandin activity during menses.
Cancer that arises From the uterine
endometrium (usually From uterine glands). Most important
sign is vaginal bleeding, which allows early detection. Risk
Factors include obesity and HRT.
sis) An inﬂammatory condition
in which endometrial tissue occurs and grows atypically in
the pelvic cavity. Characterized by abnormal uterine or rectal
bleeding, dysmenorrhea, and pelvic pain. May cause sterility.
Specialized branch oF medicine that deals with the diagnosis and
treatment oF Female reproductive system disorders.
te-ah) Development oF breast tissue
in the male; a consequence oF adrenal cortex hypersecretion oF
estrogens, certain drugs (cimetidine, spironolactone, and some
chemotherapeutic agents), and marijuana use.
Surgical removal oF the uterus.
Protrusion oF part oF the intestine into the scrotum
or through a separation in the abdominal muscles in the groin
region. Since the inguinal canals represent weak points in the
abdominal wall, inguinal hernia may be caused by heavy lifing
or other activities that increase intra-abdominal pressure.
observation) Examination oF the abdominopelvic cavity with a
laparoscope, a viewing device at the end oF a thin tube inserted
through the anterior abdominal wall. Laparoscopy is ofen used
to assess the condition oF a woman’s pelvic reproductive organs.
ovary) Surgical removal
oF the ovary.
testis) Inﬂammation oF the testes,
sometimes caused by the mumps virus.
Malignancy that typically arises From the cells in the
germinal epithelial covering oF the ovary. ±e ﬁfh most common
reproductive system cancer, its incidence increases with age. Called
the “disease that whispers” because early symptoms are nondescript
and easily mistaken For other disorders (back pain, abdominal
discomFort, nausea, bloating, and ﬂatulence). Diagnosis may involve
palpating a mass during a physical exam, visualizing it with an
ultrasound probe, or conducting blood tests For a protein marker
For ovarian cancer (CA-125). However, medical assessment is ofen
delayed until afer metastasis has occurred; ﬁve-year survival rate is
90% iF the condition is diagnosed beFore metastasis.
±e most common disorders oF the ovary; some are
tumors. Types include (1)
simple follicle retention cysts
single or clustered Follicles become enlarged with a clear ﬂuid;
, which are ﬁlled with a thick yellow ﬂuid
and contain partially developed hair, teeth, bone, etc.; and (3)
ﬁlled with dark gelatinous material, which are the
result oF endometriosis oF the ovary. None oF these is malignant,
but the latter two may become so.
Polycystic ovary syndrome (PCOS)
±e most common endocrinopathy
in women and the most common cause oF anovulatory inFertility.
Aﬀects 5–10% oF women; characterized by signs oF androgen excess,
increased cardiovascular risk (evidenced by high blood pressure,
decreased HDL cholesterol levels, and high triglycerides); and
linked to extreme obesity and some degree oF insulin resistance.
Treated with insulin-sensitizing drugs.
uterine tube) Inﬂammation oF
the uterine tubes.
AT T H E C L I N I C
We are back to look in on Mr. Heyden
today. Since we last saw him (Chapter
26), he has had an X ray to determine
the cause of his back pain, and his blood
test results have come in. According to
the note recorded at radiology: X irradiation of skeleton displays
numerous carcinomatous metastases in his skull and lumbar
vertebrae. The hematology note of interest here reads: PSA levels
What is carcinoma? What do you suppose is the primary source
of the secondary carcinoma lesions in his skull and spine?
On what basis did you come to this conclusion?
What other tests might be of some diagnostic help here?
What type of therapy do you predict Mr. Heyden will be given
to treat his carcinoma? Why?
(Answers in Appendix H)