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Toxic Responses of the Male Reproductive System
Published in Stephen K. Hall, Joana Chakraborty, Randall J. Ruch, Chemical Exposure and Toxic Responses, 2020
The adult testes are ovoid organs. Each measures about 4 × 3.5 × 3 cm. They are located at the end of a cord, called the spermatic cord. The testis is freely movable in the scrotal sac. The scrotum is composed of skin, a thin layer of dartos muscle and a layer of connective tissue which includes striated muscle, called cremaster muscle. The testis is surrounded by a thick capsule, the tunica albuginea. Numerous septa are present in the testis, dividing it into smaller compartments or lobules. Each lobule contains two to four highly tortuous seminiferous tubules (Figure 13.1 a, b, and c). The adult testis has dual functions: production of germ cell, i.e., spermatozoa; and secretion of androgens. The germ cells are produced in the seminiferous tubules while the androgen is produced by the cells outside the seminiferous tubules, the Leydig cells.
Reproduction, development and work
Published in Chris Winder, Neill Stacey, Occupational Toxicology, 2004
The wall of the scrotum contains smooth muscle (dartos muscle) which contracts in response to cold. The internal aspect of the scrotum is lined by a sac known as the tunica vaginalis testis. This has parietal and visceral layers. The parietal is attached to the scrotum, while the visceral layer adheres to the testes.
Device profile of the Ambicor two-piece inflatable penile prosthesis for treatment of erectile dysfunction: overview of its safety and efficacy
Published in Expert Review of Medical Devices, 2021
Daniel P. Simon, Kevin Alter, Petar Bajic, Laurence A. Levine
The Ambicor is generally implanted using a penoscrotal approach [8]. Though variation exists in practice, the description of the technique herein is based on the description of the procedure provided in the AMS Ambicor Penile Prosthesis Operating Room Manual as well as our own institutional experience [8,22]. A 4–5 cm transverse skin incision is made on the upper scrotum, inferior to the penoscrotal junction. A ring retractor is often used to provide optimal exposure. The corpus spongiosum is retracted laterally to avoid damage to the urethra. Buck’s fascia is incised to expose the proximal ventral tunica albuginea, and stay sutures are placed on either side of the planned corporotomy site. This procedure is then repeated on the contralateral side. A 3 cm vertical corporotomy is made between the stay sutures. The corporotomy is ideally located where two-thirds of the total corporal measurement is distal to the incision and one-third is proximal, as this will facilitate the placement of the cylinders and may avoid the need to later extend the corporotomy. The corpus cavernosum is typically dilated proximally to 14 mm and distally to 12 mm using Brooks dilators to create space for the prosthetic cylinder. In order to choose appropriately sized cylinders and RTEs, the proximal and distal aspect of each corpus are measured using a measuring rod or the Furlow insertion tool. This procedure is repeated on the contralateral side. Appropriately sized cylinders are selected, and if necessary, RTEs are applied to the proximal aspect of the device. A Furlow insertion tool is used to introduce the cylinders into the corpora cavernosa distally and the proximal cylinder is then inserted. Once both cylinders are implanted, the tunica albuginea is closed using the pre-placed stay sutures (some surgeons prefer to use a ‘box stitch’) to prevent inadvertent needle injury to the device. Meticulous attention should be paid to obtaining good hemostasis. A Dartos pouch is created in the anterior dependent portion of the scrotum with sharp and blunt dissection, and the pump is inserted into the scrotal pocket then secured with a purse-string suture placed through Dartos fascia. After both cylinders and the pump have been implanted, the prosthesis is cycled to confirm function. Dartos tissue is closed deep and superficial in two layers with a running 2-0 absorbable suture, the skin is closed in a running subcuticular fashion, and skin adhesive is applied. A compressive ‘mummy-wrap’ dressing is applied to the scrotum [23]. Placement of a scrotal drain for 24 hours postoperatively may be considered and is at the surgeon’s discretion.