General anatomy of the Male reproductive system

Genital Glands.—The first appearance of the genital gland is essentially the same in the two sexes, and consists in a thickening of the epithelial layer which lines the peritoneal cavity on the medial side of the urogenital fold. The thick plate of epithelium extends deeply, pushing before it the mesoderm and forming a distinct projection. This is termed the genital ridge, and from it the testis in the male and the ovary in the female are developed. At first the mesonephros and genital ridge are suspended by a common mesentery, but as the embryo grows the genital ridge gradually becomes pinched off from the mesonephros, with which it is at first continuous, though it still remains connected to the remnant of this body by a fold of peritoneum, the mesorchium or mesovarium. About the seventh week the distinction of sex in the genital ridge begins to be perceptible.

The Testis.—The testis is developed in much the same way as the ovary. Like the ovary, in its earliest stages it consists of a central mass of epithelium covered by a surface epithelium. In the central mass a series of cords appear, and the periphery of the mass is converted into the tunica albuginea, thus excluding the surface epithelium from any part in the formation of the tissue of the testis. The cords of the central mass run together toward the future hilus and form a network which ultimately becomes the rete testis. From the cords the seminiferous tubules are developed, and between them connective-tissue septa extend. The seminiferous tubules become connected with outgrowths from the Wolffian body, which, as before mentioned, form the efferent ducts of the testis.

Descent of the Testes.—The testes, at an early period of fetal life, are placed at the back part of the abdominal cavity, behind the peritoneum, and each is attached by a peritoneal fold, the mesorchium, to the mesonephros. From the front of the mesonephros a fold of peritoneum termed the inguinal fold grows forward to meet and fuse with a peritoneal fold, the inguinal crest, which grows backward from the antero-lateral abdominal wall. The testis thus acquires an indirect connection with the anterior abdominal wall; and at the same time a portion of the peritoneal cavity lateral to these fused folds is marked off as the future saccus vaginalis. In the inguinal crest a peculiar structure, the gubernaculum testis, makes its appearance. This is at first a slender band, extending from that part of the skin of the groin which afterward forms the scrotum through the inguinal canal to the body and epididymis of the testis. As development advances, the peritoneum enclosing the gubernaculum forms two folds, one above the testis and the other below it. The one above the testis is the plica vascularis, and contains ultimately the internal spermatic vessels; the one below, the plica gubernatrix, contains the lower part of the gubernaculum, which has now grown into a thick cord; it ends below at the abdominal inguinal ring in a tube of peritoneum, the saccus vaginalis, which protrudes itself down the inguinal canal. By the fifth month the lower part of the gubernaculum has become a thick cord, while the upper part has disappeared. The lower part now consists of a central core of unstriped muscle fiber, and outside this of a firm layer of striped elements, connected, behind the peritoneum, with the abdominal wall. As the scrotum develops, the main portion of the lower end of the gubernaculum is carried, with the skin to which it is attached, to the bottom of this pouch; other bands are carried to the medial side of the thigh and to the perineum. The tube of peritoneum constituting the saccus vaginalis projects itself downward into the inguinal canal, and emerges at the cutaneous inguinal ring, pushing before it a part of the Obliquus internus and the aponeurosis of the Obliquus externus, which form respectively the Cremaster muscle and the intercrural fascia. It forms a gradually elongating pouch, which eventually reaches the bottom of the scrotum, and behind this pouch the testis is drawn by the growth of the body of the fetus, for the gubernaculum does not grow commensurately with the growth of other parts, and therefore the testis, being attached by the gubernaculum to the bottom of the scrotum, is prevented from rising as the body grows, and is drawn first into the inguinal canal and eventually into the scrotum. It seems certain also that the gubernacular cord becomes shortened as development proceeds, and this assists in causing the testis to reach the bottom of the scrotum. By the end of the eighth month the testis has reached the scrotum, preceded by the saccus vaginalis, which communicates by its upper extremity with the peritoneal cavity. Just before birth the upper part of the saccus vaginalis usually becomes closed, and this obliteration extends gradually downward to within a short distance of the testis. The process of peritoneum surrounding the testis is now entirely cut off from the general peritoneal cavity and constitutes the tunica vaginalis.

Descent of the Ovaries.—In the female there is also a gubernaculum, which effects a considerable change in the position of the ovary, though not so extensive a change as in that of the testis. The gubernaculum in the female lies in contact with the fundus of the uterus and contracts adhesions to this organ, and thus the ovary is prevented from descending below this level. The part of the gubernaculum between the ovary and the uterus becomes ultimately the proper ligament of the ovary, while the part between the uterus and the labium majus forms the round ligament of the uterus. A pouch of peritoneum analogous to the saccus vaginalis in the male accompanies it along the inguinal canal: it is called the canal of Nuck. In rare cases the gubernaculum may fail to contract adhesions to the uterus, and then the ovary descends through the inguinal canal into the labium majus, and under these circumstances its position resembles that of the testis.

The Metanephros and the Permanent Kidney.—The rudiments of the permanent kidneys make their appearance about the end of the first or the beginning of the second month. Each kidney has a two-fold origin, part arising from the metanephros, and part as a diverticulum from the hind-end of the Wolffian duct, close to where the latter opens into the cloaca. The metanephros arises in the intermediate cell mass, caudal to the mesonephros, which it resembles in structure. The diverticulum from the Wolffian duct grows dorsalward and forward along the posterior abdominal wall, where its blind extremity expands and subsequently divides into several buds, which form the rudiments of the pelvis and calyces of the kidney; by continued growth and subdivision it gives rise to the collecting tubules of the kidney. The proximal portion of the diverticulum becomes the ureter. The secretory tubules are developed from the metanephros, which is moulded over the growing end of the diverticulum from the Wolffian duct. The tubules of the metanephros, unlike those of the pronephros and mesonephros, do not open into the Wolffian duct. One end expands to form a glomerulus, while the rest of the tubule rapidly elongates to form the convoluted and straight tubules, the loops of Henle, and the connecting tubules; these last join and establish communications with the collecting tubules derived from the ultimate ramifications of the diverticulum from the Wolffian duct. The mesoderm around the tubules becomes condensed to form the connective tissue of the kidney. The ureter opens at first into the hind-end of the Wolffian duct; after the sixth week it separates from the Wolffian duct, and opens independently into the part of the cloaca which ultimately becomes the bladder.

  The secretory tubules of the kidney become arranged into pyramidal masses or lobules, and the lobulated condition of the kidneys exists for some time after birth, while traces of it may be found even in the adult. The kidney of the ox and many other animals remains lobulated throughout life.

The Urinary Bladder.—The bladder is formed partly from the entodermal cloaca and partly from the ends of the Wolffian ducts; the allantois takes no share in its formation. After the separation of the rectum from the dorsal part of the cloaca (p. 1109), the ventral part becomes subdivided into three portions: (1) an anterior vesico-urethral portion, continuous with the allantois—into this portion the Wolffian ducts open; (2) an intermediate narrow channel, the pelvic portion; and (3) a posterior phallic portion, closed externally by the urogenital membrane. The second and third parts together constitute the urogenital sinus. The vesico-urethral portion absorbs the ends of the Wolffian ducts and the associated ends of the renal diverticula, and these give rise to the trigone of the bladder and part of the prostatic urethra. The remainder of the vesico-urethral portion forms the body of the bladder and part of the prostatic urethra; its apex is prolonged to the umbilicus as a narrow canal, which later is obliterated and becomes the medial umbilical ligament (urachus).

The Prostate.—The prostate originally consists of two separate portions, each of which arises as a series of diverticular buds from the epithelial lining of the urogenital sinus and vesico-urethral part of the cloaca, between the third and fourth months. These buds become tubular, and form the glandular substance of the two lobes, which ultimately meet and fuse behind the urethra and also extend on to its ventral aspect. The isthmus or middle lobe is formed as an extension of the lateral lobes between the common ejaculatory ducts and the bladder. Skene’s ducts in the female urethra are regarded as the homologues of the prostatic glands.

  The bulbo-urethral glands of Cowper in the male, and greater vestibular glands of Bartholin in the female, also arise as diverticula from the epithelial lining of the urogenital sinus.

The External Organs of Generation—As already stated, the cloacal membrane, composed of ectoderm and entoderm, originally reaches from the umbilicus to the tail. The mesoderm extends to the midventral line for some distance behind the umbilicus, and forms the lower part of the abdominal wall; it ends below in a prominent swelling, the cloacal tubercle. Behind this tubercle the urogenital part of the cloacal membrane separates the ingrowing sheets of mesoderm.

  The first rudiment of the penis (or clitoris) is a structure termed the phallus; it is derived from the phallic portion of the cloaca which has extended on to the end and sides of the under surface of the cloacal tubercle. The terminal part of the phallus representing the future glans becomes solid; the remainder, which is hollow, is converted into a longitudinal groove by the absorption of the urogenital membrane.

  In the female a deep groove forms around the phallus and separates it from the rest of the cloacal tubercle, which is now termed the genital tubercle. The sides of the genital tubercle grow backward as the genital swellings, which ultimately form the labia majora; the tubercle itself becomes the mons pubis. The labia minora arise by the continued growth of the lips of the groove on the under surface of the phallus; the remainder of the phallus forms the clitoris.

  In the male the early changes are similar, but the pelvic portion of the cloaca undergoes much greater development, pushing before it the phallic portion. The genital swellings extend around between the pelvic portion and the anus, and form a scrotal area; during the changes associated with the descent of the testes this area is drawn out to form the scrotal sacs. The penis is developed from the phallus. As in the female, the urogenital membrane undergoes absorption, forming a channel on the under surface of the phallus; this channel extends only as far forward as the corona glandis.

  The corpora cavernosa of the penis (or clitoris) and of the urethra arise from the mesodermal tissue in the phallus; they are at first dense structures, but later vascular spaces appear in them, and they gradually become cavernous.

  The prepuce in both sexes is formed by the growth of a solid plate of ectoderm into the superficial part of the phallus; on coronal section this plate presents the shape of a horseshoe. By the breaking down of its more centrally situated cells the plate is split into two lamellæ, and a cutaneous fold, the prepuce, is liberated and forms a hood over the glans. “Adherent prepuce is not an adhesion really, but a hindered central desquamation” (Berry Hart).

The Urethra.—As already described, in both sexes the phallic portion of the cloaca extends on to the under surface of the cloacal tubercle as far forward as the apex. At the apex the walls of the phallic portion come together and fuse, the lumen is obliterated, and a solid plate, the urethral plate, is formed. The remainder of the phallic portion is for a time tubular, and then, by the absorption of the urogenital membrane, it establishes a communication with the exterior; this opening is the primitive urogenital ostium, and it extends forward to the corona glandis.

  In the female this condition is largely retained; the portion of the groove on the clitoris broadens out while the body of the clitoris enlarges, and thus the adult urethral opening is situated behind the base of the clitoris.

  In the male, by the greater growth of the pelvic portion of the cloaca a longer urethra is formed, and the primitive ostium is carried forward with the phallus, but it still ends at the corona glandis. Later it closes from behind forward. Meanwhile the urethral plate of the glans breaks down centrally to form a median groove continuous with the primitive ostium. This groove also closes from behind forward, so that the external urethral opening is shifted forward to the end of the glans.

The Male Genital Organs (Organa Genitalia Virilia)

The male genitals include the testes, the ductus deferentes, the vesiculæ seminales, the ejaculatory ducts, and the penis, together with the following accessory structures, viz., the prostate and the bulbourethral glands.

1. The Testes and their Coverings—The testes are two glandular organs, which secrete the semen; they are suspended in the scrotum by the spermatic cords. At an early period of fetal life the testes are contained in the abdominal cavity, behind the peritoneum. Before birth they descend to the inguinal canal, along which they pass with the spermatic cord, and, emerging at the subcutaneous inguinal ring, they descend into the scrotum, becoming invested in their course by coverings derived from the serous, muscular, and fibrous layers of the abdominal parietes, as well as by the scrotum.

  The coverings of the testes are, the

Skin

Scrotum.

Cremaster.

Dartos tunic

Infundibuliform fascia.

Intercrural fascia.

Tunica vaginalis.

  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.

  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.

  The dartos tunic is closely united to the skin externally, but connected with the subjacent parts by delicate areolar tissue, upon which it glides with the greatest facility.

  The Intercrural Fascia (intercolumnar or external spermatic fascia) is a thin membrane, prolonged downward around the surface of the cord and testis. It is separated from the dartos tunic by loose areolar tissue.

  The Cremaster consists of scattered bundles of muscular fibers connected together into a continuous covering by intermediate areolar tissue.

  The Infundibuliform Fascia (tunica vaginalis communis [testis et funiculi spermatici]) is a thin layer, which loosely invests the cord; it is a continuation downward of the transversalis fascia.

Vessels and Nerves.—The arteries supplying the coverings of the testes are: the superficial and deep external pudendal branches of the femoral, the superficial perineal branch of the internal pudendal, and the cremasteric branch from the inferior epigastric. The veins follow the course of the corresponding arteries. The lymphatics end in the inguinal lymph glands. The nerves are the ilioinguinal and lumboinguinal branches of the lumbar plexus, the two superficial perineal branches of the internal pudendal nerve, and the pudendal branch of the posterior femoral cutaneous nerve.

  The Spermatic Cord (funiculus spermaticus) extends from the abdominal inguinal ring, where the structures of which it is composed converge, to the back part of the testis. In the abdominal wall the cord passes obliquely along the inguinal canal, lying at first beneath the Obliquus internus, and upon the fascia transversalis; but nearer the pubis, it rests upon the inguinal and lacunar ligaments, having the aponeurosis of the Obliquus externus in front of it, and the inguinal falx behind it. It then escapes at the subcutaneous ring, and descends nearly vertically into the scrotum. The left cord is rather longer than the right, consequently the left testis hangs somewhat lower than its fellow.

Structure of the Spermatic Cord.—The spermatic cord is composed of arteries, veins, lymphatics, nerves, and the excretory duct of the testis. These structures are connected together by areolar tissue, and invested by the layers brought down by the testis in its descent.

  The arteries of the cord are: the internal and external spermatics; and the artery to the ductus deferens.

  The internal spermatic artery, a branch of the abdominal aorta, escapes from the abdomen at the abdominal inguinal ring, and accompanies the other constituents of the spermatic cord along the inguinal canal and through the subcutaneous inguinal ring into the scrotum. It then descends to the testis, and, becoming tortuous, divides into several branches, two or three of which accompany the ductus deferens and supply the epididymis, anastomosing with the artery of the ductus deferens: the others supply the substance of the testis.

  The external spermatic artery is a branch of the inferior epigastric artery. It accompanies the spermatic cord and supplies the coverings of the cord, anastomosing with the internal spermatic artery.

  The artery of the ductus deferens, a branch of the superior vesical, is a long, slender vessel, which accompanies the ductus deferens, ramifying upon its coats, and anastomosing with the internal spermatic artery near the testis.

  The spermatic veins emerge from the back of the testis, and receive tributaries from the epididymis: they unite and form a convoluted plexus, the plexus pampiniformis, which forms the chief mass of the cord; the vessels composing this plexus are very numerous, and ascend along the cord in front of the ductus deferens; below the subcutaneous inguinal ring they unite to form three or four veins, which pass along the inguinal canal, and, entering the abdomen through the abdominal inguinal ring, coalesce to form two veins. These again unite to form a single vein, which opens on the right side into the inferior vena cava, at an acute angle, and on the left side into the left renal vein, at a right angle.

  The nerves are the spermatic plexus from the sympathetic, joined by filaments from the pelvic plexus which accompany the artery of the ductus deferens.

  The scrotum forms an admirable covering for the protection of the testes. These bodies, lying suspended and loose in the cavity of the scrotum and surrounded by serous membrane, are capable of great mobility, and can therefore easily slip about within the scrotum and thus avoid injuries from blows or squeezes. The skin of the scrotum is very elastic and capable of great distension, and on account of the looseness and amount of subcutaneous tissue, the scrotum becomes greatly enlarged in cases of edema, to which this part is especially liable as a result of its dependent position.

  The Testes are suspended in the scrotum by the spermatic cords, the left testis hanging somewhat lower than its fellow. The average dimensions of the testis are from 4 to 5 cm. in length, 2.5 cm. in breadth, and 3 cm. in the antero-posterior diameter; its weight varies from 10.5 to 14 gm. Each testis is of an oval form compressed laterally, and having an oblique position in the scrotum; the upper extremity is directed forward and a little lateralward; the lower, backward and a little medialward; the anterior convex border looks forward and downward, the posterior or straight border, to which the cord is attached, backward and upward.

  The anterior border and lateral surfaces, as well as both extremities of the organ, are convex, free, smooth, and invested by the visceral layer of the tunica vaginalis. The posterior border, to which the cord is attached, receives only a partial investment from that membrane. Lying upon the lateral edge of this posterior border is a long, narrow, fiattened body, named the epididymis.

  The epididymis consists of a central portion or body; an upper enlarged extremity, the head (globus major); and a lower pointed extremity, the tail (globus minor), which is continuous with the ductus deferens, the duct of the testis. The head is intimately connected with the upper end of the testis by means of the efferent ductules of the gland; the tail is connected with the lower end by cellular tissue, and a reflection of the tunica vaginalis. The lateral surface, head and tail of the epididymis are free and covered by the serous membrane; the body is also completely invested by it, excepting along its posterior border; while between the body and the testis is a pouch, named the sinus of the epididymis (digital fossa). The epididymis is connected to the back of the testis by a fold of the serous membrane.

Appendages of the Testis and Epididymis.—On the upper extremity of the testis, just beneath the head of the epididymis, is a minute oval, sessile body, the appendix of the testis (hydatid of Morgagni); it is the remnant of the upper end of the Müllerian duct. On the head of the epididymis is a second small stalked appendage (sometimes duplicated); it is named the appendix of the epididymis (pedunculated hydatid), and is usually regarded as a detached efferent duct.

  The testis is invested by three tunics: the tunica vaginalis, tunica albuginea, and tunica vasculosa.

  The Tunica Vaginalis (tunica vaginalis propria testis) is the serous covering of the testis. It is a pouch of serous membrane, derived from the saccus vaginalis of the peritoneum, which in the fetus preceded the descent of the testis from the abdomen into the scrotum. After its descent, that portion of the pouch which extends from the abdominal inguinal ring to near the upper part of the gland becomes obliterated; the lower portion remains as a shut sac, which invests the surface of the testis, and is reflected on to the internal surface of the scrotum; hence it may be described as consisting of a visceral and a parietal lamina.

  The visceral lamina (lamina visceralis) covers the greater part of the testis and epididymis, connecting the latter to the testis by means of a distinct fold. From the posterior border of the gland it is reflected on to the internal surface of the scrotum.

  The parietal lamina (lamina parietalis) is far more extensive than the visceral, extending upward for some distance in front and on the medial side of the cord, and reaching below the testis. The inner surface of the tunica vaginalis is smooth, and covered by a layer of endothelial cells. The interval between the visceral and parietal laminæ constitutes the cavity of the tunica vaginalis.

  The obliterated portion of the saccus vaginalis may generally be seen as a fibrocellular thread lying in the loose areolar tissue around the spermatic cord; sometimes this may be traced as a distinct band from the upper end of the inguinal canal, where it is connected with the peritoneum, down to the tunica vaginalis; sometimes it gradually becomes lost on the spermatic cord. Occasionally no trace of it can be detected. In some cases it happens that the pouch of peritoneum does not become obliterated, but the sac of the peritoneum communicates with the tunica vaginalis. This may give rise to one of the varieties of oblique inguinal hernia. In other cases the pouch may contract, but not become entirely obliterated; it then forms a minute canal leading from the peritoneum to the tunica vaginalis.

  The Tunica Albuginea is the fibrous covering of the testis. It is a dense membrane, of a bluish-white color, composed of bundles of white fibrous tissue which interlace in every direction. It is covered by the tunica vaginalis, except at the points of attachment of the epididymis to the testis, and along its posterior border, where the spermatic vessels enter the gland. It is applied to the tunica vasculosa over the glandular substance of the testis, and, at its posterior border, is reflected into the interior of the gland, forming an incomplete vertical septum, called the mediastinum testis (corpus Highmori).

The human male reproductive system consists of a number of sex organs that are a part of the human reproductive process. In the case of men, these sex organs are located outside a man’s body, around the pelvic region.

The main male sex organs are the penis and the testes which produce semen and sperm, which as part of sexual intercourse fertilize an ovum in a woman’s body and the fertilized ovum (zygote) gradually develops into a fetus, which is later born as a child.

The testicle (from Latin testiculus, diminutive of testis, meaning “witness” [of virility],^[1] plural testes) is the male generative gland in animals.

The etymology of the word is based on Roman law. The Latin word “testis“, witness, was used in the firmly established legal principle “Testis unus, testis nullus” (one witness [equals] no witness), meaning that testimony by any one person in court was to be disregarded unless corroborated by the testimony of at least another. This led to the common practice of producing two witnesses, bribed to testify the same way in cases of lawsuits with ulterior motives. Since such “witnesses” always came in pairs, the meaning was accordingly extended, often in the diminutive (testiculus, testiculi).^{[citation needed]}

Like the ovaries to which they are homologous, testes are components of both the reproductive system (being gonads) and the endocrine system (being endocrine glands). The respective functions of the testes 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)

External appearance

Male mammals have two testes, which are often contained within an extension of the abdomen called the scrotum. In mammals with external testes it is most common for one testicle to hang lower than the other. While the size of the testicle varies, it is estimated that 21.9% of men have their higher testicle being their left, while 27.3% of men have reported to have equally positioned testicles.^[2] This is due to differences in the vascular anatomical structure on the right and left sides.

In healthy European adult human males, average testicular volume is 18 cm³ per testis, with normal size ranging from 12 cm³ to 30 cm³^[3]. The average testicle size after puberty measures up to around 2 inches long, 0.8 inches in breadth, and 1.2 inches in height (5 x 2 x 3 cm). 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.

The volume is then calculated using the formula for the volume of an ellipsoid: 4/3 π × (length/2) × (width/2) × (depth/2).

 Duct system

Under a tough membraneous shell, the tunica albuginea, the testis contains very fine coiled tubes called seminiferous tubules. The tubules are lined with a layer of cells (germ cells) that from puberty into old age, develop into sperm cells (also known as spermatozoa or male gametes). The developing sperm travel through the seminiferous tubules to the rete testis located in the mediastinum testis, to the efferent ducts, and then to the epididymis where newly-created sperm cells mature (see spermatogenesis). The sperm move into the vas deferens, and are eventually expelled through the urethra and out of the urethral orifice through muscular contractions.

 Primary Cell Types

Within the seminiferous tubules

• Here, germ cells develop into spermatogonia, spermatocytes, spermatids and spermatozoon through the process of spermatogenesis. The gametes contain DNA for fertilization of an ovum^[4]
• Sertoli cells – the true epithelium of the seminiferous epithelium, critical for the support of germ cell development into spermatozoa. Sertoli cells secrete inhibin^[5].

Between tubules (interstitial cells)

• Leydig cells – cells localized between seminiferous tubules that produce and secrete testosterone and other androgens important for sexual development and puberty, secondary sexual characteristics like facial hair, sexual behavior and libido, supporting spermatogenesis and erectile function. Testosterone also controls testicular volume.

are also present.

• Also present are:
• Immature Leydig cells
• Interstitial macrophages and epithelial cells.

 Blood supply and lymphatic drainage

Blood supply and lymphatic drainage of the testes and scrotum are distinct:

• 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).
• The testis has collateral blood supply from 1. the cremasteric artery (a branch of the inferior epigastric artery, which is a branch of the external iliac artery), and 2. the artery to the ductus deferens (a branch of the superior vesical artery, which is a branch of the internal iliac artery). Therefore, if the testicular artery is ligated, e.g., during a Fowler-Stevens orchiopexy for a high undescended testis, the testis will usually survive on these other blood supplies.^[6]
• 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.

 Layers

Many anatomical features of the adult testis reflect its developmental origin in the abdomen. The layers of tissue enclosing each testicle are derived from the layers of the anterior abdominal wall. Notably, the cremasteric muscle arises from the internal oblique muscle.

 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 function of the blood-testis barrier (red highlight in diagram above) 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.

 Temperature regulation

The testes work best at temperatures slightly less than core body temperature. The spermatogenesis is less efficient at lower and higher temperatures. There are a number of mechanisms to maintain the testes at the optimum temperature.

 Cremasteric muscle

The cremasteric muscle is part of the spermatic cord. When this muscle contracts, the cord is shortened and the testicle is moved closer up toward the body, which provides slightly more warmth to maintain optimal testicular temperature. When cooling is required, the cremasteric muscle relaxes and the testicle is lowered away from the warm body and is able to cool. This phenomenon is known as the cremasteric reflex. It also occurs in response to stress (the testicles rise up toward the body in an effort to protect them in a fight). There are persistent reports that relaxation indicates approach of orgasm.^{[citation needed]} There is a noticeable tendency to also retract during orgasm.

The testicles can also be lifted voluntarily using the pubococcygeus muscle, which partially activates related muscles. This can sometimes be triggered by tightening or sucking in the stomach or abdomen.

This movement will also happen spontaneously in some men when they unintentionally contract their abdominal or PC muscles.

 Development

There are two phases in which the testes grow substantially; namely in embryonic and pubertal age.

 Embryonic

During mammalian development, the gonads are at first capable of becoming either ovaries or testes.^[7] In humans, starting at about week 4 the gonadal rudiments are present within the intermediate mesoderm adjacent to the developing kidneys. At about week 6, sex cords develop within the forming testes. These are comprised of early Sertoli cells that surround and nurture the germ cells that migrate into the gonads shortly before sex determination begins. In males, the sex-specific gene SRY that is found on the Y-chromosome initiates sex determination by downstream regulation of sex-determining factors, (such as GATA4, SOX9 and AMH), which leads to development of the male phenotype, including directing development of the early bipotential gonad down the male path of development.

 Pubertal

The testes grow in response to the start of spermatogenesis. Size depends on lytic function, sperm production (amount of spermatogenisis present in testis), interstitial fluid, and Sertoli cell fluid production. After puberty, the volume of the testes can be increased by over 500% as compared to the pre-pubertal size.^{[citation needed]} Testicles are fully descended before one reaches puberty.

Evolution

External testes

The basal condition for mammals is to have internal testes. Only the Boreoeutherian land mammals, the large group of mammals that includes humans, have externalized testes. Their testes function best at temperatures lower than their core body temperature. Their testes are located outside of the body, suspended by the spermatic cord within the scrotum. The testes of the non-boreotherian mammals such as the monotremes, armadillos, sloths, elephants remain within the abdomen.^[8] There are also some Boreoeutherian mammals with internal testes, such as the rhinoceros.

Marine boreotherian mammals such as whales and dolphins, also have internal testes, but it has recently been shown (e.g., for dolphins) that they use elaborate vascular networks to provide the necessary temperature lowering for optimum function. As external testes would increase drag, many boreotherian aquatic mammals have internal testes which are kept cool by special circulatory systems that cool the arterial blood going to the testes by placing the arteries near veins bringing cooled venous blood from the skin.

There are several hypotheses why most boreotherian mammals have external testes which operate best at a temperature that is slightly less than the core body temperature, e.g. that it is stuck with enzymes evolved in a colder temperature due to external testes evolving for different reasons, that the lower temperature of the testes simply is more efficient for sperm production.

1) More efficient. The classic hypothesis is that cooler temperature of the testes allows for more efficient fertile spermatogenesis. In other words, there are no possible enzymes operating at normal core body temperature that are as efficient as the ones evolved, at least none appearing in our evolution so far.

The early mammals had lower body temperatures and thus their testes worked efficiently within their body. However it is argued that boreotherian mammals have higher body temperatures than the other mammals and had to develop external testes to keep them cool. It is argued that those mammals with internal testes, such as the monotremes, armadillos, sloths, elephants, and rhinoceroses, have a lower core body temperatures than those mammals with external testes.

However, the question remains why birds despite having very high core body temperatures have internal testes and did not evolve external testes.^[9] It was once theorized that birds used their air sacs to cool the testes internally, but later studies revealed that birds’ testes are able to function at core body temperature.^[9].

Some mammals which have seasonal breeding cycles keep their testes internal until the breeding season at which point their testes descend and increase in size and become external^[10].

2) Irreversible adaptation to sperm competition. It has been suggested that the ancestor of the boreoeutherian mammals was a small mammal that required very large testes (perhaps rather like those of a hamster) for sperm competition and thus had to place its testes outside the body.^[11] This led to enzymes involved in spermatogenesis, spermatogenic DNA polymerase beta and recombinase activities evolving a unique temperature optimum, slightly less than core body temperature. When the boreoeutherian mammals then diversified into forms that were larger and/or did not require intense sperm competition they were stuck with enzymes that operated best at cooler temperatures and had to keep their testes outside the body. This position is made less parsimonious by the fact that the kangaroo, a non-boreoeutherian mammal, has external testicles. The ancestors of kangaroos might, separately from boreotherian mammals, have also been subject to heavy sperm competition and thus developed external testes, however, kangaroo external testes are suggestive of a possible adaptive function for external testes in large animals.

3) Protection from abdominal cavity pressure changes. One argument for the evolution of external testes is that it protects the testes from abdominal cavity pressure changes caused by jumping and galloping.^[12]

Testicular size

Testicular size as a proportion of body weight varies widely. In the mammalian kingdom, there is a tendency for testicular size to correspond with multiple mates (e.g., harems, polygamy). Production of testicular output sperm and spermatic fluid is also larger in polygamous animals, possibly a spermatogenic competition for survival. The testes of the right whale are likely to be the largest of any animal, each weighing around 500 kg (1,100 lb).^[13] Testis weight also varies in seasonal breeders like deer and horses. The change is related to changes in testosterone production.

 Physical injury

• The testicles are well-known to be very sensitive to groin attacks. The pain involved travels up from each testicle into the abdominal cavity, via the spermatic plexus, which is the primary nerve of each testicle.
• Testicular torsion, a medical emergency, which can lead to necrosis of the testis

Diseases and conditions that affect the testes

Some prominent conditions and differential diagnoses include:

• Testicular cancer and other neoplasms To improve the chances of catching possible cases of testicular cancer or other health issues early, regular testicular self-examination is recommended.
• Varicocele, swollen vein(s) from the testes, usually affecting the left side,^[14] the testis usually being normal
• Hydrocele testis, swelling around testes caused by accumulation of clear liquid within a membranous sac, the testis usually being normal
• Endocrine disorders can also affect the size and function of the testis.
• Certain inherited conditions involving mutations in key developmental genes also impair testicular descent, resulting in abdominal or inguinal testes which remain nonfunctional and may become cancerous. Other genetic conditions can result in the loss of the Wolffian ducts and allow for the persistence of Müllerian ducts.

 Effects of exogenous hormones

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. Steroids taken for muscle enhancement (especially anabolic steroids) often have the undesired side effect of testicular shrinkage.

Similarly, stimulation of testicular functions via gonadotropic-like hormones may enlarge their size. Testes may shrink or atrophy during hormone replacement therapy or through chemical castration.

In all cases, the loss in testes volume corresponds with a loss of spermatogenesis.

Penis

The penis has a long shaft and enlarged tip called the glans penis. The penis is the male copulatory organ. When the male becomes sexually aroused, the penis becomes erect and ready for sexual activity. Erection is achieved because blood sinuses within the erectile tissue of the penis become filled with blood. The arteries of the penis are dilated while the veins are passively compressed so that blood flows into the erectile cartilage under pressure. The male penis is made of two different tissues. Cartilage is not in the penis.

The human penis is made up of three columns of tissue: two corpora cavernosa lie next to each other on the dorsal side and one corpus spongiosum lies between them on the ventral side.

The enlarged and bulbous-shaped end of the corpus spongiosum forms the glans penis, which supports the foreskin or prepuce, a loose fold of skin that in adults can retract to expose the glans. The area on the underside of the penis, where the foreskin is attached, is called the frenum (or frenulum).

The urethra, which is the last part of the urinary tract, traverses the corpus spongiosum, and its opening, known as the meatus (pronounced /miːˈeɪtəs/), lies on the tip of the glans penis. It is a passage both for urine and for the ejaculation of semen. Sperm are produced in the testes and stored in the attached epididymis. During ejaculation, sperm are propelled up the vas deferens, two ducts that pass over and behind the bladder. Fluids are added by the seminal vesicles and the vas deferens turns into the ejaculatory ducts which join the urethra inside the prostate gland. The prostate as well as the bulbourethral glands add further secretions, and the semen is expelled through the penis.

The raphe is the visible ridge between the lateral halves of the penis, found on the ventral or underside of the penis, running from the meatus (opening of the urethra) across the scrotum to the perineum (area between scrotum and anus).

The human penis differs from those of most other mammals, as it has no baculum, or erectile bone, and instead relies entirely on engorgement with blood to reach its erect state. It cannot be withdrawn into the groin, and it is larger than average in the animal kingdom in proportion to body mass.

Epididymae

The epididymus is a whitish mass of tightly coiled tubes cupped against the testicles. It acts as a storage place for sperm before they enter the vasa deferentia, tubes that carry sperm form the testes to the urethra.