CHAPTER XI. 



REPRODUCTIVE ORGANS OF THE MALE. 

 The Penis. 



Malformations . 



THE penis may be absent with great defects of development of the rest of the body. 

 The urethra then usually opens into the rectum. 



An abnormally small penis may be associated with absence or arrested develop- 

 ment of the testicles. The prepuce may be rudimentary or absent. 



Congenital phimosis is not uncommon. 



HYPOSPADIAS is an arrest of development of the penis and scrotum. In its high- 

 est degree the penis is short, the glans penis small. On the lower side of the penis is a 

 deep cleft lined with mucous membrane. Into this cleft the urethra opens at the root 

 of the penis. The scrotum remains separated into two halves, resembling labia majora. 

 The testes may descend into their proper position on each side or remain in the abdo- 

 men. If the testicles continue to develop normally the individual has the appearance 

 and capacities of a man ; if their development is arrested the individual is apt to be of 

 feminine type. 



In lesser grades of hypospadias the two halves of the scrotum are joined and the penis* 

 is larger, but a part of the urethra remains open as a cleft at some point of the penis. 



EPISPADIAS is an opening of the urethra on the upper side of the penis. It pre- 

 sents various grades and forms. 



HERMAPHRODITISM. This is a union of two sexes in the same person, the test of 

 which is the presence of the secreting organs, the ovaries and testicles. True hermaph- 

 roditism is rare, but it does occur, while most of the conditions called hermaphrodit- 

 ism are in reality due to varying malformations of the external generative organs. 



Pseudo-hermaphroditism. In the male, normally, the greater part of Muller's canal 

 disappears and its lower end forms the vesicula prostatica. In this malformation 

 Muller's canal is changed, as it is in the female, into Fallopian tubes, uterus, and 

 vagina, while at the same time the testes, epididymides, vesiculse seminales, and sper- 

 matic cord are formed as usual. In the lesser degrees of this malformation we find, in 

 the place of the vesicula prostatica, a pear-shaped sac as large as a pigeon's egg, with 

 muscular walls and an epithelial lining. This sac may be incompletely divided into a 

 uterus and vagina, and it opens into the urethra. In the higher grades we find a well- 

 formed vagina and uterus. The uterus may or may not have Fallopian tubes. The 

 testicles are usually retained in the abdomen or inguinal canals, and are small. The 

 spermatic ducts run on the sides of the uterus and open into the urethra or are closed. 

 The penis and scrotum appear as in hypospadias, or are well formed. The appearance 

 of the individual varies with the development of the testicles. 



True Hermaphroditism may be lateral. In this condition there is hypospadias ; a 

 vagina and uterus and a Fallopian tube and ovary are on one side, and a testicle and 

 spermatic cord on the other. 



In certain cases, which may be called bilateral hermaphroditism, there is a testicle 

 on one side and an ovary on the other. * 



ENLARGEMENT OP THE PENIS is sometimes caused by venous congestion from 

 heart disease ; by long-continued masturbation, as a result of which the corpus caverno- 



1 For a detailed consideration of the malformations of the male and female genera- 

 tive organs consult Kleljs, ''Handbuch der pathologischeu Auatomie," and more recent 

 cases of hermaphroditism by Ileppner, Arch. f. Anat. u. Physiol., 1870, and by Rof- 

 mann, Wien. med. Jahrb., 1877. 



