Male Urinary System and Genital Ducts

External Genitalia
Scrotum – cutaneous fibromuscular sac for the testes and associated structures; it’s an
outpouching of the anterior abdominal wall and so most layers of the anterior
abdominal wall are represented
Dartos fascia – fat-free subcutaneous fascia of the scrotum
Dartos muscle – smooth muscle fibers in the dartos fascia that inserts into the
skin; assists cremaster muscle in testicular elevation as it produces
contraction of the skin of the scrotum; receives autonomic innervation
Scrotal ligament – anchors the inferior pole of the testis to the scrotum
to limit degree of movement of the testis; remnant of the fetal
gubernaculums testis
Scrotal septum – prolongation of the dartos fascia that divides
the scrotum into two compartments, one for each testis
Ductus deferens (vas deferens) – muscular tube that conveys
sperm from the epididymis to the ejaculatory duct; courses
through the substance of the prostate to open into the prostatic
part of the urethra
Coverings of the spermatic cord (derived from anterior
abdominal wall):
• External spermatic fascia – derived from the external oblique
aponeurosis and its investing fascia
• Cremaster muscle
and fascia – derived
from the internal
oblique muscle; the
cremaster fascia is
from fascia of both the
superficial and deep
layers of the internal
oblique; the muscle fibers are
the lowest fascicles of the internal oblique; innervated by
genital branch of the genitofemoral nerve (L1)
• Internal spermatic fascia – derived from the transversalis fascia at the deep inguinal ring
Pampiniform plexus of veins – 8-12 anastomosing veins lying anterior to the ductus deferens and
surrounding the testicular artery in the spermatic cord; formed by testicular veins emerging from the
testis and epididymis; part of the thermoregulatory system of the testis
Artery of the ductus deferens – arises from the inferior vesical artery, a branch of the internal iliac artery
that supplies the prostate and seminal vesicles in males
Testicular artery – arises from the aorta (at vertebral level L2) and supplies the testis and epididymis
Tunica vaginalis – closed peritoneal sac surround the testis
• Visceral layer – covers the surface of each testis except where the testis attaches to the epididymis and
spermatic cord; glistening, transparent serous membrane that is closely applied to the testis,
epididymis, and inferior ductus deferens
• Parietal layer – adjacent to internal spermatic fascia; more extensive than the visceral layer since it
extends superiorly into the distal part of the spermatic cord
Cavity of the tunica vaginalis – potential space between the visceral and parietal layer that contains a
small amount of serous fluid
Epididymis – elongated structure on the posterior surface of testis formed by minute convolutions of the
duct of the epididymis
• Tail – continuous with the ductus deferens
• Body – convoluted duct of the epididymis
• Head – superior expanded part composed of lobules formed by coiled ends of 12-14 efferent ductules
Tunica albuginea – fibrous capsule of the testis; forms a ridge on its internal, posterior aspect as the
mediastinum of the testis
Septa – extension of the tunica albuginea and mediastinum
that divides the testis up into lobules
Lobules – contained within the interval between the septa;
consists of 1-3 seminiferous tubules
Seminiferous tubules – contained within one lobule; where sperm
are formed; joined by the straight tubules to the rete testis

Pelvic Cavity
Peritoneum
(1) Descends anterior abdominal wall (loose attachment allows insertion of
bladder is it fills)
(2) Reflects onto superior surface of bladder, creating supravesical fossa
(3) Covers convex superior surface (roof) of bladder, sloping down sides of
roof to ascend lateral wall of pelvis, creating paravesical fossa on each
side
(4) Descends posterior surface of bladder as much as 2 cm
(5) Laterally, forms folds over uterus (ureteric fold), ductus deferentes, and
superior ends of seminal glands
(6) Reflects from bladder and seminal glands onto rectum, forming
rectovesical pouch
(7) Rectovesical pouch extends laterally and posteriorly to form pararectal
fossa on each side of the rectum
(8) Ascends rectum (from superior to inferior, rectum is subperitoneal then
retroperitoneal)
(9) Engulfs sigmoid colon beginning at rectosigmoid junction
Rectovesical pouch – reflection of the peritoneum from the bladder and seminal glands onto the rectum;
it’s the low point of the peritoneal cavity in erect position
Paravesical fossa – a depression of the peritoneum on either side of the bladder; limited laterally by the
peritoneum that covers the ductus deferens
Pararectal fossa – extension of the rectovesical pouch posterior and laterally on each side of the rectum
Perineal membrane – thin sheet of tough deep fascia that stretches between right and left sides of the
pubic arch; located deep to the bulb of the penis; covers the
anterior part of the pelvic outlet and is perforated by the
urethra in both sexes and by the vagina of the female
(Dissector fig 5.15, pg 122; Moore fig 3.43, pg 251)
External urethral sphincter muscle – in males, only a part of the
muscle forms a circular investment for the intermediate part of
the urethra inferior to the prostate; trough-like part extends
vertically to the neck of the bladder, displacing the prostate
and investing the prosthetic urethra anteriorly and
anterolaterally only; composed of somatically innervated
voluntary smooth muscle that allows control of urinary
continence (Moore fig 3.45A, pg 235)
Membranous urethra (intermediate urethra) – 1-1.5 cm; part of
the urethra surrounded by the external urethral sphincter;
penetrates the perineal membrane; narrowest and least
distensible part
Prostatic urethra – 3-4 cm; part of the urethra surrounded by the anterior prostate; widest and most
dilatable part; where urinary and reproductive tracts merge; interior of the prostatic urethra (Dissector fig
5.18, pg 126):
• Urethral crest – longitudinal fold on the posterior wall of the urethra from uvula of bladder through the
prostatic urethra; composed of muscular and erectile tissue; when distended, may prevent semen from
entering the bladder
• Seminal colliculus – enlargement of the urethral crest; landmark for the entrance of the seminal vesicles
• Prostatic sinus – groove on either side of the seminal colliculus, perforated by apertures for the prostatic
ducts from the lateral prostate
• Prostatic utricle – small opening on the midline of the seminal colliculus, flanked laterally by openings of
the ejaculatory ducts
• Opening of the ejaculatory duct – ~2cm union of the ductus deferens and duct of the seminal vesicles
Spongy urethra (penile urethra) - ~15 cm; courses through corpus spongiosum; initial widening occurs in
the bulb of the penis then widens against distally as navicular fossa of the glans penis
Ductus deferens – enters the deep inguinal ring lateral to the inferior epigastric vessels; as it approaches
midline, it passes superior and then medial to
the branches of the internal iliac artery; crosses
superior to the ureter; enters the retrovesical
septum and is in contact with the fundus of the
urinary bladder
Rectovesical septum – endopelvic fascia
between the fundus of the bladder and the
ampulla of the rectum; closely associated with
seminal glands and prostate (Moore fig 3.8D, pg
216)
Ampulla of the ductus deferens – enlargement of
the ductus deferens before its termination
Seminal vesicle – elongated structure that lies
between the fundus and the rectum, lateral to
the ampulla of the ductus deferens; secrete a thick alkaline fluid that mixes with the sperm as they pass
into the ejaculatory ducts and urethra; the superior ends are covered with peritoneum and lie posterior to
the ureters, separated from the rectum by the rectovesical pouch; the inferior ends are closely related to
the rectum and separated by the rectovesical septum
Ejaculatory duct – slender tube that arises by the union of the duct of a seminal gland with the ductus
deferens; arise near the neck of the bladder and converge to open at the prostatic utricle
Prostate – secretes and stores a slightly alkaline fluid that is milky in appearance; prostatic secretions join
the seminal fluid in the prostatic urethra after termination of the ejaculatory ducts; contains:
• Apex – superior aspect that is closely related to the neck of the bladder
• Base – inferior aspect that is in contact with fascia on the superior aspect of the urethral sphincter and
deep perineal muscles
Lobes of the prostrate –
• Isthmus – anterior muscular zone; represent the superior
continuation of the urethral sphincter muscle anterior to
the urethra
• Left and right lobes are divided into:
o Inferoposterior lobule – superficial, posterior to the
urethra and inferior to the ejaculatory ducts; palpable
by digital exam
o Inferolateral lobule – superficial, lateral to the urethra,
forms the major part of the prostate
o Superomedial lobule – surrounds the ejaculatory duct,
deep to the inferoposterior lobe
o Anteromedial lobule – deep to the inferolateral lobule; directly lateral to the proximal prostatic urethra
Urinary Bladder
Endopelvic fascia – abundant connective tissue between the parietal and visceral membranous fascia
Retropubic space (prevesical space) – potential space
between the pubic symphysis and urinary bladder that is
filled with loose fatty tissue (part of endopelvic fascia) to
accommodate the expansion of the urinary bladder
Puboprostatic ligament – condensation of the parietal pelvic
fascia that ties the prostate to the inner surface of the pubis
Apex – pointed part (superior end) directed toward the
anterior abdominal wall; can be identified by attachment of
the urachus
Body – part between apex and fundus
Fundus – inferior part of the posterior on the opposite side of
the apex (also called base of the urinary bladder); related to
ductus deferens, seminal vesicles, and rectum in males
Neck – where the fundus and inferolateral surfaces converge
inferiorly; where the urethra exits the urinary bladder; walls
thicken to form the internal urethral sphincter
Surfaces of the urinary bladder
• Superior – covered by peritoneum
• Posterior – covered by peritoneum on its superior part and by endopelvic fascia of the rectovesical
septum on its inferior part
• Inferolateral (2) – covered by endopelvic fascia
Detrusor muscle – bundles of smooth muscle that chiefly make up the walls of the bladder
Trigone – angles are formed by the internal urethral orifice (apex) and the orifices of the ureters
(posterolateral angles); the mucous membrane over the trigone are smooth, whereas elsewhere the
bladder has folds; the area is very sensitive to stretch and signals to brain the need to empty
Internal urethral orifice – opening of the bladder into the urethra at the most inferior point in the bladder;
fibers of the detrusor muscle form the involuntary internal
urethral sphincter around the orifice that contracts during
ejaculation to prevent retrograde ejaculation
Orifices of the Ureters – slit-like openings where the ureters
enter the bladder; it passes through the muscular wall in an
oblique direction and is encircled by loops of detrusor
musculature that tighten when the bladder contracts to
prevent reflux of urine into the ureter

Rectum and Anal Canal

Ampulla of the rectum – dilated terminal part of the rectum; supports and retains fecal mass before
defecation
Anorectal flexure - ~80° bend at the ampulla before rectum continues as the anal canal; an important
mechanism for fecal continence and is maintained during resting state by the tone of puborectalis
Transverse rectal folds – 3 internal infoldings (2 on left and 1 on right) that overlie thickened parts of the
circular muscle layer of the rectal wall
Anal columns – 5-10 longitudinal ridges of mucosa in the proximal part of the anal canal; contain terminal
branches of superior rectal arteries and veins (branches/tributaries of SMA and SMV)
Anal valves – semilunar folds of mucosa that unite the distal ends of the anal columns
Anal sinus – small pocket between the anal valve and the wall of the anal canal; when compressed by
feces, exude mucus that aids in evacuation of feces from the anal canal
Pectinate line – irregular line formed by the anal valves; indicates the junction of the superior part of the
anal canal (visceral, derived from embryologic hindgut) and inferior part of the anal canal (somatic,
derived from embryologic proctoderm); the two parts differ in their arterial supply, innervation, and
venous and lymphatic drainage
External anal sphincter – large voluntary sphincter; forms broad band on each side of the inferior 2/3rds of
the anal canal; blends superiorly with puborectalis; supplied mainly by S4 through inferior anal (rectal)
nerve
Internal anal sphincter –
involuntary sphincter surrounding
superior 2/3rds of the anal canal;
thickening of the circular muscle
layer; contraction is maintained
by the sympathetic fivers from
the superior rectal and
hypogastric plexus; inhibition by
the parasympathetic fibers