Prostate Diseases

The prostate gland is a solid, walnut-size organ in the male urinogenital system that plays an important part in male sexual function. It is located at the junction of the urinary and reproductive systems. It is also in close proximity to the bowels. Its rear surface can be examined by a physician during a digital rectal exam (DRE).

The prostate gland surrounds the first part of the urethra tube and is located under the bladder, in front of the rectum. Its close proximity to the rectal wall poses problems during radiation treatments for prostate cancer.

The ancient Egyptians and Greeks were familiar with urinary problems such as bladder and kidney stones. However, the prostate was first described by Niccolo Massa during the Italian Renaissance. The word prostate was coined from a Greek word for “to set before” which was used to describe the prostate's location in front of the bladder. The prostate gland is a part of the exocrine system. It secretes fluid from ducts that mixes with sperm immediately before the seminal fluid enters the urethra and is ejaculated during sexual intercourse. As the sperm leave the testicles, the semen passes through ducts in the seminal vesicles. Secretions of the prostate to maintain the vitality of the sperm are then added. The secretions are produced by the epithelial cells that line the microscopic glands and ducts. The prostate adds about ten to thirty percent to the volume of the seminal fluid. The secretions are slightly alkaline. which increases the motility of the sperm.

The prostate adds prostate-specific antigen (PSA) to the semen. which liquefies coagulated semen. This reaction frees the sperm to swim on their journey to fertilize the egg. High levels of PSA are normal in semen. However in a blood test, high PSA levels can be used as an indicator of the possibility of prostate cancer.

The prostate is small in young boys, weighing only a few grams. It grows with the onset of puberty in response to androgen hormones. It stops enlarging around the age of 20 years. At this time it weighs about 20 grams.

The exact reasons for the enlargement of the prostate are not understood. The safest strategy for men is regular examinations to detect any unsual enlargment as early as possible.

An infection in the prostate gland can occur in boys or men of any age. The inflammation (prostatitis) may be caused by venereal disease; by the spread of infection from the intestines; or by some non-specific urethritis. Occasionally the infection is due to injury from an examination of the inside of the bladder (cystoscopy).

The symptoms of prostatitis are similar to those of an enlarged prostate or to prostate cancer. Difficulty in urinating, painful urination or frequent urination (dysuria) are commonly experienced symptoms in acute cases. Treatment with antibiotics over a long period of time is generally required. Abstinence from sexual activity may be advisable until the infection is cured.

Clinically, the fact that the doughnut shaped prostate gland surrounds the small urethra tube is very significant. The prostate in most men begins to enlarge at about the age of fifty.

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