Prostate
Male Anatomy
Prostate with seminal vesicles and seminal ducts, viewed from in front and above. The seminal vesicles ( glandulae vesiculosae) are a pair of simple tubular glands posteroinferior to the Urinary bladder of males Each Seminal vesicle consists of a single tube coiled upon itself and giving off several irregular cecal diverticula the separate coils as well as the diverticula are connected together
Latin	prostata
Gray's	subject #263 1251
Artery	internal pudendal artery, inferior vesical artery, and middle rectal artery
Vein	prostatic venous plexus, pudendal plexus, vesicle plexus, internal iliac vein
Nerve	inferior hypogastric plexus
Lymph	external iliac lymph nodes, internal iliac lymph nodes, sacral lymph nodes
Precursor	Endodermic evaginations of the urethra
MeSH	Prostate
Dorlands/Elsevier	p_36/12671161

The prostate (from Greek προστάτης - prostates, literally "one who stands before", "protector", "guardian"^[1]) is a compound tubuloalveolar exocrine gland of the male mammalian reproductive system. Latin ( lingua Latīna, laˈtiːna is an Italic language, historically spoken in Latium and Ancient Rome. Gray's Anatomy the Respiratory apparatus ( Apparatus Respiratorius Respiratory system Respiratory apparatus Arteries are Blood vessels that carry blood away from the Heart. The internal pudendal artery is an Artery that branches off the Internal iliac artery, providing blood to the External genitalia. The inferior vesical artery is an artery in the Pelvis that supplies the lower part of the bladder. The middle rectal artery is an Artery in the pelvis that supplies blood to the Rectum. In the Circulatory system, a vein is a Blood vessel that carries Blood back toward the Heart (as opposed to Artery, a blood vessel The prostatic veins form a well-marked prostatic plexus which lies partly in the fascial sheath of the prostate and partly between the sheath and the Prostatic capsule. The internal iliac vein ( hypogastric vein) begins near the upper part of the Greater sciatic foramen, passes upward behind and slightly medial to the Hypogastric A nerve is an enclosed cable-like bundle of peripheral Axons (the long slender projections of Neurons. The inferior hypogastric plexus ( pelvic plexus in some texts is a Plexus of nerves that supplies the Viscera of the Pelvic cavity. The lymphatic system in Vertebrates is a network of conduits that carry a clear fluid called Lymph. The external iliac lymph nodes, from eight to ten in number lie along the External iliac vessels. The internal iliac lymph nodes (or hypogastric) surround the Internal iliac artery and its branches (the hypogastric vessels) and receive the Lymphatics The sacral lymph nodes are placed in the concavity of the Sacrum, in relation to the middle and Lateral sacral arteries; they receive lymphatics from the rectum and Embryology (from Greek grc ἔμβρυον embryon, "unborn embryo" and grc -λογία -logia) is the study of the development Medical Subject Headings ( MeSH) is a huge Controlled vocabulary (or metadata system for the purpose of indexing journal articles and books Elsevier, the world's largest Publisher of Medical and Scientific literature, forms part of the Reed Elsevier group Greek (el ελληνική γλώσσα or simply el ελληνικά — "Hellenic" is an Indo-European language, spoken today by 15-22 million people mainly Exocrine glands are Glands that secrete their products ( Enzymes into ducts (duct glands Mammals ( class Mammalia) are a class of Vertebrate Animals characterized by the presence of Sweat glands, including sweat glands The reproductive system is a system of organs within an Organism which work together for the purpose of Reproduction. Women do not have a prostate gland, although women do have microscopic paraurethral Skene's glands connected to the distal third of the urethra in the prevaginal space that are homologous to the prostate. In Human anatomy (female the Skene's glands (also known as the lesser vestibular, periurethral glands, skene glands, paraurethral

The prostate differs considerably among species anatomically, chemically, and physiologically. Anatomy (from the Greek anatomia, from ana separate apart from and temnein, to cut up cut open is a branch of Biology that is the consideration A chemical substance is a Material with a definite chemical composition. Physiology (from Greek grc φύσις physis, "nature origin" and grc -λογία -logia) is the study of the mechanical physical

• Posterior: urethra and rectum
• Superior: upper surface of urogenital diaphragm and urinary bladder
• Lateral: anterior fibers of levator ani muscle

Function

The main function of the prostate is to store and secrete a clear, slightly alkaline (pH 7. In Anatomy, the urethra (from Greek ουρήθρα - ourethra) is a tube which connects the Urinary bladder to the outside of The rectum (from the Latin rectum intestinum, meaning straight intestine) is the final straight portion of the Large intestine in some Mammals The deep perineal pouch (also deep perineal space) is an anatomical term that refers to the space enclosed in part by the Perineum, and located superior to the In Anatomy, the urinary bladder is a hollow muscular, and distensible (or elastic organ that sits on the Pelvic floor in Mammals It is the The Levator ani is a broad thin Muscle, situated on the side of the Pelvis. In Chemistry, a base is most commonly thought of as an aqueous substance that can accept Protons This refers to the Brønsted-Lowry theory of acids and 29) fluid that constitutes 10-30% of the volume of the seminal fluid that, along with spermatozoa, constitutes semen. Physiological aspects Internal and external fertilization Depending on the Species, spermatozoa can fertilize A spermatozoon or spermatozoan ( pl spermatozoa) from the Ancient Greek σπέρμα (seed and ζῷον (living being and more commonly known Physiological aspects Internal and external fertilization Depending on the Species, spermatozoa can fertilize The rest of the seminal fluid is produced by the two seminal vesicles. The seminal vesicles ( glandulae vesiculosae) are a pair of simple tubular glands posteroinferior to the Urinary bladder of males The alkalinity of seminal fluid helps neutralize the acidity of the vaginal tract, prolonging the lifespan of sperm.

The prostate also contains some smooth muscles that help expel semen during ejaculation. Smooth muscle is a type of non- Striated muscle, found within the Tunica media layer of large and small Arteries and Veins, the bladder Ejaculation is the ejecting of Semen from the Penis, and is usually accompanied by Orgasm.

Secretions

Prostatic secretions vary among species. They are generally composed of simple sugars, and are often slightly alkaline. In Chemistry, a base is most commonly thought of as an aqueous substance that can accept Protons This refers to the Brønsted-Lowry theory of acids and

In human prostatic secretions, the protein content is less than 1% and includes proteolytic enzymes, acid phosphatase, and prostate-specific antigen. A protease is any Enzyme that conducts Proteolysis, that is begins protein Catabolism by Hydrolysis of the Peptide bonds that link Acid phosphatase is a Phosphatase, a type of enzyme used to free attached phosphate groups from other molecules during Digestion. Prostate specific antigen ( PSA) is a protein produced by the cells of the Prostate gland The secretions also contain zinc. Zinc (ˈzɪŋk from Zink is a Metallic Chemical element with the symbol Zn and Atomic number 30

Regulation

To work properly, the prostate needs male hormones (androgens), which are responsible for male sex characteristics. Hormones (from Greek ὁρμή - "impetus" are chemicals released by cells that affect cells in other parts of the body Androgen is the generic term for any natural or synthetic compound usually a Steroid Hormone, that stimulates or controls the development and maintenance of masculine An organism's sex is defined by the gametes it produces males produce male gametes (spermatozoa or Sperm) while females produce female gametes (ova or Egg cells; individual

The main male hormone is testosterone, which is produced mainly by the testicles. Testosterone is a Steroid hormone from the Androgen group In mammals testosterone is primarily secreted in the testes of males and the Ovaries The testicle (from Latin testiculus, diminutive of testis, meaning "witness" virility plural testes) is the male Some male hormones are produced in small amounts by the adrenal glands. In Mammals the adrenal glands (also known as suprarenal glands) are the triangle-shaped Endocrine glands that sit on top of the Kidneys their However, it is dihydrotestosterone that regulates the prostate.

Development

The prostatic part of the urethra develops from the pelvic (middle) part of the urogenital sinus (endodermal origin). The urogenital sinus (also known as the persistent cloaca) is a part of the human body only present in the Development of the urinary and reproductive organs. Endodermal outgrowths arise from the prostatic part of the urethra and grow into the surrounding mesenchyme. Endoderm, (sometimes called Entoderm) is one of the Germ layers formed during animal Embryogenesis. Mesenchyme refers to loosely organized connective tissue present in the embryo regardless of origin The glandular epithelium of the prostate differentiates from these endodermal cells, and the associated mesenchyme differentiates into the dense stroma and the smooth muscle of the prostate. Smooth muscle is a type of non- Striated muscle, found within the Tunica media layer of large and small Arteries and Veins, the bladder ^[2]The prostate glands represent the modified wall of the proximal portion of the male urethra and arises by the 9th week of embryonic life in the development of the reproductive system. The development of the reproductive system is a part of the Prenatal development, and concerns the Sex organs. Condensation of mesenchyme, urethra and Wolffian ducts gives rise to the adult prostate gland, a composite organ made up of several glandular and non-glandular components tightly fused within a common capsule. Mesenchyme refers to loosely organized connective tissue present in the embryo regardless of origin In Anatomy, the urethra (from Greek ουρήθρα - ourethra) is a tube which connects the Urinary bladder to the outside of

Skene's glands found in many females are homologous to the prostate gland in males. In Human anatomy (female the Skene's glands (also known as the lesser vestibular, periurethral glands, skene glands, paraurethral In Evolutionary biology, homology has come to mean any similarity between characters that is due to their shared ancestry.

Structure

A healthy human prostate is slightly larger than a walnut. Human beings, humans or man (Origin 1590–1600 L homō man OL hemō the earthly one (see Humus Walnuts (genus Juglans) are Plants in the family Juglandaceae. It surrounds the urethra just below the urinary bladder and can be felt during a rectal exam. In Anatomy, the urethra (from Greek ουρήθρα - ourethra) is a tube which connects the Urinary bladder to the outside of In Anatomy, the urinary bladder is a hollow muscular, and distensible (or elastic organ that sits on the Pelvic floor in Mammals It is the A rectal examination or rectal exam is an internal examination of the Rectum such as by a Physician or other healthcare professional

The ducts are lined with transitional epithelium. Transitional epithelium (also known as urothelium is a type of tissue consisting of multiple layers of Epithelial cells which can contract and expand

Within the prostate, the urethra coming from the bladder is called the prostatic urethra and merges with the two ejaculatory ducts. The prostatic urethra, the widest and most dilatable part of the Urethra canal is about 3 cm The Ejaculatory ducts ( ductus ejaculatorii) are paired structures in male Anatomy, about 2 cm in length (The male urethra has two functions: to carry urine from the bladder during urination and to carry semen during ejaculation. Male (♂ refers to the sex of an organism or part of an organism which produces small mobile Gametes called spermatozoa. Urination, also known as micturition, voiding, and more rarely emiction, is the process of disposing Urine from the Urinary bladder Ejaculation is the ejecting of Semen from the Penis, and is usually accompanied by Orgasm. ) The prostate is sheathed in the muscles of the pelvic floor, which contract during the ejaculatory process.

The prostate can be divided in two different ways: by zone, or by lobe. ^[3]

Zones

The "zone" classification is more often used in pathology.

The prostate gland has four distinct glandular regions, two of which arise from different segments of the prostatic urethra:

Lobes

Prostate with a large median lobe bulging upwards. A metal instrument is placed in the urethra which passes through the prostate. In Anatomy, the urethra (from Greek ουρήθρα - ourethra) is a tube which connects the Urinary bladder to the outside of This specimen was almost 7 centimeters long with a volume of about 60 cubic centimetres on transrectal ultrasound and was removed during a Hryntschak procedure or transvesical prostatectomy (removal of the prostate through the bladder) for benign prostatic hyperplasia. A cubic centimetre or cubic centimeter (symbol cm3 —the abbreviation cc, though widely used is deprecated is a commonly used unit of Volume Transrectal ultrasound uses inaudible Sound waves produced by a probe inserted into the Rectum to create an image of organs in the Pelvis. A prostatectomy is the Surgical removal of all or part of the Prostate gland. Benign prostatic hyperplasia ( BPH) also known as nodular hyperplasia, benign prostatic hypertrophy (technically a misnomer or benign enlargement of

The "lobe" classification is more often used in anatomy.

Prostate disorders

Prostatitis

Main article: Prostatitis

Prostatitis is inflammation of the prostate gland. Prostatitis is an Inflammation of the Prostate gland in men A prostatitis diagnosis is assigned at 8% of all urologist and 1% of all primary care physician visits Prostatitis is an Inflammation of the Prostate gland in men A prostatitis diagnosis is assigned at 8% of all urologist and 1% of all primary care physician visits Inflammation ( Latin, inflamatio, to set on fire is the complex biological response of vascular tissues to harmful stimuli such as Pathogens There are different forms of prostatitis, each with different causes and outcomes. Acute prostatitis and chronic bacterial prostatitis are treated with antibiotics; chronic non-bacterial prostatitis or male chronic pelvic pain syndrome, which comprises about 95% of prostatitis diagnoses, is treated by a large variety of modalities including alpha blockers, phytotherapy, physical therapy, psychotherapy, antihistamines, anxiolytics, nerve modulators and more. In modern usage an antibiotic is a Chemotherapeutic agent with activity against Microorganisms such as Bacteria, fungi or Protozoa ^[4] More recently, a combination of trigger point and psychological therapy has proved effective as well. ^[5]

Benign prostatic hyperplasia

Main article: Benign prostatic hyperplasia

Benign prostatic hyperplasia (BPH) occurs in older men;^[6] the prostate often enlarges to the point where urination becomes difficult. Benign prostatic hyperplasia ( BPH) also known as nodular hyperplasia, benign prostatic hypertrophy (technically a misnomer or benign enlargement of Benign prostatic hyperplasia ( BPH) also known as nodular hyperplasia, benign prostatic hypertrophy (technically a misnomer or benign enlargement of Symptoms include needing to go to the toilet often (pollakisuria) or taking a while to get started (hesitancy). If the prostate grows too large it may constrict the urethra and impede the flow of urine, making urination difficult and painful and in extreme cases completely impossible. Urination, also known as micturition, voiding, and more rarely emiction, is the process of disposing Urine from the Urinary bladder

BPH can be treated with medication, a minimally invasive procedure or, in extreme cases, surgery that removes the prostate. Minimally invasive surgical procedures avoid open invasive surgery in favor of closed or local surgery with less trauma Minimally invasive procedures include Transurethral needle ablation of the prostate (TUNA) and Transurethral microwave thermotherapy (TUMT). Transurethral needle ablation ( TUNA) is a globally approved technique which can be done with a Local anesthetic on an Outpatient basis and uses low energy Transurethral microwave thermotherapy (TUMT is one of a number of effective and safe procedures used in the treatment of Lower urinary tract symptoms (LUTS caused by These outpatient procedures may be followed by the insertion of a temporary Prostatic stent, to allow normal voluntary urination, without exacerbating irritative symptoms^[7]. A Prostatic stent is used to keep open the male Urethra and allow the passing of urine in cases of Prostatic obstruction and Lower urinary tract symptoms

The surgery most often used in such cases is called transurethral resection of the prostate (TURP or TUR). In TURP, an instrument is inserted through the urethra to remove prostate tissue that is pressing against the upper part of the urethra and restricting the flow of urine. Older men often have corpora amylacea^[8] (amyloid), dense accumulations of calcified proteinaceous material, in the ducts of their prostates. Amyloids are insoluble fibrous Protein aggregates sharing specific structural traits The corpora amylacea may obstruct the lumens of the prostatic ducts, and may underlie some cases of BPH.

Urinary frequency due to bladder spasm, common in older men, may be confused with prostatic hyperplasia. Statistical observations suggest that a diet low in fat and red meat and high in protein and vegetables, as well as regular alcohol consumption, could protect against BPH. Epidemiology is the study of factors affecting the Health and Illness of populations and serves as the foundation and Logic of interventions made in the Fats consist of a wide group of compounds that are generally soluble in organic solvents and largely insoluble in water For mammal meat see Red meat. For the band see Red Meat (band. Proteins are large Organic compounds made of Amino acids arranged in a linear chain and joined together by Peptide bonds between the Carboxyl The term " vegetable " generally means the edible parts of Plants The definition of the word is traditional rather than Scientific, however ^[9]

Prostate cancer

Main article: Prostate cancer

Prostate cancer is one of the most common cancers affecting older men in developed countries and a significant cause of death for elderly men (estimated by some specialists at 3%). Cancer (medical term Malignant Neoplasm) is a class of Diseases in which a group of cells display uncontrolled The term developed country, or advanced country, is used to categorize countries with developed Economies in which the tertiary and quaternary sectors Death is the termination of the biological functions that define living Organisms It refers both to a specific Regular rectal exams are recommended for older men to detect prostate cancer early. A rectal examination or rectal exam is an internal examination of the Rectum such as by a Physician or other healthcare professional

Though prostate cancer is of most concern to older men, it is like other cancers, a complex disease with many risk factors; race, age, genetics, and lifestyle habits can all contribute to its development. ^[10]

Male sexual response

During orgasm sperm are transmitted from the ductus deferens into the male urethra via the ejaculatory ducts, which lie within the prostate gland. The prostate is often referred to as the "male G-spot". The Gräfenberg spot, or G-spot, is a female Erogenous zone which when stimulated leads to high levels of sexual arousal and powerful Orgasms Some men are able to achieve orgasm solely through stimulation of the prostate gland, such as prostate massage or receptive anal intercourse. An orgasm (sexual climax is the conclusion of the plateau phase of the sexual response cycle, and may be experienced by both males and females Prostate massage and prostate milking are terms used to describe the Massage or stimulation of the Prostate gland in males either for medical or Sexual Anal sex most often refers to the sex act involving insertion of the Penis into the Rectum. Men who report the sensation of prostate stimulation often give descriptions similar to women's accounts of G-spot stimulation. The Gräfenberg spot, or G-spot, is a female Erogenous zone which when stimulated leads to high levels of sexual arousal and powerful Orgasms ^[11]

Vasectomy and risk of prostate cancer

In 1993, the Journal of the American Medical Association revealed a connection between vasectomy and an increased risk of prostate cancer. Vasectomy is a surgical procedure in which the vasa deferentia of a man are cut for the purpose of sterilization. Reported studies of 48,000 and 29,000 men who had vasectomies showed 66 percent and 56 percent higher rates of prostate cancer, respectively. The risk increased with age and the number of years since the vasectomy was performed.

However, in March of the same year, the National Institute of Child Health and Human Development held a conference cosponsored by the National Cancer Institute and others to review the available data and information on the link between prostate cancer and vasectomies. It was determined that an association between the two was very weak at best, and even if having a vasectomy increased one's risk, the risk was relatively small.

In 1997, the NCI held a conference with the prostate cancer Progressive Review Group (a committee of scientists, medical personnel, and others). Their final report, published in 1998 stated that evidence that vasectomies help to develop prostate cancer was weak at best. ^[12]

Stenting the prostate

Recent scientific breakthroughs have now meant using a Prostatic stent is a viable method of dis-obstructing the prostate. A Prostatic stent is used to keep open the male Urethra and allow the passing of urine in cases of Prostatic obstruction and Lower urinary tract symptoms Stents are devices inserted into the urethra to widen it and keep it open. Stents can be temporary or permanent and is mostly done on an outpatient basis under local or spinal anesthesia and usually takes about 30 minutes.

Additional images

Urinary bladder	Structure of the penis	Lobes of prostate	Zones of prostate
Prostate	Prostate under a microscope This image shows the microscopic glands of the prostate	Male Anatomy	The deeper branches of the internal pudendal artery.
Lymphatics of the prostate.	Fundus of the bladder with the vesiculæ seminales.	Vesiculae seminales and ampullae of ductus deferentes, seen from the front.	Vertical section of bladder, penis, and urethra.

References

The text of this article was originally taken from NIH Publication No. 02-4806, a public domain resource [2].

External links

• "What I need to know about prostate problems" by the US National Institutes of Health.