What is the prostate gland? Structure, functions and diseases

The prostate gland isn’t that big – about the size of a walnut – but it plays an important role in male reproductive health. Located below the bladder and in front of the rectum, it wraps the top of the urethra, which drains urine from the body. Due to its location, the prostate gland can affect urination and sexual function.

Prostate gland – what is it?

The prostate gland, or prostate, is part of the male reproductive system. It is the size and shape of a walnut. It is located low in the pelvis, below the bladder and just in front of the rectum. The prostate gland helps to produce semen, the milky fluid that carries sperm from the testicles through the penis when a man ejaculates. This fluid contains special enzymes and hormones that help sperm function properly, which means that the prostate gland plays a key role in male fertility. The prostate muscles also help push semen through the urethra when you ejaculate.

This gland surrounds part of the urethra, the tube that transports urine out of the bladder through the penis.

See also: Six fertility myths. We still believe in them

Prostate gland – structure

The prostate gland is surrounded by a connective tissue capsule containing many smooth muscle fibers and flexible connective tissue, therefore it is very flexible to the touch during the examination. There are also many smooth muscle cells inside the prostate gland. During ejaculation, these muscle cells contract and forcefully push the fluid stored in the prostate into the urethra. This causes the fluid and sperm, along with the fluid from other glands, to combine to form semen which is then released.

The prostate tissue can be divided into three different zones, listed here from the innermost to the outermost, which surround the urethra like layers of an onion.

1. Transition zone it is located on the inside of the gland and is the smallest part of the prostate gland (about 10%). It surrounds the urethra between the bladder and the top third of the urethra.
2. Middle zone surrounds the transition zone and accounts for about a quarter of the total mass of the prostate. Here are the common duct for the prostate, the seminal cord, and the seminal vesicles. This tube is also known as the ejaculation tube (Ejaculatory duct).
3. Perimeter zone it constitutes the main part of the prostate gland – about 70% of the tissue mass is part of the peripheral zone.

The tissue of the transition zone tends to grow mildly (non-cancerous) in old age. The medical term for this is benign prostatic hyperplasia (BPH). If this tissue presses against the bladder and urethra, it can lead to difficulty urinating. It is a common problem among older men. Malignant (cancerous) neoplasms of the prostate develop mainly in the peripheral zone.

See also: Tumors in Poland. What do we get sick and die of most often? [INFOGRAPHICS]

Prostate gland – functions

The prostate gland has various functions, such as sperm production and hormone metabolism.

Semen production by the prostate gland:

1. one part of the semen is produced in the prostate. Along with testicular sperm, seminal vesicle fluid, and secretions secreted by another pea-sized gland below the prostate gland (the bulbourethral gland), the prostate fluid forms semen. All of these fluids mix together in the urethra;
2. prostate secretion is important for the proper functioning of sperm and therefore also for male fertility. The thin, milky fluid contains many enzymes such as PSA Prostate Specific Antigen. This enzyme causes the seed to be diluted;
3. The hormone-like substance spermine is primarily responsible for sperm motility (the ability to move).

Closing the urethra into the bladder when ejaculating: During ejaculation, the prostate and bladder sphincter close the urethra into the bladder to prevent semen from entering the bladder.

Closure of the seminal ducts during urination: when urinating, the muscles in the prostate close the ducts of the prostate so that urine cannot get inside.

Hormone metabolism: in the prostate, the male sex hormone testosterone is converted into the biologically active form of DHT (dihydrotestosterone).

To support the proper functioning of the prostate gland, it is worth using regularly For prostate – a natural herbal mixture for him Lorem Vit, which is available on Medonet Market at a promotional price.

Prostate enlargement and age

Since the prostate gland tends to enlarge with age, it can constrict the urethra and cause problems urinating. Occasionally, men in their 30s and 40s may begin to experience urinary symptoms and need medical attention. For others, symptoms do not appear until later in life. An infection or cancer can also cause the prostate to enlarge.

Remember to tell your doctor if you have any of the urinary symptoms listed below.

1. We urinate more often during the day;
2. We have an urgent need to urinate;
3. Less urine flow;
4. We feel a burning sensation when urinating;
5. We have to get up many times at night to urinate.

Aging increases the risk of prostate problems. The three most common problems with the prostate gland are inflammation (prostatitis), enlarged prostate (BPH or benign prostatic hyperplasia), and prostate cancer.

One change doesn’t lead to another. For example, prostatitis or an enlarged prostate does not increase the risk of prostate cancer. It’s also possible to have more than one prostate problem at the same time.

See also: Urinary system diseases

Inflammation of the prostate gland

Prostatitis is inflammation that can result from a bacterial infection. At some point in life, it affects at least half of all men. Having this condition does not increase your risk of any other prostate disease.

The symptoms of prostatitis include:

1. problems urinating;
2. a burning or prickling sensation or pain when urinating;
3. a strong, frequent need to urinate, even with a small amount of urine;
4. chills and high fever;
5. low back pain or body aches;
6. pain low in the abdomen, groin or behind the scrotum;
7. pressure or pain in the anus;
8. discharge from the urethra with bowel movements;
9. pulsation of the genitals and rectum;
10. sexual problems and loss of sex drive;
11. painful ejaculation (sexual climax).

Several tests, such as the DRE, which is rectal examination of the prostate and urine examination, may be performed to see if you have prostatitis. Correctly diagnosing the exact type of prostatitis is key to getting the best treatment. Even if we do not have any symptoms, we should follow the doctor’s instructions to complete the treatment.

Types and treatment of prostatitis

1. Acute prostatitis

This type is caused by a bacterial infection and comes on suddenly (acute). Symptoms include severe chills and fever. Blood often appears in the urine. PSA levels may be higher than normal. You should go to the doctor’s office or the emergency room for treatment. It is the least common of the four types, but the easiest to diagnose and treat.

Most cases can be treated with high doses of antibiotics for 7 to 14 days, followed by lower doses for several weeks. You may also need medications to relieve pain or discomfort. If your PSA has been high, it is likely to return to normal once the infection is cleared.

1. Chronic prostatitis

This type of prostatitis, also caused by bacteria, does not appear suddenly but can be troublesome. The only symptom you can have is bladder infections that keep coming back. The cause may be a defect in the prostate, which allows bacteria to build up in the urinary tract. For this kind, treatment with antibiotics for a long time is best. The treatment lasts from 4 to 12 weeks. This type of treatment helps about 60 percent of the time. Long-term, low-dose antibiotics can help relieve symptoms when they do not go away.

1. Painful pelvic syndrome

This disorder is the most common but least understood type of prostatitis. It occurs in men of all ages, from late teens to the elderly, and symptoms can come and go without warning. There may be pain or discomfort in the groin or bladder area. Infection-fighting cells are often present even though no bacteria can be found.

There are several different treatments for this problem, depending on your symptoms. These include anti-inflammatory medications and other pain treatments such as warm baths. Other medications such as alpha blockers may also be given. Alpha-blockers relax the muscle tissue of the prostate, making it easier to pass urine. Some men are treated with antibiotics if symptoms are due to an undetected infection.

1. Asymptomatic prostatitis

We have no symptoms of this condition. It often occurs when we undergo research for other conditions, such as finding the cause of infertility or looking for prostate cancer. If we have this form of prostatitis, our PSA test may show a higher number than normal. Men with this condition are usually left untreated, but a re-test for PSA is usually performed if the PSA count is high.

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Benign prostatic hyperplasia – BPH

BPH stands for benign prostatic hyperplasia (BPH). Mild means “non-cancerous” and hyperplasia means abnormal cell growth. This causes the prostate to enlarge. BPH is not associated with cancer and does not increase your risk of developing prostate cancer – however, the symptoms of BPH and prostate cancer may be similar.

Symptoms of benign prostatic hyperplasia include:

1. having trouble making a urine stream or doing more than passing a few drops of urine;
2. frequent urination, especially at night;
3. a feeling that the bladder has not been completely emptied;
4. a strong or sudden urge to urinate;
5. weak or slow urine stream;
6. stopping and urinating again several times while urinating;
7. straining to start urinating.

At worst, BPH can lead to: bladder weakness, retraction of urine causing bladder or kidney infections, complete obstruction of urine flow, and kidney failure.

The prostate gland is the size of a walnut in a 20-year-old male. At 40, it may slightly grow to the size of an apricot. At 60, it can be about the size of a lemon. The enlarged prostate can press against the bladder and urethra. This can slow down or block the flow of urine.

Some men may find it difficult to run a urine stream, even if they feel the urge to go to the bathroom. Once started, the urine flow can be difficult to stop. Other men may feel the need to urinate continuously or wake up during sleep with a sudden urge to urinate. It takes many years for the early symptoms of BPH to develop into bothersome problems. These early symptoms are a signal to see a doctor.

Treatment of benign prostatic hyperplasia

Some men with BPH eventually find their symptoms bothersome enough to require treatment. BPH cannot be cured, but medications or surgery can often ease symptoms.

Men with mild symptoms of BPH who are not bothersome often choose steps to help relieve their symptoms:

1. limit drinking in the evening, especially drinks with alcohol or caffeine;
2. empty the bladder completely when urinating;
3. use the toilet frequently. Don’t wait long without urinating.

Certain medications can make BPH symptoms worse, so let’s talk to your doctor or pharmacist about the medications you are taking, such as:

1. over-the-counter cold and cough medications (especially antihistamines);
2. sedatives;
3. antidepressant;
4. blood pressure medications.

Many men with mild to moderate symptoms of BPH choose prescription drugs over surgery since the early 90s. Two main types of drugs are used. One type relaxes the muscles near the prostate and the other reduces the prostate gland. Some evidence suggests that taking both drugs together may be best at preventing BPH symptoms from getting worse.

1. Alpha blockers are drugs that help relax the muscles near the prostate to reduce pressure and allow urine to flow more freely, but do not reduce the size of the prostate. For many men, these medications can improve urine flow and reduce BPH symptoms within days. Possible side effects include dizziness, headache and fatigue.
2. 5 alpha-reductase inhibitors are drugs that help to shrink the prostate. They ease symptoms by blocking the activity of an enzyme known as 5-alpha reductase. This enzyme converts the male hormone testosterone into dihydrotestosterone (DHT), which stimulates prostate growth. When the action of 5-alpha reductase is blocked, DHT production is lowered and prostate growth slows down. This helps to shrink the prostate, reduce blockage, and reduce the need for surgery.

Taking these medications can help increase urine flow and reduce symptoms. We must continue taking these medications to prevent symptoms from returning. 5-alpha reductase inhibitors can cause the following side effects in a small percentage of men, including: decreased interest in sex, difficulty getting or maintaining an erection, and less semen when ejaculating.

It’s important to remember that taking these medications can lower our PSA score. There is also evidence that these drugs reduce the risk of developing prostate cancer, but it is still unclear if they can help lower the risk of dying from prostate cancer.

The number of prostate operations has declined over the years. But BPH operations are still among the most common operations among men. Surgery is used when symptoms are severe or drug treatment is not working well. Be sure to discuss your options with your doctor and ask about the potential short- and long-term benefits and risks of each procedure.

The types of surgery for BPH include:

1. TURP (transurethral resection of the prostate gland). The most common BPH operation, TURP accounts for 90 percent of all BPH operations. The doctor passes the instrument through the urethra and cuts off additional prostate tissue. The procedure uses spinal anesthesia. The tissue is sent to a lab to check for prostate cancer. TURP generally avoids two main dangers of another type of surgery called open prostatectomy (complete removal of the prostate through an incision in the lower abdomen): including urinary incontinence and / or impotence. However, TURP can have serious side effects such as bleeding. In addition, men may need to stay in the hospital and need a catheter for several days after surgery.
2. TUIP (transurethral incision of the prostate). This procedure, similar to TURP, is used on slightly enlarged prostate glands. The surgeon places one or two small incisions into the prostate. This relieves pressure without cutting the tissue. It has a low risk of side effects. Like TURP, this treatment helps urine flow by widening the urethra.
3. TUNA (transurethral needle ablation). Radio waves are used to burn excess prostate tissue. TUNA helps urine flow, relieves symptoms, and may have fewer side effects than TURP. Most men need catheterization to drain their urine for some time after surgery.
4. TUMT (transurethral microwave thermotherapy). The microwaves sent through the catheter are used to destroy excess prostate tissue. It may be an option for men who shouldn’t undergo major surgery because they have other health problems.
5. TUVP (transurethral electroevaporation of the prostate). Electricity is used to vaporize the prostate tissue.
6. Laser surgery. The doctor inserts the laser fiber through the urethra into the prostate with a cystoscope and then delivers several pulses of laser energy. The laser energy destroys the prostate tissue and helps to improve urine flow. Like TURP, laser surgery requires anesthesia. One of the benefits of laser surgery over TURP is that laser surgery causes little blood loss. The recovery period after laser surgery may also be shorter. However, laser surgery may not be effective for larger prostate glands.
7. Open prostatectomy. This may be the only option in rare cases, such as when the obstruction is severe, the prostate is very large, or other procedures cannot be performed. General anesthesia or spinal anesthesia is used, and the catheter remains for 3 to 7 days after surgery. This operation carries the greatest risk of complications. The tissue is sent to a lab to check for prostate cancer.

Prostate (prostate) cancer

Prostate cancer means that cancer cells form in the tissues of the prostate gland. Prostate cancer tends to grow slowly compared to most other cancers. Cell changes can begin 10, 20, or even 30 years before the tumor becomes large enough to cause symptoms. Eventually, the cancer cells can spread (metastasize). By the time symptoms appear, the cancer may be advanced.

By the age of 50, very few men have symptoms of prostate cancer, but some precancerous or cancerous cells may be present. For example, more than half of all American men have prostate cancer by the age of 80. Most of these tumors are never a problem. They may never cause symptoms or pose a serious health risk.

Symptoms of prostate cancer include:

1. problems urinating;
2. frequent need to urinate, especially at night;
3. weak or interrupted urine stream;
4. pain or burning sensation when urinating;
5. blood in urine or semen;
6. painful ejaculation;
7. nagging pain in the back, hips or pelvis.

Prostate cancer can spread to the pelvic lymph nodes. It can also spread throughout the body. It tends to spread to the bone. So bone pain, especially in the back, can be a symptom of advanced prostate cancer.

Prostate cancer risk factors

Some risk factors are associated with prostate cancer. A risk factor is something that can make you more likely to get sick. Having one or more risk factors does not mean that we will develop prostate cancer. It simply means that the risk of the disease is greater.

1. Age. Men aged 50 or older are more likely to develop prostate cancer.
2. Feel. African-American men are most at risk of developing prostate cancer – the disease begins at an earlier age and progresses faster than men of other races. After African American men, prostate cancer is most common among white men, followed by Hispanics and Native Americans. Asian men have the lowest prostate cancer rate.
3. Family history. Men whose fathers or brothers had prostate cancer have a 2 to 3 times greater risk of prostate cancer than men who do not have a family history of the disease. A man who has 3 immediate family members with prostate cancer is about 10 times more at risk than a man who has no family history of prostate cancer. The younger the relatives of a man with prostate cancer, the greater the risk of developing the disease. The risk of prostate cancer also appears to be slightly higher in men with a history of breast cancer.
4. Diet. The risk of prostate cancer may be higher in men who are on a high-fat diet.

Screening for prostate cancer

Screening means testing for cancer before you develop any symptoms. A screening test can help detect cancer at an early stage when it is less likely to spread and may be easier to treat. By the time symptoms started, the cancer may have started spreading.

The most useful screening tests are those that are proven to lower the risk of dying from cancer. Doctors don’t know yet whether prostate cancer screening reduces the risk of dying from prostate cancer. That is why there is now a large amount of research being carried out with thousands of men participating in prostate cancer screening. The National Cancer Institute is investigating a combination of PSA and DRE tests as a way to get more accurate results.

While some people find it best to treat any cancer that is found, including those found during screening, treatment for prostate cancer can cause serious, and sometimes permanent, side effects. Some doctors are concerned that many men who are diagnosed with cancer through screening are treated – and experience side effects – unnecessarily. It is worth talking to your doctor about your risk of developing prostate cancer and the need for screening.

There is a lot of research on how to prevent prostate cancer. Studies have shown that 5-alpha reductase inhibitors, finasteride and dutasteride, can reduce the risk of developing prostate cancer, but it is still unclear whether they can reduce the risk of dying from prostate cancer.

See also: Cancer cells can remain dormant for years. Scientists have found a way to metastasize cancer?

Prostate gland – research

This first step allows the clinician to hear and understand the “history” of prostate problems. The doctor will ask us if we have symptoms, how long we have had them and how much they affect our lifestyle. Our personal medical history also covers any risk factors, pain, fever, or trouble urinating. We may be asked to submit a urine sample for testing.

Prostate examination – digital rectal examination (DRE)

The rectal examination is the standard way to check the prostate. Using a glove and a lubricated finger, the doctor can sense the prostate through the rectum. The test takes about 10-15 seconds.

This test checks:

1. prostate size, firmness and texture;
2. any hard areas, lumps, or growth that goes beyond the prostate;
3. any pain caused by touching or pressing on the prostate.

DRE allows the doctor to feel only one side of the prostate. PSA testing is another way to help your doctor check the health of the prostate.

Prostate gland research – PSA test (Prostate Specific Antigen)

PSA is a protein produced by prostate cells. It is normally secreted into the ducts in the prostate where it helps to produce sperm, but sometimes it is released into the blood. Once PSA is in the blood, it can be measured with a blood test called a PSA test.

In prostate cancer, more PSA enters the blood than normal. However, high blood levels of PSA are not evidence of cancer, and many other factors can cause a false-positive test result. For example, blood levels of PSA are often elevated in men with prostatitis or BPH. Even things that disrupt the prostate gland – such as riding a bicycle or motorcycle, or a DRE, an orgasm in the last 24 hours, a prostate biopsy, or prostate surgery – can increase PSA levels.

In addition, some prostate glands naturally produce more PSA than others. PSA levels increase with age. African American males generally have higher PSA levels than males of other races. Certain medications, such as finasteride and dutasteride, can lower a man’s PSA levels.

PSA testing is often used to follow up men after prostate cancer treatment for signs of a cancer recurrence. It is not yet known for certain whether PSA testing for prostate cancer can reduce a man’s risk of dying from the disease.

Scientists are working to learn more about the PSA test’s ability to help doctors distinguish prostate cancer from benign prostate problems, and the best solution if a man has high PSA levels. For now, men and their doctors use PSA readings over time as a guide to see if further monitoring is needed.

PSA levels are measured as the amount of PSA per volume of fluid tested. Doctors often use a value of 4 nanograms (ng) or higher per milliliter of blood as a sign that further tests, such as a prostate biopsy, are needed. Your doctor may monitor how quickly your PSA levels change. Rapid increases in PSA readings may suggest cancer. If we have slightly elevated PSA levels, your doctor may decide to perform PSA tests on schedule and watch for any changes in PSA levels.

See also: Dutasteride prevents prostate cancer

Prostate studies – prostate biopsy

If your symptoms or test results suggest prostate cancer, your doctor will refer you to a specialist (urologist) for a prostate biopsy. Small tissue samples are taken directly from the prostate gland for biopsy. Your doctor will take samples from several areas of the prostate gland. This can help reduce the risk of missing any areas of the gland where cancerous cells may be present. Like other cancers, prostate cancer can only be diagnosed by looking at tissue under a microscope. Most men who have a biopsy after prostate cancer screening do not have cancer.

A positive post-biopsy result indicates the presence of prostate cancer. The pathologist will check the biopsy for cancerous cells and give it a Gleason score. The Gleason score ranges from 2 to 10 and describes the likelihood of the tumor spreading. The lower the number, the less aggressive the tumor is and the less likely it is to spread. Treatment options depend on the stage (or extent) of cancer (stages 1-4), Gleason score, PSA level, and age and overall health.

Making the decision to treat prostate cancer is a complex process. Many men find it helpful to talk to doctors, family, friends, and other men who have faced similar decisions.

See also: The most common cancer in men. How does his treatment in Poland look like?

Prostate gland – prevention

Healthy eating is essential

Rather than focusing on a specific food, nutritionists, doctors and researchers tout the overall pattern of healthy eating – and eating healthy is easier than you might think. Here’s what the experts recommend at a glance.

1. Eat at least five servings of fruit and vegetables a day. Choose those with a deep, bright color.
2. Choose whole grain bread over white bread, and choose whole grain pasta and cereals.
3. Limit your consumption of red meat, including beef, pork, lamb and goat, and processed meats such as mortadella and hot dogs. Fish, skinless poultry, beans, and eggs are healthier sources of protein.
4. Choose healthy fats such as olive oil, nuts (almonds, walnuts, pecans), and avocados. Cut down on saturated fat from dairy and other animal products. Avoid partially hydrogenated fats (trans fats), which are found in many fast food and packaged foods.
5. Avoid sugar-sweetened beverages such as sodas and many fruit juices. Eat sweets as occasional snacks.
6. Limit salt. Choose low sodium products by reading and comparing product labels. Limit your consumption of canned, processed, and frozen foods.
7. Pay attention to the serving sizes. Eat slowly and stop eating when you feel full.

Stay active to support the health of your prostate gland

In addition to a healthy diet, we should be active. Regular exercise reduces your risk of developing some fatal conditions, including heart disease, stroke, and certain types of cancer. And while relatively few studies have directly assessed the effects of exercise on prostate health, those that have been conducted have largely found exercise to be beneficial.

1. Using questionnaires completed by more than 30 men in a health care professional follow-up study, researchers found an inverse relationship between exercise and symptoms of benign prostatic hyperplasia (BPH). Simply put, men who were more physically active suffered less from BPH. Even low to moderate intensity physical activity, such as regular walking at a moderate pace, has paid off.
2. Using data from the Health Professionals Follow-up Study, researchers also investigated the link between erectile dysfunction and exercise. They found that men who ran for an hour and a half or performed three hours of rigorous outdoor work a week were 20% less likely to develop erectile dysfunction than those who did not exercise at all. More physical activity brought greater benefits. Interestingly, regardless of exercise level, overweight or obese men had a higher risk of developing erectile dysfunction than men with an ideal body mass index, or BMI.
3. Italian researchers randomly assigned 231 seated men with chronic prostatitis to one of two exercise programs for 18 weeks: aerobic exercise, which included brisk walking, or anaerobic exercise, which included leg lifting, squatting, and stretching. Each group exercised three times a week. At the end of the study, men in both groups felt better, but those in the aerobic exercise group experienced significantly less discomfort, anxiety and depression, and improved their quality of life

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