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Medical Specializations

Urology => Prostate Gland

Prostate Gland

Prostate Gland, chestnut-shaped male organ located next to the bladder and surrounding the urethra (the tube that carries urine from the bladder to the penis). The prostate gland produces a secretion known as prostate fluid that makes up most of the liquid part of semen, which is discharged from the penis during sexual orgasm. Measuring about 3 cm (about 1.2 in) across, the prostate gland is composed of both glandular tissue that produces prostate fluid and muscle tissue that helps in male ejaculation. Prostate fluid also helps to keep sperm, which is found in semen, healthy and lively, thereby increasing the chances that fertilization will occur.

There are a variety of prostate disorders that commonly afflict men of all ages. The most common prostate disease is benign prostatic hyperplasia (BPH), a noncancerous condition of unknown cause. It occurs in approximately 70 to 80 percent of men as they reach their 70s and 80s. In BPH, the prostate gland can increase in size from 20 g (0.71 oz), which is the average size of the prostate in younger men, to as large as 150 g (5.31 oz). As the prostate grows, it constricts the urethra, possibly causing a partial obstruction of the bladder. Such obstruction may lead to bladder wall thickening and urination problems. Symptoms such as frequent urination, nighttime urination, a feeling of urgency to urinate, difficulty emptying the bladder, and a weak urinary stream are the most common problems men encounter from prostate enlargement.

There are several treatment options for BPH, including medications that either shrink the prostate gland or relax the smooth muscle in the prostate gland to alleviate the obstruction of the bladder. The standard surgical procedure for removing the enlarged tissue in the prostate is called transurethral resection of the prostate (TURP). During this procedure, the surgeon uses an endoscope, a tube equipped with a small television camera and a sharp instrument, to cut away the excess prostate tissue.
Prostate cancer is the most common cancer in elderly men and the second most common cause of cancer-related death in men. Prostate cancer causes few if any symptoms in its early stages, but as it progresses it can lead to difficulties with urination and bleeding in the urinary tract, and the cancer can spread to other areas of the body. Prostate cancer may be detected by digital rectal examination. Testing for abnormally high blood levels of the protein known as prostate-specific antigen (PSA) is also used to diagnose the disease. Prostate cancer is treated using hormones, chemotherapy, radiation therapy, or surgical procedures.

Prostatitis is an inflammatory condition of the prostate that is most common in men ages 20 to 50. There are two broad classes of prostatitis: nonbacterial and bacterial. Nonbacterial prostatitis is the most common form of prostatic inflammation. It causes pelvic pain, problems with urination, discomfort after ejaculation, and lower back pain. The cause of nonbacterial prostatitis remains unclear but possible sources include viruses, prostate muscle spasm, backflow of urine through prostate ducts, and psychological disturbances. Recent evidence suggests that nonbacterial prostatitis may be caused by bacteria that are present in the middle of a prostate but cannot be detected by conventional diagnostic techniques.

Patients with nonbacterial prostatitis are treated with medications ranging from antibiotics to antispasmodics; less often, medications that relax the muscle in the prostate gland are administered. The success of such treatments varies widely, and in many cases men must live with the symptoms of prostatitis.

In bacterial prostatitis, which may be sexually transmitted, a bacterial infection in the prostate gland leads to infection, swelling, pain, and difficulty in urinating; the penis may release bacterial fluid, and blood may appear in the urine. In some cases bacterial prostatitis can cause a severe infection throughout the body, producing a dangerously high fever. Bacterial prostatitis is treated with antibiotics but sometimes all the infection cannot be eliminated from the prostate gland, and some men develop a chronically infected prostate.



Prostate Cancer