The prostate which is part of the male reproductive system is a walnut-shaped organ about the size of a chestnut, consisting of glandular and muscular tissue. It is
located in front of
the rectum and below the neck of the bladder, surrounding the urethra
(prostatic part). It principally stores and secretes a milky
alkaline fluid which contains about 20 percent of the semen,
spermatozoa and seminal fluid. The secretion provides an
added medium that helps to maintain the life and motility of
sperm and also helps neutralize the acidic fluid in the
female vaginal tract. The proper function of the prostate is
dependent on testosterone. The prostate weighs only few
grams at birth, but grows significantly during puberty and
reaches the adult size of about 20g by age 20. It then
remains relatively stable in size until the fifth decade of
life when the second growth spot begins in most men.
Therefore prostate health problems are commoner in men over
the age of 45years and the incidence increases with age, such that by the ninth decade of life, almost 90
percent of men have some degree of prostate gland enlargement.
While age is the most important
predisposing factor, it has been observed that for some
unknown reason, prostate health problems are more common
in African American men when compared to Caucasians.There
are multiple conditions that may affect the prostate and the
patient's complaint depends on the cause, the stage of the
condition and whether it causes obstructive or irritative
symptoms. We will discuss the most common disorders: benign
prostate hyperplasia, prostate cancer and prostatism.
enlargement of the prostate (commonly referred to as
hyperplasia) is a disease that commonly affects aging males.
There is stromal and epithelial hyperplasia which
predominantly affects the transitional (periurethral) zone
of the prostate. The symptoms of benign prostate hyperplasia
can either be due to obstruction to urinary flow (from
compression of the bladder neck or prostatic urethra) or
irritative (due to contraction of bladder detrusor muscle
from irritation caused by the enlarged prostate gland). Both
types of symptoms coexist 50 percent of the time.
caner is now the most common malignancy in men ( in the US)
and also the second leading cause of cancer related deaths
in men. The symptoms and signs of prostate cancer can
resemble very closely those of benign prostate hyperplasia,
except that other abnormalities are also found on
examination of the prostate gland. Patients may be
asymptomatic, show mild or exhibit frank symptoms.
Prostatitis describes the inflammation of the prostate
gland which is often caused by infections. But
inflammation of the prostate may also occur without any
evidence of bacterial infection. Most bacterial prostatitis
are caused by E.coli and Klebsiella, while non-bacterial
prostatis are often caused by Chlamydia trachomatis and
Ureaplasma Urealyticum. Prostatitis can cause urinary
symptoms and impaired ejaculation. There are three major types: bacterial, non-bacterial,
and prostatodynia prostatitis.
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