WHAT IS THE PROSTATE GLAND?

The prostate gland, part of the male reproductive system, is an internal gland that is situated at the base of the bladder between the bladder and the pelvis. 

The primary function of the prostate is secretion formation. It is also involved in sperm formation, hormone metabolism, (testosterone is converted to dihydrotestosterone), and ejaculation.

It also keeps the sperm healthy for successful fertilisation.

The gland is about the size of a walnut but gets bigger as men get older.

The male reproductive system

The male reproductive system includes the penis, the testes and the epididymides held within the scrotum, the vas deferens and internally the seminal vesicles, and the prostate gland.

The urethra is a tube that runs from the bladder through the prostate gland and the middle of the penis, to carry urine out of the body. The testes produce sperm and the hormone testosterone.

At the back of each testis is the epididymis. A tube where sperm is stored. When the penis is erect sperm moves from the epididymis and through the vas deferens to the urethra.

The seminal vesicles make a fluid that mixes with sperm in the urethra. The prostate gland surrounds the first part of the urethra and adds more fluid to the sperm. During orgasm the prostate squeezes this fluid into the urethra and out of the body.

2 Types of prostate problems

Enlarged prostate        

Many men suffer from prostate problems. An enlarged prostate is very common in men over 50 – nearly all men in their 70s are thought to have some symptoms of an enlarged prostate.

Irritation and abnormal urination are the most common prostate problems. Symptoms of irritation often manifest through frequent urge to urinate, pain when urinating and a disturbing feeling of residual urine. It is not uncommon for those affected to have the feeling that they must go to the toilet up to 7 times during the night.

Symptoms          

Weak urine flow and difficulty urinating are the most common symptoms. An enlarged prostate presses on the bladder and causes a strong urge to urinate. In most cases, the change is benign prostate enlargement that is related to the change in hormonal balance.

The prostate gland produces a protein called prostate specific antigen (PSA). A blood test can measure the level of PSA. By scanning and determining the PSA value, doctors can usually diagnose any problem quickly.

Prostate problems usually get worse with age so early detection and treatment should be the focus.

There are many advantages to a healthy prostate. Men with a constant urge to urinate suffer from a lack of confidence both at work and at home. The persistent need to urinate makes travel and leisure activities torture. It can also lead to erectile dysfunction which can have significant negative effects on intimate relationships.

Inflammation of the prostate gland (Prostatitis)

Prostatitis is a disorder of the prostate gland usually associated with inflammation. Prostatitis often causes painful or difficult urination, as well as pain in the groin, pelvic area or genitals. Bacterial infections cause some but not all cases of prostatitis.

Types

There are generally four types of prostatitis:

  • Acute bacterial prostatitis, a bacterial infection of the prostate usually with sudden, severe symptoms – is usually caused by common strains of bacteria. The infection may have spread from other parts of the urinary or reproductive systems.

  • Chronic bacterial prostatitis, ongoing or recurring bacterial infection usually with less severe symptoms – generally has the same cause as acute bacterial infection. It may occur when treatment for an acute infection isn’t long enough or fails to kill all the bacteria.

  • Chronic prostatitis/chronic pelvic pain syndrome, ongoing or recurring pelvic pain and urinary tract symptoms with no evidence of infection – this condition is not well understood. Research suggests that multiple factors may collectively play a role. These include previous infection, nervous system dysfunction, immune system dysfunction, psychological stress or irregular hormone activity.

  • Asymptomatic inflammatory prostatitis, signs of an inflamed prostate with no symptoms – has no known cause, is generally found only during an exam for other medical conditions and is not treated.

Risk factors

Risk factors for prostatitis include:

  • Young or middle-aged adulthood

  • Previous prostatitis

  • Infection of the urinary or reproductive system

  • HIV infection or AIDS

  • Use of a tube inserted into the urethra to drain the bladder (urinary catheter)

  • Diagnostic sampling of prostate tissue (biopsy)

Additional risk factors for chronic prostatitis/chronic pelvic pain syndrome may include:

  • Psychological stress

  • Nerve damage in the pelvic region due to surgery or trauma

Complications

Complications of acute or chronic prostatitis can include:

  • Bacterial infection of the blood (bacteremia)

  • Inflammation of the coiled tube attached to the back of the testicle (epididymitis)

  • Pus-filled cavity in the prostate (prostatic abscess)

  • Infection that spreads to the upper pelvic bone or lower spine

Complications of chronic prostatitis/chronic pelvic pain syndrome may include:

  • Anxiety or depression

  • Sexual dysfunction, such as the inability to get and maintain an erection (erectile dysfunction)

  • Changes in sperm and semen that may cause infertility

There’s no direct evidence that prostatitis can lead to prostate cancer. Researchers are investigating whether chronic inflammation of the prostate is a risk factor for cancer.

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