prostate gland

The prostate gland – Anatomy, functions and conditions

The human body is wonderfully made and each organ and component has its own role that contributes to the well-functioning of the organism. People often read and talk about the vital organs of the body, such as the liver, heart, kidneys, or lungs. Nevertheless, they carry on important functions of the body. But there are also glands that regulate many of these functions. One of the lesser talked about organs of a man’s body is the prostate gland. This article will get deeper into understanding the prostate’s anatomy, functions, and roles. Being informed about the importance of this gland helps a man take steps for maintaining the health of the prostate. 

Location of the prostate gland

The prostate gland is a small walnut-sized organ located in the pelvic area, between the bladder and the penis. It is surrounding the urethra, the tube that empties urine from the bladder. This part of the urethra that passes through the prostate is called “prostatic urethra”. This part of the urethra finally joins with the ejaculatory ducts. It is usually described as consisting of lobes or zones, in microanatomy. A fibromuscular capsule is surrounding the gland, known as the prostatic capsule or prostatic fascia. 

The average weight of the prostate is 11 grams, ranging from 6-16 grams, depending on its growth. 

Prostate zones – The anatomy of the prostate

Typically, the prostate is described as having 3 main zones, the fourth one not always being considered a zone in itself. These are the zones that are highlighted in prostate MRI scans:

Zone 1 – Peripheral zone – The peripheral zone is covering almost 70% of the total area of the prostate. It is actually the back part of the gland that is located beneath the prostatic capsule and surrounds the distal urethra. This zone is known as the place where the majority of prostate cancers originate. 

Zone 2 – Central zone – This zone surrounds the ejaculatory ducts and covers just about 20% of the prostate gland. Very few prostate cancers originate in this part of the prostate. However, these cancers are known to be very aggressive and fast-spreading. 

Zone 3 – Transition zone – This transition zone is covering 5% of the total area of the gland and surrounds the proximal urethra. This is the part of the prostate that can start growing in aged men and causes the disease known as benign prostatic hyperplasia (BPH). About 20% of prostate cancers originate in this zone. 

Zone 4 is not always considered to be a zone of the prostate because it does not consist of glandular tissue. It is only formed by muscles and fibrous tissue and it’s named “Anterior fibromuscular zone”.

MRI scans can differentiate between healthy and diseased tissues and can detect cancerous cells in any of the zones. 

A study from Stanford University California published in 2014 revealed the differences in cancer development based on the specific zone from where they originate.

The study revealed that:

  • The tumors that originate in the transition zone are having a larger total cancer volume and generate higher PSA values. However, these tumors are not so aggressive, usually do not spread out of the prostate, and do not cause cancer recurrence after being treated. 

The neurovascular bundles and innervation of the prostate gland

The prostate gland is surrounded by two neurovascular bundles that go through the pelvic floor toward the penis. Penis erection is based on the health of these neurovascular bundles. Post-operative potency is possible just by sparing the tiny nervous bundles that surround the gland. 

Also, the muscle of the gland is innervated by sympathetic fibers that activate during ejaculation. 

The role and functions of the prostate

The prostate is part of the men’s’ reproductive system. It secrets proteolytic enzymes that become part of the semen. These enzymes allow the semen to remain in a fluid state and contributes to the potential fertilization. After being emitted, the sperm transients the vas deferens and reaches the urethra, through the ejaculatory ducts. When ejaculation takes place, the semen is being expulsed from the urethra. The secretions of the gland combined with the secretions of the seminal vesicles form a major part of the semen. 

The prostatic fluid is slightly alkaline and helps neutralize the acidity of the vaginal tract, contributing to prolonging the sperm-life and fertilization. 

Knowing the important role the prostate gland is playing in the reproductive system can stimulate awareness of the prostate problems that can affect a man’s sexual life. 

What are the conditions that affect the prostate gland?

This small gland can be affected by various conditions, including Prostatitis, BPH, or Prostate Cancer. 

Prostatitis

Prostatitis is the inflammation of the prostate gland that is usually caused by bacterias. This inflammation causes painful ejaculation or urination, difficulty while urinating, groin pain, or, rarely, fever or fatigue. Prostatitis causes the gland to enlarge and to become tinder. Antibiotics are used to treat acute prostatitis. Non-bacterial prostatitis is treated by means of alpha-blockers antihistamines or other medications.

Benign Prostatic Hyperplasia 

Benign Prostatic Hyperplasia (BPH) or enlarged prostate is a non-cancerous condition. The enlargement of the prostate is caused by an increase in the number of cells. This condition is very common in older men and causes various symptoms that disrupt everyday life. Urinary frequency and urgency, painful urination, blood in the urine, nocturia, or hesitancy. BPH can be treated by means of medication or other procedures, such as TURP or UroLift. Transurethral resection of the prostate is a urological procedure performed through the urethra and involves the electrocautery or resection of the prostate. UroLift system, on the other hand, is a minimally invasive procedure that can be performed in a doctor’s office without requiring hospitalization. 

Prostate cancer 

Statistics say that about 1 in 9 men will be diagnosed with prostate cancer in America. It is usually asymptomatic and if detected early, can be treated without being so aggressive. In this case, early detection is vital. Prostate cancer can be localized, locally-advanced, or advanced (metastatic). Advanced prostate cancer has no available cure, but there are treatments for symptoms control. Radical robotic prostatectomy is the standard in treating men with prostate cancer, due to the efficiency of the procedure and long-term benefits. Radiation and hormonal therapies are also used. 

Tests used for screening and diagnosis

In order to detect all the conditions described above, doctors use various tests and screening techniques. Here are some of the most common prostate tests you can expect at a prostate screening:

  • The PSA test – The blood test checks for the prostate-specific antigens in the blood cells. Prostate cells produce these antigens and a level of PSA above 4.0 ng/ml is considered usually a high PSA and may require follow-up tests.
  • DRE exam – The Digital Rectal Exam involves checking the prostate by means of a lubricated gloved finger that is introduced by the physician into the rectum. Through this procedure, the doctor can discover lumps or nodules that may indicate abnormal tissue. 
  • Prostate Ultrasound – This procedure utilizes soundwaves to create an image of the prostate. The scan requires the insertion of an ultrasound probe. Through this procedure, the doctor collects a sample of prostatic tissue that can form a probe to detect cancerous cells. 
  • Prostate biopsy – During a biopsy, the surgeon removes samples of suspicious tissue in order to be examined under a microscope. Classic biopsies are no longer effective diagnosis methods, taking into account that there are improved guidance methods for sample collection.
  • MRI scans – The MRI scan is a non-invasive procedure that does not use X-rays to form images of the prostate and effectively detect the affected parts of the organ. The images are generated with the help of magnetic fields and radio waves. These scans are usually performed before biopsies, helping to avoid unnecessary procedures. 
  • Genetic tests are also available, ranging from saliva tests to DNA tests.

The prostate gland may be small, but regulates important functions of the body. Knowing the prostate’s roles and the importance of screening tests, men can enjoy the benefits of a healthy prostate. 

Dr. David Samadi | Robotic Prostate Surgeon
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About

ProstateCancer911.com is a resource created by Dr. David Samadi in order to raise awareness and get more men to receive prostate cancer treatment. The information is strictly general and you should always discuss with your doctor issues concerning your health.

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