Prostate Gland

What Is Prostate Gland?

Only men have the prostate gland and it is part of the male genital system. It feels like a rubbery mas on rectal examination and is like the size of a large marble. The prostate gland lies on the floor of the pelvis and positions itself between the penis and the bladder.


What Does The Prostate Gland Do ?

It secretes a protein-like mixture rich in albumin for the sperms to live on and it also acts as a transport medium for the sperms. Semen is a mixture of sperms and a collection of fluids secreted by the seminal vesicles, bulbo-urethral glands and the prostate gland.


What Can Go Wrong With The Prostate Gland?

There are 3 main problems:

1. Infection
2. Benign enlargement
3. Cancer
   
   

1. Infection
Acute infection causes pain, fever, chills and a burning sensation when passing urine. Chronic infection may present with vague symptoms like pain or discomfort or no symptoms at all. Some men may be carriers of sexually transmitted disease like Chlamydia, syphills and gonorrhoea. Testing prostatic secretions and urine will identify the offending bacteria.

2. Benign Prostatic Enlargement or Hypertrophy
This is a very common condition, 70% of men have it by the age of 60 and 90% of men by the age of 70. The enlargement of the prostate gland causes compression on the urethra and inteference with the passage of urine. The common symptons are delayed starting, poor weak flow, terminal dribbling and some retention of urine in the bladder.

Sometimes there is acute retention of urine in the bladder causing severe pain and and distress to the patient. Inspite of the common nature of this condition only a small percentage (5-10%) of patients require an operation called prostatectomy which will relieve the obstruction to the passage of urine.


3. Cancer Of The Prostate Gland
It is the most common cancer in man (21%) followed by lung cancer (19%) and bowel cancer (15%). Every year it is the second most common cause of cancern death in men (12%) behind lung cancer (34%) and ahead of bowel cancer (11%). Treatment depends on the staging of the cancer and may comprise a combination of surgery, radiotherapy and hormone therapy.


Screening And EArly Detection of Prostate Cancer

There is a protein in the blood called Prostate Specific Antigen, PSA. It is produced by cells in the prostate gland and is though to play a role in preventing semen from coagulating.

60% of men with early stage prostate cancer already have an elevated PSA level above the highest value found in the normal population (4 ng/mL). Therefore, the blood test of PSA can be used to screen for the presence of this cancer.

PSA levels usually begin to rise 2 - 3 years before prostate cancer begin to invade the surrounding tissue. Therefore annual tests allow early detection of most cancers while still confined within the prostate gland. This augurs well for curative treatment. PSA is therefore a very useful screening test for prostate cancer in men after 40 years of age.

Infection and benign enlargement of the prostate may also caused elevated PSA levels in the blood. The level of PSA in benign hyperthrophy of the prostate is relatively stable or rise slowly. The PSA level in prostate cancer is also 10 times higher for any given gland size than when no cancer is present.

The symptons of prostatitis will be recognised by your doctor and the PSA levels will fall to normal after treatment.


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