What Is the Prostate Gland?

The largest parenchymal organ in the male glandular accessory gland. Consists of prostate tissue and muscle tissue.

The largest parenchymal organ in the male glandular accessory gland. Consists of prostate tissue and muscle tissue.

Chinese name

prostate

Foreign name

prostate

Definition

Male-specific gonads

Shape

Chestnut-shaped bottom up, pointed down

Prostate size

4cm in width, 3cm in vertical, 2cm in front and back

Function

Secretion, urination control, transportation

Disease

Prostatitis, cancer, hyperplasia, etc.

Prostate Anatomy

1. The prostate is an accessory gland of the male reproductive system. It is an unpaired parenchymal gland. It is located between the bladder and the urogenital crest and surrounds the root of the urethra. Its shape and size are similar to flat chestnuts. The upper end is wide, the lower end is sharp, and the back of the body is flat. It is close to the rectum and can be touched by digital rectal examination. The longitudinal diameter is 3cm, the transverse diameter is 4cm, the front-rear diameter is 2cm, and the weight is about 20g. Its size and function are largely dependent on androgens. The pediatric prostate is very small and grows rapidly during sexual maturity; the glandular tissue of the elderly gradually degenerates, and the connective tissue in the gland proliferates, forming prostatic hyperplasia, urinating the urethra, causing difficulty in urination.

2. The prostate capsule is located in the deep part of the prostate on the dorsal side of the urethra. Its epithelium is similar to the acinus of the prostate gland, sometimes ciliated, often with many folds and adenoid depressions. The prostate sac is a remnant of the Mül-ler tube during embryogenesis, also known as the male uterus. It was previously thought that it had no function. In recent years, some scholars believe that it is also an accessory gland of the male reproductive system.

Histological structure of prostate

1. It is composed of 30-50 multivesicular vesicular glands and merges into 15-30 catheters, which are respectively opened in the urethra. Connective tissue and smooth muscle form the prostate capsule, and extend into the gland to form the interstitial gland, which divides and surrounds the acinus and duct. The prostate has a large acinar cavity, and the glandular epithelium often forms many nipples or folds and extends into the glandular cavity, so the glandular cavity is very irregular. The types of glandular epithelium vary from single-layered cubic, single-layered columnar to pseudo-stratified columnar, and their changes are related to androgen levels. Acinar cells have a rich rough endoplasmic reticulum in the cytoplasm, a developed Golgi complex in the upper nucleus, and a large number of secretory particles on the top. Epithelial cells have strong acid phosphatase activity. There are often round or oval-shaped prostate coagulum in the glandular cavity, with a diameter of 0.2 to 2 mm. The solidified body is condensed from secretions, which can be calcified, and its cut surface is in the form of concentric circles. This structure increases with age.

2. The glands can be divided into three groups: mucosal glands: the smallest, located in the urethral mucosa, and the catheter opens in the urethra; submucosal glands: located in the submucosal layer of the urethra, the catheter opens in the urethra on both sides of the essence; main glands: located in the prostate The outer periphery, which accounts for most of the prostate, also opens on both sides of the sperm. Mucosal glands are prone to nodular hyperplasia and compress the urethra. Prostate cancer mostly occurs in the main gland. When cancerous, the activity of glandular acid phosphatase is significantly enhanced. Examining this enzyme is helpful for the diagnosis of prostate cancer.

3. Prostate secretion is the main component of semen. It is a colorless turbid fluid with weak acidity (pH 6.5). It is rich in proteolytic enzymes, plasmin, and has the function of liquefied semen. It also contains high concentrations of zinc, Citric acid and acid phosphatase, the latter two are sensitive indicators for detecting prostate function and forensic identification of semen. The secretory activity of the prostate is regulated by testosterone.

Prostate Related Diseases and Treatment

1. Benign prostatic hyperplasia (BPH), also known as prostatic hypertrophy, is located in the bladder neck, causing urinary tract obstruction, causing frequent urination and difficulty in urination, which seriously affects patients' quality of life. It is called benign prostatic hypertrophy. It is second only to urolithiasis in urological hospitalized patients.

2. Treatment methods

Drug therapy: The first-line drugs for BPH treatment today are alpha receptor blockers, 5alpha reductase inhibitors, and plant drugs. Among them, alpha receptor blockers work quickly and are effective for different degrees of prostate hypertrophy, but only have good curative effect on patients with mild symptoms and small prostate volume, and may cause orthostatic hypotension; 5 Reductase inhibitors can reduce the volume of the prostate, reverse the progress of the disease, and improve symptoms, but the onset of action is relatively slow. Generally, it takes more than 2 to 3 months of continuous medication to take effect. In addition, there may be erectile dysfunction and low libido. Although -blocker and 5-reductase inhibitor combination therapy is more effective than monotherapy in reducing the clinical progress rate of BPH and reducing the incidence of acute urinary retention, the adverse reactions and costs also increase accordingly. The mechanism of botanicals for the treatment of benign prostatic hyperplasia is still unclear, and high-quality, large-scale, placebo-controlled long-term clinical trials are still lacking to further test the effectiveness and safety of botanicals.

Physical therapy: The working principle of field-effect ablation treatment for benign prostatic hyperplasia is to establish an electric field in the human body. The electric field accumulates to generate high heat, which causes irreversible changes in proteins. Prostate cells and smooth muscle cells coagulate and necrotize, and fall off after a period of time, reducing the urethral pressure. However, the pain of field-effect ablation treatment increases with the increase of temperature. When the temperature is low, the treatment time is long and the effect is poor, and the probe contacts the tissue surface, which is easy to crust and calcify. Ultrasound therapy is based on the use of medical ultrasound to improve local blood and lymph circulation, strengthen local metabolism, reduce acidosis, and thereby achieve pain relief or elimination. The use of ultrasound to treat benign prostatic hypertrophy, patients with frequent urination, urgency, dysuria, lacrimal pain in the perineum and lower abdomen all disappeared, the number of nocturia decreased significantly, urine waiting, endless urine, bifurcation symptoms improved, patients with B-ultrasound hyperplasia The prostate volume has been reduced to varying degrees, and even the low-cost ultrasonic therapy instrument can achieve significant results and cure rates of 82% when treating prostate diseases. From the perspective of safety and no side effects, it is worth mentioning several non-invasive treatments, such as magnetic therapy and infrared therapy. The magnetic field can improve the permeability of blood vessel walls and cell membranes, increase blood flow, and accelerate the speed of prostate blood flow in patients with BPH, leading to the absorption and dissipation of inflammatory exudates, which has the effect of swelling and analgesia, and relieves smooth muscle spasm. Reducing obstructive symptoms, while reducing the volume of the glands through the repair of the cell's own tissue, and reducing the resistance to urination. Infrared rays are more and more widely used in clinical treatment of prostate diseases due to its convenient use, small side effects and good curative effect.

Surgery: Laparoscopic surgery is an alternative method for larger prostate hyperplasia. This surgery is safe and reliable, and bladder irrigation can be eliminated after surgery, and the patient recovers quickly. High-intensity focused ultrasound (HIFU) is safer for treating benign prostatic hyperplasia, with fewer complications, easy tolerability, and low recurrence rate. However, patients should be treated with subarachnoid anesthesia before surgery, and all catheters should be indwelling, and the prostate volume is not large. Fibrotic benign prostatic hyperplasia may not be suitable for focused ultrasound treatment. Transurethral resection of the prostate (TUERP) combines the characteristics of endoluminal surgery and open surgery. The short-term effect after surgery is similar to TURP with fewer complications. At the same time, it can achieve long-term effects similar to open surgery. Nowadays It has attracted attention in some areas at home and abroad, but surgical treatment of benign prostatic hyperplasia is applicable to severe patients, that is, only when drug treatment and physical therapy can not relieve the condition. Surgery has certain risks, which may cause a variety of complications, and the probability of recurrence of the lesion is higher during a period of time after surgery.