The prostate is a walnut-sized gland located between the bladder and the penis, in front of the rectum.
The urethra passes through the center of the prostate and extends from the bladder to the penis, carrying urine outside the body.
The prostate secretes fluid that nourishes and protects the sperm. During ejaculation, the prostate squeezes fluid into the urethra, where it is expelled with the sperm as part of the seminal fluid. The vas deferens carries sperm from the testes to the seminal vesicles. The seminal vesicles secrete fluid during ejaculation that makes up part of the seminal fluid.
Types of prostate disease
- Prostatitis: Inflammation of the prostate gland, sometimes caused by an infection, is usually treated with antibiotics.
- Enlarged prostate: Also known as benign prostatic hypertrophy (BPH), prostate enlargement can affect almost all men over the age of 50. As the symptoms of difficulty urinating become more severe with age, medications or surgery may be used to treat BPH.
- Prostate cancer: This is the most common type of cancer in men (except skin cancer), but only 1 in 41 men die from prostate cancer. Surgery, radiation, hormone therapy, and chemotherapy are usually used to treat prostate cancer, and some men choose to delay treatment, or wait and see.
Prostate screening tests
- Digital rectal examination (DRE): The doctor inserts a lubricated and gloved finger into the rectum and feels the prostate.
- Prostate-specific antigen: The prostate produces a protein called PSA, which can be measured by a blood test. If PSA levels are high, you are more likely to have prostate cancer, but prostate enlargement can also cause PSA levels to be high. Whether and when to get screened varies from person to person, and patients should consult with their doctor to determine if they need to be screened and to understand the potential benefits and risks of screening.
- Prostate ultrasound (transrectal ultrasound): The examiner inserts an ultrasound probe into the patient’s rectum close to the prostate. A puncture biopsy is usually performed during the ultrasound to check for the presence of prostate cancer.
- Prostate biopsy: A biopsy needle is inserted into the prostate to obtain some tissue to check for the presence of prostate cancer. This is done primarily transrectally.
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Treatment of prostate disease
Prostatitis
Acute and chronic prostatitis: Depending on the type of prostatitis, treatment options may include antibiotics, other medications, or surgery.
Prostate enlargement
- α-blockers: Alpha-blockers relax the muscles around the urethra in men with symptoms of prostate enlargement so that urine can flow more freely.
- 5α reductase inhibitors: These drugs reduce the levels of a form of testosterone (dihydrotestosterone (DHT)), and when DHT is reduced, the prostate gland contracts, which improves urine flow.
- Prostate enlargement surgery: Usually, medications will improve the symptoms of prostate enlargement, but some men will need to undergo surgery to improve symptoms and prevent complications.
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Prostate cancer
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- Prostatectomy: The prostate gland is removed through prostate cancer surgery (called a prostatectomy) in order to remove all the cancerous tissue.
- Radiation therapy: Radiation therapy kills prostate cancer cells while minimizing damage to healthy cells.
- Radiation particle implantation: While radiation therapy radiates the prostate gland from outside the body, radiation particle implantation therapy involves implanting radioactive particles into the prostate gland to kill cancer cells.
- Cryotherapy: Cryotherapy kills prostate cancer cells by freezing them.
- Hormone therapy: Prostate cancer cells grow in response to hormones. Hormone therapy helps inhibit the growth of cancer cells.
- Chemotherapy: When prostate cancer is in an advanced stage, chemotherapy may help to keep the cancer from spreading.
- Watchful waiting: Because prostate cancer is usually slow-growing, some older men with the disease and their doctors hold off on treatment to see if the cancer grows.
- Clinical trials: With prostate cancer clinical trials, researchers test the effectiveness of a new drug in a group of prostate cancer volunteers.
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