The prostate gland (prostate)

the prostate gland prostate
The prostate gland prostate (shaded) and the surrounding its bodies: 1 - bladder; 2 - rectum; 3 - the urethra; 4 - penis.

The prostate gland (prostate) - Gypsy muscle-glandular organ that is part of the extension of the glands of the male sexual system.
The prostate gland is located in the pelvis between the bottom of the bladder and the ampulla of the rectum. It covers the neck of the bladder and the back part of the urethra (Fig).
Adult prostate is a chestnut shape in length, 2.5-4 cm long, 2.5-3 cm, weighs 17-28, On the back surface of the prostate goes median groove, divides it into right and left lobe. Through the prostate, urethra passes and two semyavyvodyaschih duct. Blood flow through the blood vessels leading from the bladder and rectum. Venous outflow through the internal iliac vein. The prostate gland is surrounded by a dense capsule, educated and muscle connective tissue fibers. The glandular tissue of the prostate tubular form-alveolar gland opening into the urethra.
The development and function of the prostate gland depend on the formulation by the testicles are the male sex hormone. The prostate gland is involved in the implementation of sexual function, producing a secret, which mixes with the seminal fluid, supports the activity of sperm. Castration causes atrophy of the glandular tissue of the prostate.
The main method of investigation of the prostate is palpation - finger feeling through the rectum, which is produced in the knee-elbow position of the patient, or his position on the right side with reduced to the belly by feet or on his back with legs bent and divorced feet. Palpation must be made after emptying of the bladder.
In the normal boundaries of the prostate clear, consistency is elastic, smooth surface. The mucous membrane of the rectum over prostate mobile.
The study of prostate fluid helps the diagnosis of diseases of the prostate. The secret to getting through massage the prostate (see).
With suspected prostate cancer spend Cytology secret, produce biopsy by perineal or rectal puncture cancer. For differential diagnosis of BPH and prostate cancer are producing instrumental exploration - cystoscopy (see). Among the diseases of prostate cancer at the age of 20-40 years is most often found its inflammation - prostatitis (see).

   Embryology
Bookmark prostate takes place on the 11 - 12th week of fetal life in the area sinus urogenitalis reproduction ectodermal epithelium primary urethra. To 15-16 weeks begins the formation ducts, growth of muscle and connective tissue. On the 4th month there are new groups glands: under the mucous membrane of the triangle of the bladder and in the area of the bladder neck. To 5-6-month glands secrete, the secret, the size and the number of them increases.

prostate
Fig. 1. The prostate gland and surrounding organs (rear view): 1 - corpus vesicae urinariae; 2 - urether dext.; 3 - ductus deferens dext.; 4 - the fundus vesicae urinariae; 5 - ampulla ductus deferentis; 6 - vesica seminalis; 7 - prostata (facies post.); 8 pars membranacea urethrae; 9 - gl. bulbourethralis; 10 - ductus deferens sin.; 11 - urether sin.

Fig. 2. The prostatic portion of the urethra and seed tubercle: 1 and 12 - vesica urinaria; 2 - colliculus seminalis; 3 - ostium utriculi prostatici; 4 - crista urethralis; 5 - gl. bulbourethralis; 6 - pars membranacea urethrae; 7 - ostium ductus ejaculatorii; 8 - gl. prostata; 9 - anulus urethralis; 10 - ostium uretheris; 11 - tunica muscularis vesicae urinariae.

   Anatomy
The prostate (Fig. 1 and 2) is located under the bottom of the bladder, circular embracing his neck and the upper part of the urethra. Its base is in contact with the seminal vesicles, the top - with urogenital diaphragm (diaphragma urogenitale), the front surface is connected pubic-prostate ligament (lig. puboprostaticum) with the pubic bone, the back surface adjacent to the lower section of the rectum, the lateral surface of the border with the muscles that raise the anus (mm. levatores ani). On the rear surface of the gland is groove, divides it into right and left parts; sometimes there's the average share. Through the prostate are the urethra and semyavynosyaschih ducts. The size, shape and weight cancer can vary. In adults, it is wrong cone, weighs 17-28 g, width 2,5-3 cm, length of 3-4 cm, thickness is 2-2,5 cm
The blood supply of the prostate is: lower artery bladder (a. vesicalis inf.), average artery rectum (a. rectalis media), prostate artery. The outflow of venous blood goes through magdalsophia veins, venous plexuses lying around the urethra, through venous plexus along the VAS deferens, plexus vesicoprostaticus and then in the hypogastric Vienna. The lymphatic system consists of a network of capillaries and plexus vessels.
Innervation of the prostate is carried out with the participation of the sympathetic and parasympathetic nervous system. In tissue it has the nerve fibers, intramural ganglia, motor, sensitive, secretory nerves.
Histology. Prostate covered by a dense capsule, its basis is composed of smooth muscle fibers of connective tissue with numerous elastic fibers and glandular tissue, formed by 30 - 50 tubular glands-alveolar structures that are grouped into segments. Secretory departments lined cubic or prismatic epithelium, ductless - prismatic and transitional epithelium. Excretory ducts appear in seed tubercle or about him. The composition of the prostate are periuretralnuu cancer, a more extensive than prostatic, and Windows that in the urethra.
Depending on the age of the ratio between glandular, muscle and connective tissue changes.


   Physiology
Close embryological and topographic connection with prostate excretory pathways of the male reproductive system, the dependence of this gland from androgenic hormones, special muscular apparatus, providing emptying prostate during sexual intercourse and adulteration of her secret to throw away the sperm, suggest that prostate involved in the implementation of the male reproductive function, especially as the extirpation of the prostate and seminal vesicles prevents fertilization (Matte (that is, Steinach), 1894].
The dependence of the condition of the prostate gland from sex hormones. Atrophy prostate, especially its glandular epithelium, in conditions of castration and elimination of these phenomena introduction of androgens show that the growth, differentiation and function of the prostate stimulated male sex hormone. Hence the attempts to use castration as a remedy for prostate cancer, which in some cases has had a beneficial clinical effect. On the other hand, the introduction of estrogen in males clearly inhibits the secretory activity of the prostate, which is accompanied by the reduction of the height of cells of glandular epithelium and their functional inactivity. There is some massive fibro muscular hypertrophy prostate stromal.
If to consider, that growth and development of prostate specific stimulates the male sex hormone, it is difficult to understand why BPH occurs, as a rule, in old age, when the endocrine activity of the testis obviously weakened. The assumption that in these conditions the development of BPH is caused by the estrogen whose production in the testes increases in old age due to the weakening of the production of androgen, also does not explain because excess estrogen should slow down, as not to stimulate the growth of prostate epithelium. According to Hally (R. Chwalla, 1954), prostate adenoma, to some extent associated with the secretion of adrenal cortex. Given that the adrenal cortex in the number of its active principles produces corticosteroids (see) with androgenic properties, it seems quite likely.

The prostate gland (prostata) is located between the bladder and urogenital diaphragm. She tightly covered prostate urethra, shaped like a chestnut. The wide part of the base is adjacent to the bladder; top of the prostate is adjacent to the urogenital diaphragm. The anterior surface addressed to the pubic joint, and back - to the rectum (Fig. 7). The sizes of the normal prostate gland adult vary in length 4-4,5 cm, width-2,5 see

the prostate gland and seminal vesicles
Fig. 7. The prostate gland and seminal vesicles.
and - prostate; b - seminal vesicles: - the tubes that carry sperm. Front and top.

Prostate surrounded by its own connective tissue capsule and reinforced in the pelvic area pubic-prostatic ligaments. Median groove divides it into two symmetrical parts - the left and right.
Parenchyma prostate consists of own glandular tissue and paraurethral glands. Own the glandular tissue of the prostate is composed of alveoli, which, grouping together, form a separate segments, surrounded by a fibrous and muscular walls. Parauretral gland is separated from the actual prostate layer of smooth muscles of the urethra. The excretory ducts of the prostate gland open 30-50 spot the holes in prostatic Department urethra on the lateral surfaces of seed tubercle. Through the prostate are semyavynosyaschih ducts, which appear on the top seed tubercle. The blood supply of prostate comes from the bottom of the cystic artery and medium-hemorrhoid. Vienna prostate rich, are widely anastomose with each other and with the veins of the bubble, forming a powerful venous plexus (plexus venosus periprostaticus).
Lymph ducts of the prostate go in three directions: along the VAS deferens to the iliac lymph nodes, to lower the lymph nodes to the lower lumbar lymph nodes.
Innervation cancer comes from the vagus nerve and hypogastric plexus.
The secret of the prostate is composed of opal liquid and lecithin (lipid) beans, which are under the microscope overlook small brilliant points, refracting the light. There are conglomerates lipoid grains in the form of so-called starch or amyloid Taurus. Physiological importance of prostate secretion is that, coming into contact with a fixed sperm, he gives them the ability of active movement. In addition, its alkaline reaction he will neutralize harmful to sperm exposure to the acidic environment of the vagina.