Prostate

The prostate (PROSS-tate) gland surrounds the urethra and ejaculatory ducts immediately inferior to the
urinary bladder (see Insight 27.2). It measures about 2 by 4 by 3 cm and is an aggregate of 30 to 50
compound tubuloacinar glands enclosed in a single fbrous capsule. These glands empty through about
20 pores in the urethral wall. The stroma of the prostate consists of connectve tssue and smooth
muscle, like that of the seminal vesicles. The thin, milky secreton of the prostate consttutes about 30%
of the semen. Its functons, too, are considered later.

Functon of the Prostate Gland
The prostate gland secretes a thin, milky fuid that contains calcium, citrate ion, phosphate ion, a clotng
enzyme, and a profbrinolysin. During emission, the capsule of the prostate gland contracts
simultaneously with the contractons of the vas deferens so that the thin, milky fuid of the prostate
gland adds further to the bulk of the semen. A slightly alkaline characteristc of the prostatc fuid may be
quite important for successful fertlizaton of the ovum, because the fuid of the vas deferens is relatvely
acidic owing to the presence of citric acid and metabolic end products of the sperm and, consequently,
helps to inhibit sperm fertlity. Also, the vaginal secretons of the female are acidic (pH of 3.5 to 4.0).
Sperm do not become optmally motle untl the pH of the surrounding fuids rises to about 6.0 to 6.5.
Consequently, it is probable that the slightly alkaline prostatc fuid helps to neutralize the acidity of the
other seminal fuids during ejaculaton, and thus enhances the motlity and fertlity of the sperm.
Prostate Diseases
The prostate gland weighs about 20 g by age 20, remains at that weight untl age 45 or so, and then
begins to grow slowly again. By age 70, over 90% of men show some degree of benign prostatc
hyperplasia (BPH)noncancerous enlarge- ment of the gland. The major complicaton of this is that it
compresses the urethra, obstructs the fow of urine, and may promote bladder and kidney infectons.
Prostate cancer is the second most common cancer in men (afer lung cancer); it afects about 9% of
men over the age of 50. Prostate tumors tend to form near the periphery of the gland, where they do
not obstruct urine fow; therefore, they ofen go unnotced untl they cause pain. Prostate cancer ofen
metastasizes to nearby lymph nodes and then to the lungs and other organs. It is more common among
American blacks than whites and very uncommon among Japanese.
The positon of the prostate immediately anterior to the rectum allows it to be palpated through the
rectal wall to check for tumors. This procedure is called digital rectal examinaton (DRE). Prostate cancer
can also be diagnosed from elevated levels of serine protease (also known as prostate-specifc ant- gen,
PSA) and acid phosphatase (another prostatc enzyme) in the blood. Up to 80% of men with prostate
cancer survive when it is detected and treated early, but only 10% to 50% survive if it spreads beyond
the prostatc capsule.
Prostatc infammaton, or prostatts( ), can occur in males at any age, but it most commonly aficts
older men. Prostatts can result from bacterial infectons but also oc-curs in the apparent absence of
pathogens. Symptoms can re-semble those of prostate cancer. Individuals with prostatts may complain
of pain in the lower back, perineum, or rectum. In some cases, the symptoms are accompanied by
painful uri-naton and the discharge of mucus from the external urethral orifce. Antbiotc therapy is
efectve in treatng most cases caused by bacterial infecton.