How to treat prostate problems in men

Men's prostate glands are prone to problems around middle age, so this is often an item that is checked during physical examinations. Facts have proven that most middle-aged men have some problems. However, some men are not aware that they have prostate problems, which leads to worsening of the condition. So how can men with prostate gland problems be treated? Doctors say that it is necessary to confirm the problem and then carry out targeted treatment.

The prostate is a male-specific sex gland. The prostate is an unpaired, solid sex organ composed of glandular tissue and muscle tissue. The prostate is chestnut-shaped, with the bottom facing upwards, attached to the bladder, and the tip facing downwards, against the urogenital diaphragm, the front attached to the pubic symphysis, and the back attached to the rectum. Therefore, when the prostate is enlarged, a rectal examination can be performed to feel the back of the prostate. The urethra passes through the middle of the prostate gland, guarding the upper opening of the urethra. Therefore, when the prostate is diseased, urination is the first to be affected.

The prostate is a very rare sex gland in the human body that has both internal and external secretory functions. As an exocrine gland, the prostate secretes about 2 ml of prostatic fluid every day, which is the main component of semen; as an endocrine gland, the hormones secreted by the prostate are called "prostaglandins".

Chinese name

prostate

Foreign name

prostate

Definition

Male-specific sex glands

Shape

Chestnut-shaped bottom facing up, point facing down

Prostate size

About 4cm in width, about 3cm in height, about 2cm in front and back

Features

Structure

The horizontal diameter of the upper end of the prostate is about 4cm, the vertical diameter is about 3cm, and the front-back diameter is about 2cm. The surface is covered with a fascial sheath, called the prostate capsule. There is a prostate vein between the capsule and the prostate. The secretion of the prostate is the main component of semen.

Prostate image

The prostate is an unpaired solid organ composed of glandular tissue and muscle tissue. The upper end of the prostate has a horizontal diameter of about 4 cm, a vertical diameter of about 3 cm, and an anterior-posterior diameter of about 2 cm. The surface is covered with a fascial sheath, called the prostate capsule. There is a prostate vein between the capsule and the prostate. The secretions of the prostate are the main component of semen.

The prostate is chestnut-shaped and slightly flattened front and back. The wide upper end is called the prostate base, which is adjacent to the bladder neck. The lower end is pointed and located on the urogenital diaphragm, called the prostate apex. The part between the base and the apex is called the prostate body. The back of the body is relatively flat, and there is a longitudinal shallow groove on the midline, called the prostate groove. The male urethra penetrates the prostate near the anterior edge of the gland base, passes through the anterior part of the glandular parenchyma, and exits from the prostate apex. Near the posterior edge of the base, a pair of ejaculatory ducts penetrate the prostate and open on the spermatic caruncle on the posterior wall of the prostatic part of the urethra. The excretory duct of the prostate opens on the posterior wall of the prostatic part of the urethra. The prostate is generally divided into 5 lobes: anterior lobe, middle lobe, posterior lobe and lateral lobes. The middle lobe is wedge-shaped and located between the urethra and the ejaculatory duct. After the age of 40, the middle lobe may become enlarged, protruding upward against the bladder, causing the bladder to bulge significantly and compressing the urethra, causing difficulty in urination.

The prostate is located between the bladder and the primordial diaphragm. The base of the prostate is adjacent to the bladder neck, the seminal vesicles and the vas deferens. The pubic symphysis is in front and the rectal vas deferens is in the back. During rectal examination, the back of the prostate can be touched to diagnose whether the prostate is enlarged, etc., and the vas deferens vas deferens and the seminal vesicles can be touched upwards. The prostate of children is very small, and the gland grows rapidly during sexual maturity. In old age, the prostate degenerates and atrophies. If the connective tissue in the gland proliferates, prostate hypertrophy will occur.

There is a layer of capsule on the surface. There are more elastic fibers and smooth muscles inside, which can extend into the gland to form the support of the prostate. The substance of the prostate is composed of 30 to 50 alveolar glands, with a total of 15 to 30 ducts opening on both sides of the urethral spermatophore. According to the distribution of the glands, it can be divided into mucosal glands, submucosal glands and main glands.

Features

1. The acinar epithelium is single-layered cuboidal, single-layered columnar or pseudo-stratified columnar;

Prostate location

2. Different shapes and irregular glandular cavities;

3. The interstitium is abundant and contains not only connective tissue but also elastic fibers and smooth muscles.

4. Condensed bodies are often seen in the alveolar cavity, which are formed by the concentrated secretions of epithelial cells.

Function: The secretion participates in the formation of semen, and the secretion activity is regulated by male hormones.

Prostate location: Located below the bladder neck, surrounding the junction of the bladder opening and the urethra, this part of the urethra is therefore called the "urethral prostatic part", which means that the tube formed in the middle of the prostate constitutes the upper opening of the urethra. It can be said that the prostate guards the upper opening of the urethra, and this is why urination is first affected by prostate disease.

Prostate structure: The surface is covered by a very flexible 3-layer structure. The outer layer is composed of loose connective tissue and veins, the middle layer is a fibrous sheath, and the inner layer is a muscle layer. The capsule of the prostate forms a "barrier" that protects the prostate. Things are often two-sided. While the capsule protects the prostate, it also makes it difficult for therapeutic drugs to enter the glandular tissue, which is called the reason for the difficulty in treatment. The prostate is divided into 5 lobes, namely the anterior lobe, middle lobe, posterior lobe and lateral lobes. The posterior lobe is located behind the middle lobe and the lateral lobes. This lobe is what the doctor touches during a rectal digital examination.

Prostate structure

The physiological functions of the prostate can be summarized into four aspects.

First, it has exocrine function. The prostate is the largest accessory gland in men and one of the exocrine glands in the human body. It can secrete prostatic fluid, which is an important component of semen. It plays an important role in the normal function of sperm and is very important for fertility. The secretion of prostatic fluid is regulated by male hormones.

Second, it has endocrine function. The prostate contains abundant 5α-reductase, which can convert testosterone into more physiologically active dihydrotestosterone. Dihydrotestosterone plays an important role in the pathogenesis of benign prostatic hyperplasia. By blocking 5α-reductase, the production of dihydrotestosterone can be reduced, thereby causing the hyperplastic prostate tissue to atrophy.

Third, it has the function of controlling urination. The prostate surrounds the urethra and is close to the bladder neck, forming the proximal urethral wall. Its annular smooth muscle fibers surround the prostatic part of the urethra and participate in the formation of the internal urethral sphincter. When the urge to urinate occurs, the detrusor muscle contracts and the internal sphincter relaxes, allowing urination to proceed smoothly.

Fourth, it has a transport function. The urethra and two ejaculatory ducts pass through the prostate. When ejaculating, the muscles of the prostate and seminal vesicles contract, which can push the contents of the vas deferens and seminal vesicles into the posterior urethra through the ejaculatory ducts and then excrete them out of the body. In summary, the prostate has four important functions and plays an important role in the human body.

Prostatic fluid

Physiological functions

1. Promote the formation of fertilized eggs: Prostatic fluid contains protease and fibrosis, which can help sperm pass through multiple barriers - the mucus barrier in the cervix and the zona pellucida of the egg cell, allowing sperm and egg cells to combine smoothly.

Male reproductive system

2. Stimulate sperm motility: Prostatic fluid contains a special ingredient that enables sperm to obtain nutrients from semen and stimulate sperm motility.

3. Promote the liquefaction of semen: Chymotrypsin in prostatic fluid can promote the liquefaction of semen.

4. Improve sperm survival rate: Prostatic fluid is slightly alkaline, which can neutralize the acidic secretions in the female vagina, reduce the erosion of acidic substances on sperm, and improve the survival rate of sperm.

5. Maintaining the hygiene of the reproductive and urinary systems: The prostate is located in front of the bladder and below the rectum, surrounding the urethra. The zinc ions in the prostatic fluid have a bactericidal effect, which enables the prostate to play a role in resisting external pathogens, thereby helping to maintain the health of the reproductive and urinary systems.

6. Improve the quality of sex life: The prostate is filled with a large number of nerve networks and nerve endings, so it is a sexually sensitive area that can stimulate sexual impulse and excitement, thus contributing to a harmonious sex life.

Definition

An important function of the prostate is to secrete prostatic fluid, which can be obtained by inserting the index finger into the anus and massaging the rectum. Normal prostatic fluid is light milky white with a protein luster, and the daily secretion volume is about 0.5-2ml. Prostatic fluid is a part of semen, accounting for about 15%-30% of semen; its pH value is 6-7, acidic; it has the functions of protecting and enhancing sperm activity and lubricating the urethra. When the inflammation is severe, the prostatic fluid may become thick, yellow or light red turbid, or contain flocs and sticky threads. Examination under a microscope can reveal the following components:

1. Lecithin bodies are evenly distributed in prostatic fluid. They are spherical bodies, large, highly refractive, and numerous. Normal prostatic fluid contains 280 mg/d1 of total lipids, of which 65% are phospholipids, and lecithin is the main component. Lecithin bodies are almost everywhere in the field of vision. When the prostate is inflamed, macrophages engulf a large amount of lipids, so the number of lecithin bodies decreases significantly. Therefore, the number of lecithin bodies reflects the severity of prostatitis to a certain extent. As the condition stabilizes and improves after treatment, the number of lecithin bodies may also increase.

2. Blood cells include white blood cells and red blood cells. Under normal circumstances, red blood cells are occasionally seen, and only appear during inflammation. Excessive massage can cause an increase in the number of red blood cells, and even visible bleeding. White blood cells are scattered in normal prostatic fluid, with more than 10 per high-power field of view, and they are dispersed and not in piles or strings. During inflammation, due to the uncontrolled drainage of the excretory duct, pus cells or white blood cells can be seen in piles. If more than 10-15 white blood cells are observed per high-power field of view under a microscope, bacterial prostatitis can be diagnosed.

3. Starch granules, stones or sperm can also be seen in prostatic fluid, but they are not of great significance in the diagnosis of prostatic diseases, so they are generally not introduced. The biochemical components of prostatic fluid are very rich, including pH, zinc, acid phosphatase, citrate and leucine aminopeptidase, etc., which are of significance in the diagnosis of prostatic diseases. The content of zinc and various enzymes will decrease when inflammation occurs, but it is rarely used in clinical practice.

4. Protein The content of protein in prostatic fluid is very small, and it mainly contains high concentrations of zinc ions, acid phosphatase, protease, fibrosis, spermine, aliphatic polypeptides, etc. Among them, protease and fibrosis have the effect of promoting semen liquefaction, and the detection of acid phosphatase and citric acid can help judge the function of the prostate and whether there is cancer.

Prostatic fluid and semen are different, but they are closely related. Prostatic fluid is a component of semen, mainly secreted by the prostate, while semen contains secretions from multiple glands. Semen is a mixture of sperm and seminal plasma. Sperm is a large number of living cells produced in the seminiferous tubules of the testicles. Seminal plasma is composed of testicular fluid, epitesticular fluid, vas deferens peritoneal fluid, accessory gland secretions and urethral gland fluid, including prostatic fluid. Prostatic fluid accounts for about 20% to 30% of seminal plasma, but the largest amount is the seminal vesicle secretion fluid, which accounts for about 60% to 70% of seminal plasma, and the remaining components account for only 10%. Seminal plasma is a necessary medium for transporting sperm, and it also contains substances necessary to maintain sperm life and can stimulate the activity of sperm. Semen contains many substances, such as high concentrations of organic substances, inorganic ions and various enzymes. Among them, many enzymes related to semen coagulation or liquefaction come from prostatic fluid, such as aminopeptidase, fibroblastic protein lysing enzyme, arginine ester hydrolase, etc. In addition, citric acid is all secreted by the prostate, and its function is to maintain semen osmotic pressure and the activity of sperm hyaluronidase.

Infection route

What are the infection pathways of the prostate? Knowing the infection pathways of the prostate will help you take effective measures to cut off the infection pathways of prostate pain and prevent prostate diseases.

Prostate infection route 1: Direct spread through the urethra

Direct spread through the urethra is a more common route of infection. Bacteria ascend into the urethra through the urethral opening, and then invade the prostate through the prostatic duct, causing acute or chronic prostatitis. It is worth noting that gonococcal urethritis is an important cause of prostatitis. With the rapid development of gonorrhea in China in recent years, it has become an important cause of chronic prostatitis. Prostatic hyperplasia or the presence of stones can cause the prostatic urethra to deform, twist, become congested, and cause urination difficulties, and reduce the immune ability of the prostatic urethral mucosa against non-pathogenic bacteria that can coexist peacefully in the urethra, making prostatitis more likely to occur. Hypersexuality or excessive masturbation can cause repeated congestion of the prostate and induce prostatitis. Catheterization or urethral instrument examination can bring bacteria into the urethra and cause prostate infection.

Prostate infection route 2: Infection through blood circulation

Pathogens from infection sites elsewhere in the body can reach the prostate through the blood circulation and cause prostatitis. Common examples include bacteria from infection sites in the skin, tonsils, caries, respiratory tract, or intestinal tract that enter the blood and invade the prostate.

Prostate infection route three: lymphatic infection

The lymphatic infection route is relatively rare. Prostatitis can be caused by inflammation of the prostate gland's vicinity, such as the rectum, colon, bladder, and urethra, through the lymphatic ducts.

The classification of prostatitis is relatively complex. In addition to common bacterial prostatitis, which can be divided into acute prostatitis and chronic prostatitis, there is also specific prostatitis, including prostatitis caused by gonorrhea, tuberculosis, syphilis, fungi and parasites (such as Trichomonas); prostatitis caused by viral, mycoplasma, and chlamydia infection; and granulomatous prostatitis; prostatitis and prostatic congestion, etc.