The prostate is a small gland that is part of the male reproductive system and a hormone-dependent organ. Its shape and size have been compared to a large walnut.
The prostate gland is located in the small pelvis, under the bladder and above the rectum. The urethra, the urethra, passes through the thickness of the gland. The prostate is surrounded by a capsule composed of smooth muscle, collagen and elastic fibers; covered with three layers of dense connective tissue on the front, side and back surfaces. On the posterior surface, the prostate is bordered by the ampulla of the rectum. They are separated by the retrovesical fascia or Denonville’s fascia, which allows palpation of the posterior surface of the prostate.
It is customary to divide the organ into 3 zones.
The transition zone accounts for 10% of glandular tissue and 20% of cases of malignant prostate tumors. In this zone, one of the main age-related diseases in men is formed – benign prostatic hyperplasia, which can lead to difficulty urinating due to tissue overgrowth.
The area surrounding the ejaculatory ducts. Consists of glandular tissue, connective tissue and muscle elements. Tumors in this area are extremely rare.
Covers the posterior and lateral sides of the prostate gland and contains 70% of the glandular tissue. This is an area that is palpable through the rectum and allows the urologist to assess the condition of the prostate gland. Up to 70% of malignant tumors are localized precisely in the peripheral zone. Therefore, digital rectal examination is an important diagnostic method and should be performed in patients over 45 years of age.
The production of prostate secretion, which is an integral part of the sperm and is involved in liquefying the ejaculate, as well as saturating it with nutrients such as various enzymes and vitamins, citric acid, zinc ions, which help to improve sperm motility and activity;
The prostate contains smooth muscle fibers that aid in the release of sperm from the urethra during ejaculation, prevent sperm from entering the bladder and are involved in the mechanism of urinary retention.
Prostatitis, benign prostatic hyperplasia and prostate cancer are the three main diseases of the prostate.
All three diseases can coexist in the same prostate at the same time. That is, the presence of prostatitis does not exclude the presence of prostate hyperplasia and prostate cancer in the patient and vice versa.
According to statistics, prostatitis is the most common urological disease – after prostate hyperplasia and prostate cancer – in men under 50 and the third most common in men over 50.
The most common causative agent of prostatitis are strains of E. coli, which are determined in 80% of cases. More rare pathogens are enterococci, Pseudomonas aeruginosa, Klebsiella and other gram-negative bacteria. The role of sexually transmitted infections (such as chlamydia trachomatis) in inflammation of the prostate is still not clearly established and is under study. In patients with HIV infection and other severe changes in the immune system, cytomegalovirus, mycobacterium tuberculosis, fungi and other rare pathogens may be the possible causative agents. There are data indicating the presence of microorganisms in the prostate gland that are not detected in standard studies, but play a role in the appearance of inflammatory changes and the subsequent development of symptoms of prostatitis.