What is the prostate?

What is the prostate?

What is the prostate and why is it important to have regular prostate exams?

The prostate is a walnut-sized gland located between the male bladder and penis. The urethra runs through the centre of the prostate, from the bladder to the penis.

The prostate is responsible for secreting a milky fluid that both nourishes and protects sperm, making up about 30% of the total fluid ejaculated. The rest is comprised of sperm and fluid from the seminal vesicles.

What does the prostate do?

The prostate appears only in men and is responsible for secreting a fluid that keeps the sperm alive whilst protecting them and the genetic information that they carry. During ejaculation the prostate will contract and release its fluid into the urethra.

The sperm will travel along two tubes called the vas deferens during ejaculation. They come from the testes where they are made and end up in the seminal vesicles. The seminal vesicles are attached to the prostate and add extra fluid to the semen before it is sent through the urethra. During ejaculation the prostate contracts, closing off the opening between the bladder urethra in order to push semen through at a speed, it is for this reason that it is impossible to urinate and ejaculate at the same time.

What does prostatic fluid do?

The prostatic fluid protects sperm by helping them to be more mobile and to live longer. It contains various ingredients including zinc, citric acid and enzymes, one of which is actually a prostate-specific antigen (PSA). After ejaculation, PSA makes semen less thick, helping sperm to travel through it more easily and more likely to successfully fertilize an egg. During ejaculation, the prostate will squeeze prostatic fluid into the urethra which is then expelled with sperm as a part of semen. This is a vital part of male reproduction. There are a number of opportunities to interrupt the development of prostatic fluid and travel which can be optimized for male birth control and contraception.

How does the prostate change with age?

There is a tendency for the prostate gland to grow larger, potentially squeezing the urethra and causing problems with urination. It is possible for men in their 30s and 40s to begin experiencing these symptoms, while other men can experience them much later in life. Infection or a tumour can also enlarge the prostate so be sure to let your doctor know if you experience any of the following urinary symptoms:

  • Infection or passing urine more during the day
  • The urgent need to urinate
  • Less urine flow
  • Burning sensation when passing urine
  • Getting up multiple times during the night to pass urine

With age, your risk of prostate problems does increase. The three most common prostate problems are:

  1. Inflammation (prostatitis)
  2. Enlarged prostate (BPH or benign prostatic hyperplasia)
  3. Prostate cancer

One problem does not lead to another although it is possible to have more than one at the same time.

Tests used to check the prostate

When visiting the doctor you will be asked about symptoms, how long you’ve had them and if they affect your lifestyle. You may be asked to give a urine sample for testing and then the examination will take place.

A Digital Rectal Exam (DRE) is a standard means of checking the prostate where the doctor examines your prostate from the rectum. It lasts about 10 – 15 seconds and the doctor checks for the size and texture of the prostate, any hard areas or lumps and any pain.

A Prostate-Specific Antigen (PSA) Test can be used to help detect prostate cancer in men 50 and older. PSA is a protein made by prostate cells that are secreted into ducts in the prostate where it helps to make semen but sometimes can leak into the blood. If PSA is in the blood then the PSA test can be used through a high PSA blood level is not proof of prostate cancer as there are other things that could cause a false positive result.

Prostate biopsy

If your symptoms or test results are indicative of prostate cancer, then your doctor will refer you to a urologist who will perform a prostate biopsy wherein small tissue samples will be taken directly from the prostate. Samples will be taken from several areas of the prostate gland which lowers the risk of missing any areas that might contain cancer cells. Prostate cancer can only be diagnosed by viewing the tissue under a microscope. Most men who have biopsies after prostate cancer screening exams usually do not have prostate cancer.

Unfortunately, there is no magic PSA level below which a male can be sure that there is no risk of prostate cancer not above which that a biopsy should be performed. A man’s decision to have a prostate biopsy requires an in-depth discussion with the physician to discuss health, symptoms, risks and lifestyle.

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