Prostate – the heart between the legs?

What is the prostate?

The prostate, also known as the prostate gland or prostate, is a glandular organ that is part of the male urinary and reproductive system. It consists of 2 lobes connected by the isthmus. It is surrounded by smooth muscle that contracts during ejaculation.

Female prostate

It is often said that the prostate gland is only present in men, but research conducted as early as the 17th century (and confirmed at the end of the 19th century) has shown that women have structures homologous to the male prostate gland, which – to put it simply – function like their male counterpart and may be responsible for female ejaculation (there is no clear evidence for this yet). These are the so-called Skene's glands (named after the British-American gynecologist who discovered these structures) or the minor vestibular glands, although some scientific studies insist on calling this paired organ the "female prostate", because other names suggest the existence of some paraprostatic structures.

It's gone, it's gone

Let's get back to the subject of the male prostate. It was first described in the 1530s by Niccolò Massa (an anatomist from Venice), and its appearance and shape (a walnut or chestnut is mentioned here, but it looks more like a heart to me :)) were illustrated in 1538 by the Flemish anatomist Andreas Vesalius. The term "prostate" itself is credited to the Frenchman André du Laurens in 1600, but there are references to its earlier use more than 50 years earlier.

Prostate location

But let's get back to the present. The prostate is located under the bladder, in the lower part of the pelvis (in the so-called lesser pelvis). A part of the urethra runs through the gland itself, which is why prostate diseases are often accompanied by discomfort related to urination. The posterior part of the prostate is located near the rectum, and is even adjacent to it. This has its positive significance both in terms of health and those related to sexual life - but more on that later.

Prostate function

The prostate gland takes an active part in the reproductive process. Its most important task is to produce a cloudy, whitish secretion, which is both a means of transport and a source of nutrients for sperm traveling to the egg. The composition of the substance produced by the prostate allows sperm to survive for up to several days in the difficult conditions prevailing in the genital tract of people with a uterus , and also gives sperm the right pH, thanks to which biological reactions of DNA synthesis are possible. The aforementioned smooth muscles surrounding the prostate contract during orgasm, which causes ejaculation, i.e. ejaculation of sperm from the penis through the spermatic ducts and urethra.

Prostate diseases

The inconspicuous size of the prostate gland should not deceive us, because in the case of problems caused by the prostate, our daily functioning can be significantly hindered. Diagnosis of prostate diseases involves determining the level of the PSA enzyme produced by the prostate gland. A blood test conducted to assess the PSA concentration allows for the identification of any irregularities and the implementation of appropriate therapy. Early detection of symptoms of prostate diseases allows them to be treated pharmacologically, which gives measurable effects especially in the initial and intermediate stages.

Benign prostatic hyperplasia

This condition, also known as benign prostatic hyperplasia, is quite common in aging people, as testosterone levels drop with age, causing hormonal imbalances that result in an enlarged prostate. Due to its close proximity to the bladder, part of the urethra passes through the prostate, and when the prostate becomes enlarged, it impedes urine flow. It is worth mentioning that the prostate enlarges throughout life, but it is not entirely clear why this happens. The only clue may be that with age, there is an imbalance in sex hormones.

Symptoms of benign prostatic hyperplasia

As is often the case, the severity and type of symptoms that make up BPH vary from person to person. The fact is, however, that symptoms tend to get worse if not treated properly. BPH can present itself in the following ways:

• frequent need to urinate,
• nocturia – the need to urinate more than once a night,
• intermittent urine stream,
• feeling of not completely emptying the bladder.

Treatment of benign prostatic hyperplasia

Treatment for this condition may include:

• pharmacotherapy,
• minimally invasive surgical procedures,
• operation.

After conducting appropriate tests (I will talk about them a little later), the urologist will decide on the appropriate treatment regimen for a specific person and the stage of advancement (enlargement) of prostate enlargement.

Acute prostatitis

In this case, we are dealing with a bacterial disease that develops at the prostate gland openings. The colon flora bacteria responsible for this disease are not sexually transmitted, but are inadvertently transported by the person to the urethra.

Symptoms of acute prostatitis

• Painful urination,
• prostate pain,
• blood in urine,
• pain in the perineum area,
• painful ejaculation.

Treatment of acute prostatitis

Bacterial diseases are treated with antibiotics, so their use will also bring relief in this case. Depending on the exact cause of the disease, its development can be gradual or sudden. The same applies to treatment - acute prostatitis can subside quite quickly (both through pharmacological treatment and spontaneously), but it can also develop into a chronic form.

Chronic prostatitis

We can talk about chronic prostatitis when it lasts for at least 3 months. There are 2 types of this disease, which are classified based on the causes of its occurrence:

• Chronic bacterial prostatitis is the result of a bacterial infection that can happen to people of any age, but most often affects young and middle-aged people.
• Chronic pelvic pain syndrome – This variant of the condition presents in a very similar way to its bacterial variant, but its causes remain unknown. It is estimated that this type accounts for the majority (about 90%) of cases of chronic prostatitis.

Symptoms of chronic prostatitis

Both the bacterial form and the one whose causes have not been fully investigated present in a similar way. The most common symptoms include:

• severe pain and burning when urinating,
• blood in urine,
• painful ejaculation,
• pain located in the lower back, lower abdomen, perineum area, between the testicles and the anus,
• The bacterial form may also cause fever and chills.

Treatment of chronic prostatitis

The treatment of this disease depends of course on the diagnosed type, but in both the bacterial form and the one with unknown causes, 2 types of drugs are used. The treatment will probably start with chemotherapeutics with bactericidal action. Antibiotics should be taken until the symptoms disappear, which usually takes from a few to a dozen weeks. There are no shortcuts! In most cases, the symptoms disappear after a sufficiently long course of therapy.

Another method of treatment used is to relieve pain and other symptoms accompanying this condition. For this purpose, alpha blockers are used, which have a relaxing effect on the smooth muscles surrounding the prostate. The group of such drugs includes:

• tamsulosin,
• doxazosin,
• terazosin,
• alfuzosin,
• silodosin.

These medications cause blood vessels to dilate, which may result in erection problems.

Prostate cancer

Prostate cancer is the most common cancer in men in Poland and is the most serious prostate disease. In many cases, its development is slow and stops within the prostate itself. The period from the formation of the first cancer cells to the appearance of the first symptoms of the disease can be as long as a dozen or so years. Sometimes, however, we are faced with a much more serious variety. I am referring to malignant prostate cancer. This type can develop very quickly and result in metastases to other important organs.

Risk factors for prostate cancer

The origins of prostate cancer are not fully understood, so it is impossible to provide precise preventive recommendations for this disease. However, based on research, we can develop risk factors that increase the chances of developing prostate cancer. These include:

• Age – the risk increases with age, and prostate cancer most often affects people over the age of 50.
• Race - for reasons not yet fully understood, the black race is at greater risk of contracting the disease than other races. It is also more common for black people to develop malignant strains.
• Genetic factors – if a close family member has prostate cancer, the chances of siblings or children developing the disease also increase.
• Obesity – Obese people are more susceptible to prostate cancer, although research into this is not conclusive. However, it does indicate that these people are more likely to develop the malignant form of prostate cancer and experience recurrences.

Symptoms of prostate cancer

Prostate cancer often does not present itself in any particular way at first, which is why it is so difficult to diagnose early. Symptoms include:

• problems with urination,
• weak urine stream,
• blood in urine and semen (in advanced form),
• uncontrolled weight loss (in advanced form),
• musculoskeletal pain (with bone metastases).

Prostate cancer treatment and diagnosis

Due to the fact that most of the symptoms overlap with those experienced by the patient in other prostate diseases, making an accurate diagnosis is extremely problematic. If you notice any of the symptoms mentioned in the entire article, consider seeing a specialist - in this case, a urologist.

The diagnosis of prostate cancer, as well as other prostate diseases, can be (and usually is) carried out according to the following scheme:

• Medical interview – at the beginning the urologist will ask basic questions about your general health, and then ask about any symptoms concerning the genitourinary system – do not hide anything, because even a seemingly trivial ailment may turn out to be crucial in making the right diagnosis.
• Rectal examination – performed with a finger through the rectum, allowing to assess its condition and detect any abnormalities. A rectal examination is usually accompanied by an internal (though not always) cry of terror, but it lasts very briefly and is practically painless.
• Serum PSA (prostate specific antigen) test – its elevated level does not necessarily mean cancer, as similar values ​​can be obtained in other prostate diseases, as well as due to mechanical injuries during other tests. It is recommended that people between 40 and 50 years of age have this test done at least once, and those who have already passed the magic fifty – at least once a year.
• Transrectal ultrasound.
• Biopsy – similarly to other diseases from the cancer category, a sample of the prostate is taken to examine it for the presence of cancer cells (at a later stage also to assess the stage of the disease advancement and malignancy).
• Prostate MRI – should be performed if the above tests indicate a medium or high risk of prostate cancer.

After collecting all the necessary information and conducting the appropriate tests, the urologist makes a decision regarding the choice of prostate cancer treatment. This depends on many factors, such as: the extent and advancement of the disease, risk assessment based on the level of prostate-specific antigen or the age of the person and their life expectancy.

There are 3 main treatments for prostate cancer:

• prostate surgery – radical prostatectomy involves the surgical removal of the prostate gland (it may lead to problems with sexual activity or make it completely impossible, a complication of the surgery may also be urinary incontinence);
• radiotherapy;
• hormone therapy or chemotherapy.

Sex and the prostate

There have been debates in the scientific community for years about the relationship between the frequency of ejaculation in adulthood and the reduced risk of prostate cancer. A cohort study described in 2016, conducted since the 1990s, involving thousands of men, showed that with 21 or more ejaculations per month, the risk of developing prostate cancer drops by about 20%. The results may not be mind-blowing, but it's certainly something to think about during an afternoon of relaxation. :)

Also read our articles about sex: how to talk about sex with your partner and Is masturbation healthy ?.

Male G-spot

There was already something for the body, so now, before the curtain falls, it's time for something for the soul (okay, it will also be something for the body :)). I'm talking about the male G-spot, although I should rather write the P-spot (from the prostate, because it is the cause of all the, oh so pleasant, chaos here). You can get to it in 2 ways: internally and externally. The prostate is located about 4 centimeters inside the anus, so you don't have to look far to find it. You can also stimulate the prostate externally in the area between the testicles and the anus. Both methods provide unforgettable sensations.

Have fun, experiment, experiment – ​​just not with your health! Take care of your prostate, and it will take care of you – and if you notice any worrying symptoms, run to the doctor!