Assistant professor Dept of Anatomy The prostate is an accessory gland of the male reproductive system The prostate is firm in consistency Its firmness is due to the presence of a dense fibromuscular stroma in which the glandular elements are embedded In the female the prostate is represen ID: 1012333
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1. PROSTATE By Dr. Berlina Terrence Mary. DAssistant professor Dept of Anatomy
2. The prostate is an accessory gland of the male reproductive system. The prostate is firm in consistency. Its firmness is due to the presence of a dense fibromuscular stroma in which the glandular elements are embedded. In the female the prostate is represented by the paraurethral glands of Skene.Situation: The prostate lies in the lesser pelvis, below the neck of the urinary bladder, behind the lower part of the pubic symphysis and the upper part of the pubic arch. It measures about 4 cm transversely at the base (width); 3 cm vertically (length); and 2 cm anteroposteriorly (thickness). It weighs about 8 g.
3. Gross Features: Apex, base An apex directed downwards; surrounds the junction of prostatic and membranous parts of posterior urethra. Base directed upwards and is structurally continuous with the neck of the bladder. Four surfaces: anterior, posterior and two inferolateral.
4. The anterior surface lies 2 cm behind the pubic symphysis, with retropubic fat intervening. Its upper part is connected to the pubic bones by the puboprostatic ligaments. The lower end of this surface is pierced by the urethra. The lower end of urethra emerges from this surface. The posterior surface is triangular in shape. It is flattened from side to side and convex from above downwards. Near its upper border it is pierced on each side of the median plane by the ejaculatory duct. Inferolateral surface are related to the side walls of pelvis. The anterior fibres of the levator ani enclose the gland in pubourethral sling.
5. Zones of the Prostate: According to McNeal, the gland is divided into 1. The peripheral zone forms 70% of glandular tissue. 2. Central zone constitutes 25% of glandular tissue 3. There is a periurethral transition zone (5%)Lobes: The glandular tissue is divided into three lobes, two lateral and one median.
6. Sphincters Related to Prostate: In the preprostatic part of urethra there is external urethral sphincter mechanism that subserves sexual function of closing during ejaculation. Distal urethral sphincter mechanism is seen at the junction of prostatic and membranous parts of urethra.Structures within the Prostate Prostatic urethra The prostatic utricle The ejaculatory ducts
7. Capsules and Ligaments of Prostate True Capsule is formed by condensation of the peripheral part of the gland. The venous plexus lies between true and false capsules The false capsule is derived from the endopelvic fascia. Anteriorly continuous with puboprostatic ligaments. On each side , the prostatic venous plexus is embedded in between false and true capsules. Posteriorly , it is avascular, and is formed by the rectovesical fascia of Denonvillers.
8. Blood Supply: The prostate is supplied by branches from the inferior vesical, middle rectal and internal pudendal arteries. Venous Drainage: The veins form a rich plexus. The plexus communicates with the vesical plexus and with the internal pudendal vein, and drains into the vesical and internal iliac veins. Valveless communications exist between the prostatic and vertebral venous plexuses through which prostatic carcinoma can spread to the vertebral column and to the skull.
9. Lymphatic Drainage: Lymphatics from the prostate drain chiefly into the internal iliac and sacral nodes and partly into the external iliac nodes.Nerve Supply: The prostatic plexus of nerves is derived from the lower part of the inferior hypogastric plexus. The prostate is supplied by both sympathetic and parasympathetic nerves.
10. Age Changes in Prostate: At birth, the prostate is small in size, and is made up mainly of stroma in which a simple duct system is embedded. During the first 6 weeks after birth the epithelium of the ducts and of the prostatic utricle undergoes hyperplasia and squamous metaplasia, under the stimulation of maternal oestrogens. Between 9 and 14 years, the duct system becomes more elaborate by formation of side buds, and the gland slowly increases in size. At puberty, the male hormones bring about rapid changes in the gland. In about one year, it becomes double its prepubertal size due to rapid growth of the follicles and condensation and reduction of the stroma.
11. From 20 to 30 years, there is marked proliferation of the glandular elements From 30 to 45 years, the size of the prostate remains constant, and involution starts. After 45 to 50 years, the prostate is either enlarged or may undergo malignant changes. Development: Prostate develops from a series of endodermal buds from the lining of primitive urethra and the adjacent portion of urogenital sinus, surrounding mesenchyme condenses to form the stroma of the gland.
12. Clinical Anatomy: Senile enlargement of prostate: Digital examination of the rectum is very helpful in the diagnosis of an enlarged prostate. Inflammation of prostate - Prostatitis Benign prostatic hyperplasia occurs in periurethral zone. Carcinoma of prostate occurs in peripheral zone. The prostate is a common site of carcinoma. Removal of prostate - Prostatectomy
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