The prostate is an accessory gland of the

male reproductive system The male reproductive system consists of a number of sex organs that play a role in the process of human reproduction. These organs are located on the outside of the body, and within the pelvic cavity, pelvis. The main male sex organs are the hu ...

and a muscle-driven mechanical switch between

urination Urination is the release of urine from the bladder through the urethra in Placentalia, placental mammals, or through the cloaca in other vertebrates. It is the urinary system's form of excretion. It is also known medically as micturition, v ...

and

ejaculation Ejaculation is the discharge of semen (the ''ejaculate''; normally containing sperm) from the penis through the urethra. It is the final stage and natural objective of male sexual stimulation, and an essential component of natural conception. ...

. It is found in all male mammals. It differs between species anatomically, chemically, and physiologically. Anatomically, the prostate is found below the bladder, with the urethra passing through it. It is described in

gross anatomy Gross anatomy is the study of anatomy at the visible or macroscopic level. The counterpart to gross anatomy is the field of histology, which studies microscopic anatomy. Gross anatomy of the human body or other animals seeks to understand the ...

as consisting of lobes and in microanatomy by zone. It is surrounded by an elastic, fibromuscular capsule and contains glandular tissue, as well as

connective tissue Connective tissue is one of the four primary types of animal tissue, a group of cells that are similar in structure, along with epithelial tissue, muscle tissue, and nervous tissue. It develops mostly from the mesenchyme, derived from the mesod ...

. The prostate produces and contains fluid that forms part of

semen Semen, also known as seminal fluid, is a bodily fluid that contains spermatozoon, spermatozoa which is secreted by the male gonads (sexual glands) and other sexual organs of male or hermaphrodite, hermaphroditic animals. In humans and placen ...

, the substance emitted during

as part of the male sexual response. This prostatic fluid is slightly

alkaline In chemistry, an alkali (; from the Arabic word , ) is a basic salt of an alkali metal or an alkaline earth metal. An alkali can also be defined as a base that dissolves in water. A solution of a soluble base has a pH greater than 7.0. The ...

, milky or white in appearance. The alkalinity of semen helps neutralize the acidity of the vaginal tract, prolonging the lifespan of

sperm Sperm (: sperm or sperms) is the male reproductive Cell (biology), cell, or gamete, in anisogamous forms of sexual reproduction (forms in which there is a larger, female reproductive cell and a smaller, male one). Animals produce motile sperm ...

. The prostatic fluid is expelled in the first part of ejaculate, together with most of the sperm, because of the action of smooth muscle tissue within the prostate. In comparison with the few spermatozoa expelled together with mainly seminal vesicular fluid, those in prostatic fluid have better

motility Motility is the ability of an organism to move independently using metabolism, metabolic energy. This biological concept encompasses movement at various levels, from whole organisms to cells and subcellular components. Motility is observed in ...

, longer survival, and better protection of genetic material. Disorders of the prostate include enlargement,

inflammation Inflammation (from ) is part of the biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. The five cardinal signs are heat, pain, redness, swelling, and loss of function (Latin ''calor'', '' ...

infection An infection is the invasion of tissue (biology), tissues by pathogens, their multiplication, and the reaction of host (biology), host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmis ...

, and

cancer Cancer is a group of diseases involving Cell growth#Disorders, abnormal cell growth with the potential to Invasion (cancer), invade or Metastasis, spread to other parts of the body. These contrast with benign tumors, which do not spread. Po ...

. The word ''prostate'' is derived from

Ancient Greek Ancient Greek (, ; ) includes the forms of the Greek language used in ancient Greece and the classical antiquity, ancient world from around 1500 BC to 300 BC. It is often roughly divided into the following periods: Mycenaean Greek (), Greek ...

(), meaning "one who stands before", "protector", "guardian", with the term originally used to describe the seminal vesicles.

Structure

The prostate is a exocrine gland of the

. In adults, it is about the size of a walnut, and has an average weight of about , usually ranging between . The prostate is located in the pelvis. It sits below the

urinary bladder The bladder () is a hollow organ in humans and other vertebrates that stores urine from the Kidney (vertebrates), kidneys. In placental mammals, urine enters the bladder via the ureters and exits via the urethra during urination. In humans, the ...

and surrounds the urethra. The part of the urethra passing through it is called the prostatic urethra, which joins with the two ejaculatory ducts. The prostate is covered in a surface called the ''prostatic capsule'' or ''prostatic fascia''. The internal structure of the prostate has been described using both lobes and zones. Because of the variation in descriptions and definitions of lobes, the zone classification is used more predominantly. The prostate has been described as consisting of three or four zones. Zones are more typically able to be seen on

histology Histology, also known as microscopic anatomy or microanatomy, is the branch of biology that studies the microscopic anatomy of biological tissue (biology), tissues. Histology is the microscopic counterpart to gross anatomy, which looks at large ...

, or in

medical imaging Medical imaging is the technique and process of imaging the interior of a body for clinical analysis and medical intervention, as well as visual representation of the function of some organs or tissues (physiology). Medical imaging seeks to revea ...

, such as

ultrasound Ultrasound is sound with frequency, frequencies greater than 20 Hertz, kilohertz. This frequency is the approximate upper audible hearing range, limit of human hearing in healthy young adults. The physical principles of acoustic waves apply ...

or MRI. The "lobe" classification describes lobes that, while originally defined in the fetus, are also visible in gross anatomy, including dissection and when viewed endoscopically. The five lobes are the anterior lobe or isthmus, the posterior lobe, the right and left lateral lobes, and the middle or median lobe. File:Illu prostate lobes.jpg, Lobes of prostate File:Prostate zones.png, Zones of prostate Inside of the prostate, adjacent and parallel to the prostatic urethra, there are two longitudinal muscle systems. On the front side ( ventrally) runs the urethral dilator (''musculus dilatator urethrae''), on the backside ( dorsally) runs the muscle switching the urethra into the ejaculatory state (''musculus ejaculatorius'').Michael Schünke, Erik Schulte, Udo Schumacher: ''PROMETHEUS Innere Organe. LernAtlas Anatomie'', vol 2: ''Innere Organe'', Thieme Verlag, Stuttgart/Germany 2012, , p. 298
PDF

Blood and lymphatic vessels

The prostate receives blood through the inferior vesical artery, internal pudendal artery, and middle rectal arteries. These vessels enter the prostate on its outer surface where it meets the bladder, and travel forward to the apex of the prostate. Both the inferior vesical and the middle rectal arteries often arise together directly from the internal iliac arteries. On entering the bladder, the inferior vesical artery splits into a urethral branch, supplying the urethral prostate; and a capsular branch, which travels around the capsule and has smaller branches, which perforate into the prostate. The veins of the prostate form a network – the prostatic venous plexus, primarily around its front and outer surface. This network also receives blood from the deep dorsal vein of the penis, and is connected via branches to the vesical plexus and internal pudendal veins. Veins drain into the vesical and then internal iliac veins. The lymphatic drainage of the prostate depends on the positioning of the area. Vessels surrounding the vas deferens, some of the vessels in the seminal vesicle, and a vessel from the posterior surface of the prostate drain into the external iliac lymph nodes. Some of the seminal vesicle vessels, prostatic vessels, and vessels from the anterior prostate drain into internal iliac lymph nodes. Vessels of the prostate itself also drain into the obturator and sacral lymph nodes. File:Internal_iliac_branches.PNG, Imaging showing the inferior vesical, inferior pudendal and middle rectal arteries arising from the internal iliac arteries. File:Gray611.png, Image showing the external iliac lymph nodes and their positions around the external iliac artery and vein

Microanatomy

The prostate consists of glandular and

. Tall column-shaped cells form the lining (the

epithelium Epithelium or epithelial tissue is a thin, continuous, protective layer of cells with little extracellular matrix. An example is the epidermis, the outermost layer of the skin. Epithelial ( mesothelial) tissues line the outer surfaces of man ...

) of the glands. These form one layer or may be pseudostratified. The epithelium is highly variable and areas of low cuboidal or flat cells can also be present, with transitional epithelium in the outer regions of the longer ducts. Basal cells surround the luminal epithelial cells in benign glands. The glands are formed as many follicles, which drain into canals and subsequently 12–20 main ducts, These in turn drain into the urethra as it passes through the prostate. There are also a small amount of flat cells, which sit next to the basement membranes of glands, and act as stem cells. The connective tissue of the prostate is made up of fibrous tissue and smooth muscle. The fibrous tissue separates the gland into lobules. It also sits between the glands and is composed of randomly orientated smooth-muscle bundles that are continuous with the bladder. Over time, thickened secretions called corpora amylacea accumulate in the gland. File:Prostatehistology.jpg, Microscopic glands of the prostate File:Prostate gland microanatomy.png, Microanatomy of a prostatic gland, showing both luminal cells and surrounding basal cells. H&E stain. File:Histology of normal prostate.jpg, Histology of normal prostate, H&E stain, with benign features: Glands are rounded to irregularly branching, with an inner layer of epithelial cells surrounded by an outer layer of basal cells. They are surrounded by ample stroma. File:Histology of prostate atrophy.jpg, Histology of prostate with gradually increasing simple atrophy from left to right, H&E stain. Crowding and angulation may mimic that of adenocarcinoma, but there is nuclear basophilia rather than atypia, and occasional basal cells can still be seen.

Gene and protein expression

About 20,000 protein-coding genes are expressed in human cells and almost 75% of these genes are expressed in the normal prostate. About 150 of these genes are more specifically expressed in the prostate, with about 20 genes being highly prostate specific. The corresponding specific proteins are expressed in the glandular and secretory cells of the prostatic gland and have functions that are important for the characteristics of

, including prostate-specific

protein Proteins are large biomolecules and macromolecules that comprise one or more long chains of amino acid residue (biochemistry), residues. Proteins perform a vast array of functions within organisms, including Enzyme catalysis, catalysing metab ...

s, such as the prostate specific antigen (PSA), and the prostatic acid phosphatase.

Development

In the developing

embryo An embryo ( ) is the initial stage of development for a multicellular organism. In organisms that reproduce sexually, embryonic development is the part of the life cycle that begins just after fertilization of the female egg cell by the male sp ...

, at the hind end lies an inpouching called the

cloaca A cloaca ( ), : cloacae ( or ), or vent, is the rear orifice that serves as the only opening for the digestive (rectum), reproductive, and urinary tracts (if present) of many vertebrate animals. All amphibians, reptiles, birds, cartilagin ...

. This, over the fourth to the seventh week, divides into a

urogenital sinus The urogenital sinus is a body part of a human or other Placentalia, placental only present in the development of the urinary system, development of the urinary and development of the reproductive organs, reproductive organs. It is the ventral p ...

and the beginnings of the

anal canal The anal canal is the part that connects the rectum to the anus, located below the level of the pelvic diaphragm. It is located within the anal triangle of the perineum, between the right and left ischioanal fossa. As the final functional s ...

, with a wall forming between these two inpouchings called the urorectal septum. The urogenital sinus divides into three parts, with the middle part forming the urethra; the upper part is largest and becomes the

, and the lower part then changes depending on the biological sex of the embryo. The prostatic part of the urethra develops from the middle, pelvic, part of the urogenital sinus, which is of endodermal origin. Around the end of the third month of embryonic life, outgrowths arise from the prostatic part of the urethra and grow into the surrounding mesenchyme. The cells lining this part of the urethra differentiate into the glandular epithelium of the prostate. The associated mesenchyme differentiates into the dense connective tissue and the smooth muscle of the prostate. Condensation of mesenchyme, urethra, and Wolffian ducts gives rise to the adult prostate gland, a composite organ made up of several tightly fused glandular and non-glandular components. To function properly, the prostate needs male

hormones A hormone (from the Greek participle , "setting in motion") is a class of signaling molecules in multicellular organisms that are sent to distant organs or tissues by complex biological processes to regulate physiology and behavior. Hormones a ...

(

androgen An androgen (from Greek ''andr-'', the stem of the word meaning ) is any natural or synthetic steroid hormone that regulates the development and maintenance of male characteristics in vertebrates by binding to androgen receptors. This includes ...

s), which are responsible for male sex characteristics. The main male hormone is

testosterone Testosterone is the primary male sex hormone and androgen in Male, males. In humans, testosterone plays a key role in the development of Male reproductive system, male reproductive tissues such as testicles and prostate, as well as promoting se ...

, which is produced mainly by the

testicle A testicle or testis ( testes) is the gonad in all male bilaterians, including humans, and is Homology (biology), homologous to the ovary in females. Its primary functions are the production of sperm and the secretion of Androgen, androgens, p ...

s. It is dihydrotestosterone (DHT), a metabolite of testosterone, that predominantly regulates the prostate. The prostate gland enlarges over time, until the fourth decade of life.

Function

In ejaculation

The prostate secretes fluid, which becomes part of the

. Its secretion forms up to 30% of the semen. Semen is the fluid emitted ( ejaculated) through the male urethra during the sexual response. Sperm are emitted from the vas deferens into the male urethra via the ejaculatory duct, which lies within the prostate gland. Semen is moved into the urethra following contractions of the smooth muscle of the vas deferens and seminal vesicles, following stimulation, primarily of the

glans penis In male human anatomy, the glans penis or penile glans, commonly referred to as the glans, (; from Latin ''glans'' meaning "acorn") is the bulbous structure at the Anatomical terms of location#Proximal and distal, distal end of the human penis ...

. Stimulation sends nerve signals via the internal pudendal nerves to the upper

lumbar spine The lumbar vertebrae are located between the thoracic vertebrae and pelvis. They form the lower part of the back in humans, and the tail end of the back in quadrupeds. In humans, there are five lumbar vertebrae. The term is used to describe t ...

; the nerve signals causing contraction act via the hypogastric nerves. After traveling into the urethra, the seminal fluid is ejaculated by contraction of the bulbocavernosus muscle. The secretions of the prostate include proteolytic enzymes, prostatic acid phosphatase, fibrinolysin,

zinc Zinc is a chemical element; it has symbol Zn and atomic number 30. It is a slightly brittle metal at room temperature and has a shiny-greyish appearance when oxidation is removed. It is the first element in group 12 (IIB) of the periodic tabl ...

, and prostate-specific antigen. Together with the secretions from the seminal vesicles, these form the major fluid part of semen. The prostate contains various metals, including zinc, and is known to be the primary source of most metals found in semen, which are released during ejaculation.

In urination

The prostate's changes of shape, which facilitate the mechanical switch between urination and ejaculation, are mainly driven by the two longitudinal muscle systems running along the prostatic urethra. These are the ''urethral dilator'' (''musculus dilatator urethrae'') on the urethra's front side, which contracts during urination and thereby shortens and tilts the prostate in its vertical dimension thus widening the prostatic section of the urethral tube, and the muscle switching the urethra into the ejaculatory state (''musculus ejaculatorius'') on its backside. In case of an operation, e.g. because of benign prostatic hyperplasia (BPH), damaging or sparing of these two muscle systems varies considerably depending on the choice of operation type and details of the procedure of the chosen technique. The effects on postoperational urination and ejaculation vary correspondingly.

In stimulation

It is possible for some men to achieve orgasm solely through stimulation of the prostate gland, such as via prostate massage or anal intercourse. This has led to the area of the rectal wall adjacent to the prostate to be popularly referred to as the "male G-spot".

Clinical significance

Inflammation

Prostatitis is

of the prostate gland. It can be caused by infection with bacteria, or other noninfective causes. Inflammation of the prostate can cause painful urination or ejaculation, groin pain, difficulty passing urine, or constitutional symptoms such as

fever Fever or pyrexia in humans is a symptom of an anti-infection defense mechanism that appears with Human body temperature, body temperature exceeding the normal range caused by an increase in the body's temperature Human body temperature#Fever, s ...

or tiredness. When inflamed, the prostate becomes enlarged and is tender when touched during digital rectal examination. The bacteria responsible for the infection may be detected by a urine culture. Acute prostatitis and chronic bacterial prostatitis are treated with

antibiotic An antibiotic is a type of antimicrobial substance active against bacteria. It is the most important type of antibacterial agent for fighting pathogenic bacteria, bacterial infections, and antibiotic medications are widely used in the therapy ...

s. Chronic non-bacterial prostatitis, or male chronic pelvic pain syndrome is treated by a large variety of modalities including the medications

alpha blockers Alpha blockers, also known as α-blockers or α-adrenoreceptor antagonists, are a class of pharmacological agents that act as neutral antagonist, antagonists on Adrenergic receptor#.CE.B1 receptors, α-adrenergic receptors (Adrenergic receptor ...

, non-steroidal anti-inflammatories and amitriptyline,

antihistamine Antihistamines are drugs which treat allergic rhinitis, common cold, influenza, and other allergies. Typically, people take antihistamines as an inexpensive, generic (not patented) drug that can be bought without a prescription and provides ...

s, and other anxiolytics. Other treatments that are not medications may include

physical therapy Physical therapy (PT), also known as physiotherapy, is a healthcare profession, as well as the care provided by physical therapists who promote, maintain, or restore health through patient education, physical intervention, disease preventio ...

psychotherapy Psychotherapy (also psychological therapy, talk therapy, or talking therapy) is the use of Psychology, psychological methods, particularly when based on regular Conversation, personal interaction, to help a person change behavior, increase hap ...

, nerve modulators, and

surgery Surgery is a medical specialty that uses manual and instrumental techniques to diagnose or treat pathological conditions (e.g., trauma, disease, injury, malignancy), to alter bodily functions (e.g., malabsorption created by bariatric surgery s ...

. More recently, a combination of trigger point and psychological therapy has proved effective for category III prostatitis as well.

Prostate enlargement

An enlarged prostate is called prostatomegaly, with benign prostatic hyperplasia (BPH) being the most common cause. BPH refers to an enlargement of the prostate due to an increase in the number of cells that make up the prostate () from a cause that is not a malignancy. It is very common in older men. It is often diagnosed when the prostate has enlarged to the point where urination becomes difficult. Symptoms include needing to urinate often ( urinary frequency) or taking a while to get started ( urinary hesitancy). If the prostate grows too large, it may constrict the urethra and impede the flow of urine, making urination painful and difficult, or in extreme cases completely impossible, causing urinary retention. Over time, chronic retention may cause the bladder to become larger and cause a backflow of urine into the kidneys ( hydronephrosis). BPH can be treated with medication, a minimally invasive procedure or, in extreme cases, surgery that removes the prostate. In general, treatment often begins with an

alpha-1 adrenergic receptor alpha-1 (α1) adrenergic are G protein-coupled receptors (GPCRs) associated with the Gq alpha subunit, Gq heterotrimeric G protein. α1-adrenergic receptors are subdivided into three highly homologous subtypes, i.e., α1A-adrenergic, α1A-, α1B ...

antagonist An antagonist is a character in a story who is presented as the main enemy or rival of the protagonist and is often depicted as a villain.tamsulosin, which reduces the tone of the smooth muscle found in the urethra that passes through the prostate, making it easier for urine to pass through. For people with persistent symptoms, procedures may be considered. The surgery most often used in such cases is transurethral resection of the prostate, in which an instrument is inserted through the urethra to remove prostate tissue that is pressing against the upper part of the urethra and restricting the flow of

urine Urine is a liquid by-product of metabolism in humans and many other animals. In placental mammals, urine flows from the Kidney (vertebrates), kidneys through the ureters to the urinary bladder and exits the urethra through the penile meatus (mal ...

. Minimally invasive procedures include transurethral needle ablation of the prostate and transurethral microwave thermotherapy. These outpatient procedures may be followed by the insertion of a temporary stent, to allow normal voluntary urination, without exacerbating irritative symptoms.

Cancer

Prostate cancer is one of the most common

s affecting older men in the UK, US, Northern Europe and Australia, and a significant cause of death for elderly men worldwide. Often, a person does not have symptoms; when they do occur, symptoms may include urinary frequency, urgency, hesitation and other symptoms associated with BPH. Uncommonly, such cancers may cause weight loss, retention of urine, or symptoms such as

back pain Back pain (Latin: ''dorsalgia'') is pain felt in the back. It may be classified as neck pain (cervical), middle back pain (thoracic), lower back pain (lumbar) or coccydynia (tailbone or sacral pain) based on the segment affected. The lumbar area ...

due to lesions that have spread outside of the prostate. A digital rectal examination and the measurement of a prostate-specific antigen (PSA) level are usually the first investigations done to check for prostate cancer. PSA values are difficult to interpret, because a high value might be present in a person without cancer, and a low value can be present in someone with cancer. The next form of testing is often the taking of a prostate biopsy to assess for tumour activity and invasiveness. Because of the significant risk of

overdiagnosis Overdiagnosis is the diagnosis of disease that will never cause symptoms or death during a patient's ordinarily expected lifetime and thus presents no practical threat regardless of being pathologic. Overdiagnosis is a side effect of screening ...

with widespread screening in the general population, prostate cancer screening is controversial. If a tumour is confirmed,

such as an MRI or bone scan may be done to check for the presence of tumour in other parts of the body. Prostate cancer that is only present in the prostate is often treated with either surgical removal of the prostate or with

radiotherapy Radiation therapy or radiotherapy (RT, RTx, or XRT) is a treatment using ionizing radiation, generally provided as part of cancer therapy to either kill or control the growth of malignant cells. It is normally delivered by a linear particle ...

or by the insertion of small radioactive particles of iodine-125 or palladium-103, called brachytherapy. Cancer that has spread to other parts of the body is usually treated also with hormone therapy, to deprive a tumour of sex hormones (androgens) that stimulate proliferation. This is often done through the use of GnRH analogues or agents (such as bicalutamide) that block the receptors that androgens act on; occasionally, surgical removal of the testes may be done instead. Cancer that does not respond to hormonal treatment, or that progresses after treatment, might be treated with

chemotherapy Chemotherapy (often abbreviated chemo, sometimes CTX and CTx) is the type of cancer treatment that uses one or more anti-cancer drugs (list of chemotherapeutic agents, chemotherapeutic agents or alkylating agents) in a standard chemotherapy re ...

such as docetaxel.

Radiotherapy Radiation therapy or radiotherapy (RT, RTx, or XRT) is a treatment using ionizing radiation, generally provided as part of cancer therapy to either kill or control the growth of malignant cells. It is normally delivered by a linear particle ...

may also be used to help with pain associated with bony lesions. Sometimes, the decision may be made not to treat prostate cancer. If a cancer is small and localised, the decision may be made to monitor for cancer activity at intervals ("active surveillance") and defer treatment. If a person, because of frailty or other medical conditions or reasons, has a

life expectancy Human life expectancy is a statistical measure of the estimate of the average remaining years of life at a given age. The most commonly used measure is ''life expectancy at birth'' (LEB, or in demographic notation ''e''0, where '' ...

less than ten years, then the impacts of treatment may outweigh any perceived benefits.

Surgery

Surgery to remove the prostate is called prostatectomy, and is usually done as a treatment for cancer limited to the prostate, or prostatic enlargement. When it is done, it may be done as open surgery or as laparoscopic (keyhole) surgery. These are done under

general anaesthetic General anaesthetics (or anesthetics) are often defined as compounds that induce a loss of consciousness in humans or loss of righting reflex in animals. Clinical definitions are also extended to include an induced coma that causes lack of awaren ...

. Usually the procedure for cancer is a radical prostatectomy, which means that the seminal vesicles are removed and the vasa deferentia are also tied off. Part of the prostate can also be removed from within the urethra, called transurethral resection of the prostate (TURP). Open surgery may involve a cut that is made in the

perineum The perineum (: perineums or perinea) in placentalia, placental mammals is the space between the anus and the genitals. The human perineum is between the anus and scrotum in the male or between the anus and vulva in the female. The perineum is ...

, or via an approach that involves a cut down the midline from the belly button to the pubic bone. Open surgery may be preferred if there is a suspicion that lymph nodes are involved and they need to be removed or biopsied during a procedure. A perineal approach will not involve lymph node removal and may result in less pain and a faster recovery following an operation. A TURP procedure uses a tube inserted into the urethra via the penis and some form of heat, electricity or laser to remove prostate tissue. The whole prostate can be removed. Complications that might develop because of surgery include urinary incontinence and

erectile dysfunction Erectile dysfunction (ED), also referred to as impotence, is a form of sexual dysfunction in males characterized by the persistent or recurring inability to achieve or maintain a Human penis, penile erection with sufficient rigidity and durat ...

because of damage to nerves during the operation, particularly if a cancer is very close to nerves.

Ejaculation Ejaculation is the discharge of semen (the ''ejaculate''; normally containing sperm) from the penis through the urethra. It is the final stage and natural objective of male sexual stimulation, and an essential component of natural conception. ...

will not occur during orgasm if the vasa deferentia are tied off and seminal vesicles removed, such as during a radical prosatectomy. This will mean a man becomes infertile. Sometimes, orgasm may not be able to occur or may be painful. The penis length may shorten slightly if the part of the urethra within the prostate is also removed. General complications due to surgery can also develop, such as

s, bleeding, inadvertent damage to nearby organs or within the abdomen, and the formation of blood clots.

History

The prostate was first formally identified by Venetian anatomist Niccolò Massa in ''Anatomiae libri introductorius'' (Introduction to Anatomy) in 1536 and illustrated by Flemish anatomist

Andreas Vesalius Andries van Wezel (31 December 1514 – 15 October 1564), latinized as Andreas Vesalius (), was an anatomist and physician who wrote '' De Humani Corporis Fabrica Libri Septem'' (''On the fabric of the human body'' ''in seven books''), which is ...

in ''Tabulae anatomicae sex'' (six anatomical tables) in 1538. Massa described it as a "glandular flesh upon which rests the neck of the bladder," and Vesalius as a "glandular body". The first time a word similar to ''prostate'' was used to describe the gland is credited to André du Laurens in 1600, who described it as a term already in use by anatomists at the time. The term was however used at least as early as 1549 by French surgeon Ambroise Pare. At the time, Du Laurens was describing what was considered to be a pair of organs (not the single two-lobed organ), and the

Latin Latin ( or ) is a classical language belonging to the Italic languages, Italic branch of the Indo-European languages. Latin was originally spoken by the Latins (Italic tribe), Latins in Latium (now known as Lazio), the lower Tiber area aroun ...

term ''prostatae'' that was used was a mistranslation of the term for the

word used to describe the seminal vesicles, ''parastatai''; although it has been argued that surgeons in Ancient Greece and Rome must have at least seen the prostate as an anatomical entity. The term ''prostatae'' was taken rather than the grammatically correct ''prostator'' (singular) and ''prostatores'' (plural) because the

gender Gender is the range of social, psychological, cultural, and behavioral aspects of being a man (or boy), woman (or girl), or third gender. Although gender often corresponds to sex, a transgender person may identify with a gender other tha ...

of the Ancient Greek term was taken as female, when it was in fact male. The fact that the prostate was one and not two organs was an idea popularised throughout the early 18th century, as was the English language term used to describe the organ, ''prostate'', attributed to William Cheselden. A

monograph A monograph is generally a long-form work on one (usually scholarly) subject, or one aspect of a subject, typically created by a single author or artist (or, sometimes, by two or more authors). Traditionally it is in written form and published a ...

, "Practical observations on the treatment of the diseases of the prostate gland" by Everard Home in 1811, was important in the history of the prostate by describing and naming anatomical parts of the prostate, including the median lobe. The idea of the five lobes of the prostate was popularized following anatomical studies conducted by American urologist Oswald Lowsley in 1912. John E. McNeal first proposed the idea of "zones" in 1968; McNeal found that the relatively homogeneous cut surface of an adult prostate in no way resembled "lobes" and thus led to the description of "zones". Prostate cancer was first described in a speech to the Medical and Chiurgical Society of London in 1853 by surgeon

John Adams John Adams (October 30, 1735 – July 4, 1826) was a Founding Fathers of the United States, Founding Father and the second president of the United States from 1797 to 1801. Before Presidency of John Adams, his presidency, he was a leader of ...

and increasingly described by the late 19th century. Prostate cancer was initially considered a rare disease, probably because of shorter life expectancies and poorer detection methods in the 19th century. The first treatments of prostate cancer were surgeries to relieve urinary obstruction. Samuel David Gross has been credited with the first mention of a prostatectomy, as "too absurd to be seriously entertained" The first removal for prostate cancer (radical perineal prostatectomy) was first performed in 1904 by Hugh H. Young at Johns Hopkins Hospital; partial removal of the gland was conducted by Theodore Billroth in 1867. Transurethral resection of the prostate (TURP) replaced radical prostatectomy for symptomatic relief of obstruction in the middle of the 20th century because it could better preserve penile erectile function. Radical retropubic prostatectomy was developed in 1983 by Patrick Walsh. In 1941, Charles B. Huggins published studies in which he used

estrogen Estrogen (also spelled oestrogen in British English; see spelling differences) is a category of sex hormone responsible for the development and regulation of the female reproductive system and secondary sex characteristics. There are three ...

to oppose testosterone production in men with metastatic prostate cancer. This discovery of "chemical

castration Castration is any action, surgery, surgical, chemical substance, chemical, or otherwise, by which a male loses use of the testicles: the male gonad. Surgical castration is bilateral orchiectomy (excision of both testicles), while chemical cas ...

" won Huggins the 1966 Nobel Prize in Physiology or Medicine. The role of the

gonadotropin-releasing hormone Gonadotropin-releasing hormone (GnRH) is a releasing hormone responsible for the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the anterior pituitary. GnRH is a tropic peptide hormone synthesized and rele ...

(GnRH) in reproduction was determined by Andrzej W. Schally and Roger Guillemin, who both won the 1977 Nobel Prize in Physiology or Medicine for this work. GnRH receptor agonists, such as leuprorelin and goserelin, were subsequently developed and used to treat prostate cancer.

Radiation therapy Radiation therapy or radiotherapy (RT, RTx, or XRT) is a therapy, treatment using ionizing radiation, generally provided as part of treatment of cancer, cancer therapy to either kill or control the growth of malignancy, malignant cell (biology), ...

for prostate cancer was first developed in the early 20th century and initially consisted of intraprostatic radium implants. External beam radiotherapy became more popular as stronger

X-ray An X-ray (also known in many languages as Röntgen radiation) is a form of high-energy electromagnetic radiation with a wavelength shorter than those of ultraviolet rays and longer than those of gamma rays. Roughly, X-rays have a wavelength ran ...

radiation sources became available in the middle of the 20th century. Brachytherapy with implanted seeds (for prostate cancer) was first described in 1983. Systemic

for prostate cancer was first studied in the 1970s. The initial regimen of cyclophosphamide and 5-fluorouracil was quickly joined by multiple regimens using a host of other systemic chemotherapy drugs.

Other animals

The prostate is found only in mammals. The prostate glands of male

marsupial Marsupials are a diverse group of mammals belonging to the infraclass Marsupialia. They are natively found in Australasia, Wallacea, and the Americas. One of marsupials' unique features is their reproductive strategy: the young are born in a r ...

s are proportionally larger than those of placental mammals. The presence of a functional prostate in monotremes is controversial, and if monotremes do possess functional prostates, they may not make the same contribution to semen as in other mammals. The structure of the prostate varies, ranging from tubuloalveolar (as in humans) to branched tubular. The gland is particularly well developed in carnivorans and boars, though in other mammals, such as bulls, it can be small and inconspicuous. In other animals, such as marsupials and small ruminants, the prostate is disseminate, meaning not specifically localisable as a distinct tissue, but present throughout the relevant part of the urethra; in other animals, such as

red deer The red deer (''Cervus elaphus'') is one of the largest deer species. A male red deer is called a stag or Hart (deer), hart, and a female is called a doe or hind. The red deer inhabits most of Europe, the Caucasus Mountains region, Anatolia, Ir ...

and American elk, it may be present as a specific organ and in a disseminate form. In some marsupial species, the size of the prostate gland changes seasonally. The prostate is the only accessory gland that occurs in male dogs. Dogs can produce in one hour as much prostatic fluid as a human can in a day. They excrete this fluid along with their urine to mark their territory. Additionally, dogs are the only species apart from humans seen to have a significant incidence of prostate cancer. The prostate is the only male accessory gland that occurs in

cetaceans Cetacea (; , ) is an infraorder of aquatic mammals belonging to the order Artiodactyla that includes whales, dolphins and porpoises. Key characteristics are their fully aquatic lifestyle, streamlined body shape, often large size and exclusively c ...

, consisting of diffuse urethral glands surrounded by a very powerful compressor muscle. The prostate gland originates with tissues in the urethral wall. This means the urethra, a compressible tube used for urination, runs through the middle of the prostate; enlargement of the prostate can constrict the urethra so that urinating becomes slow and painful. Prostatic secretions vary among species. They are generally composed of simple sugars and are often slightly alkaline. In

eutheria Eutheria (from Greek , 'good, right' and , 'beast'; ), also called Pan-Placentalia, is the clade consisting of Placentalia, placental mammals and all therian mammals that are more closely related to placentals than to marsupials. Eutherians ...

n mammals, these secretions usually contain

fructose Fructose (), or fruit sugar, is a Ketose, ketonic monosaccharide, simple sugar found in many plants, where it is often bonded to glucose to form the disaccharide sucrose. It is one of the three dietary monosaccharides, along with glucose and gal ...

. The prostatic secretions of

s usually contain N-Acetylglucosamine or glycogen instead of fructose.

Skene's gland

Because the Skene's gland and the male prostate act similarly by secreting prostate-specific antigen (PSA), which is an ejaculate protein produced in males, and of prostate-specific acid phosphatase, the Skene's gland is sometimes referred to as the "female prostate". Although homologous to the male prostate (developed from the same embryological tissues), various aspects of its development in relation to the male prostate are widely unknown and a matter of research.

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Attribution

* Portions of the text of this article originate from NIH Publication No. 02-4806, a public domain resource.

External links

* * {{Authority control Exocrine system Glands Human male reproductive system Mammal male reproductive system Sex organs Sexual anatomy