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The Prostate Gland
 Prostate Gland is a chestnut-shaped male organ that surrounds the urethra below the bladder secreting a fluid into the semen that acts to improve the movement and viability of sperm. The prostate gland produces a secretion known as prostate fluid that makes up most of the liquid part of semen which is discharged from the penis during sexual orgasm. Measuring about 3 cm (about 1.2 in) across, the prostate gland is composed of both glandular tissue that produces prostate fluid and muscle tissue that helps in male ejaculation.
There are a variety of prostate disorders that commonly afflict men of all ages. The most common prostate disease is benign prostatic hyperplasia (BPH) or benign prostatic hypertrophy, a non cancerous condition of unknown cause. It occurs in approximately 70 to 80 percent of men as they reach their 70s and 80s. In BPH, the prostate gland can increase in size from 20 g (0.71 oz) which is the average size of the prostate in younger men to as large as 150 g (5.31 oz). As the prostate grows, it constricts the urethra possibly causing a partial obstruction of the bladder. Such obstruction may lead to bladder wall thickening and urination problems. Many symptoms of BPH stem from obstruction of the urethra and gradual loss of bladder function which results in incomplete emptying of the bladder. The symptoms of BPH vary but the most common ones involve changes or problems with urination such as
- a hesitant, interrupted, weak stream
- urgency and leaking or dribbling
- more frequent urination, especially at night
- a feeling that your bladder isn't empty after urination
You may first notice symptoms of BPH yourself, or your doctor may find that your prostate is enlarged during a routine checkup. When BPH is suspected, you may be referred to urologist, a doctor who specializes in problems of the urinary tract and the male reproductive system. Several tests help the doctor identify the problem and decide whether surgery is needed. The following are the most common tests given by the doctor.
Digital Rectal Examination (DRE)
This examination is usually the first test done. The doctor inserts a gloved finger into the rectum and feels the part of the prostate next to the rectum. This examination gives the doctor a general idea of the size and condition of the gland.
Prostate-Specific Antigen (PSA) Blood Test
To rule out cancer as a cause of urinary symptoms, your doctor may recommend a PSA blood test. PSA, a protein produced by prostate cells, is frequently present at elevated levels in the blood of men who have prostate cancer. The U.S. Food and Drug Administration (FDA) has approved a PSA test for use in conjunction with a digital rectal examination to help detect prostate cancer in men who are age 50 or older and for monitoring men with prostate cancer after treatment. However, much remains unknown about the interpretation of PSA levels, the test's ability to discriminate cancer from benign prostate conditions, and the best course of action following a finding of elevated PSA.
Rectal Ultrasound and Prostate Biopsy
If there is a suspicion of prostate cancer, your doctor may recommend a test with rectal ultrasound. In this procedure, a probe inserted in the rectum directs sound waves at the prostate. The echo patterns of the sound waves form an image of the prostate gland on a display screen. To determine whether an abnormal-looking area is indeed a tumor, the doctor can use the probe and the ultrasound images to guide a biopsy needle to the suspected tumor. The needle collects a few pieces of prostate tissue for examination with a microscope.
Urine Flow Study
Your doctor may ask you to urinate into a special device that measures how quickly the urine is flowing. A reduced flow often suggests BPH.
Cystoscopy
In this examination, the doctor inserts a small tube through the opening of the urethra in the penis. This procedure is done after a solution numbs the inside of the penis so all sensation is lost. The tube called a cystoscope, it contains a lens and light systems that help the doctor see the inside of the urethra and the bladder. This test allows the doctor to determine the size of the gland and identify the location and degree of the obstruction.
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