I. Introduction/General Information A. Attached inferiorly to urinary bladder by ligaments B. Posterior to pubic symphysis C. Surrounds superior portion of urethra D. Anterior to rectum (palpation, ultrasound) E. Conical shape
F. Walnut sized
1. 4 cm trans x 2 cm A/P x 3 cm Sup/Inf
G. Lightly encapsulated
1. Fibrous connective tissue 2. Smooth muscle 3. Capsule extends into lobes
D. Double Capsule 1. Fibrous portion contacts gland 2. External capsule formed by pelvic fascia 3. Venous plexus lies between
E. Conical shape with base (sup), apex (inf), four surfaces 1. Surfaces: posterior, anterior, right &
left inferolateral
Prostate Anatomy
Prostatic Urethra
3. Apex: inferior
a. Rests on superior fascia of urogenital diaphragm muscle
b. Associated with sphincter urethrae
4. Posterior surface: triangular, flat 5. Anterior surface: narrow, convex 6. Inferiorolateral surfaces
a. Meet with anterior surface b. Rest on levator ani fascia above urogenital diaphragm
3. Median lobe
a. Lies posterior and superior to prostatic utricle and ejaculatory ducts b. May project into urinary bladder c. Utricle lies within lobe
1. Vestigial remains of uterine homolog 2. Sometimes called uterus masculinis
4. Lateral lobes
a. Comprise the greatest mass of the gland b. Contain most secretory tissue
2. Veins
a. Form venous plexus b. Drain into internal iliac veins c. Communicate with vesical & vertebral venous plexuses
3. Lymphatics
a. Most terminate in internal iliac & sacral nodes (unable to palpate) b. From posterior: to external iliac nodes (unable to palpate)
H. Glandular tissue
b. Discharged at ejaculation
III. Pathology
A. Benign prostatic hypertrophy (BPH):
1. Affects ~90% of men >50
BPH, continued
2. Common cause of urethral obstruction: causes a. Nocturia b. Dysuria c. Urgency d. Back-pressure effects e. Complete obstruction can occur
Pathology, continued
B. Prostate cancer
1. Most common cancer in males
Pathology, continued
2. Metastasizes via blood (hematogenous) or lymph (lymphogenous) 3. Common sites: vertebrae, pelvis
a. Via venous plexus surrounding prostate b. Bone or direct metastasis most common
Pathology, continued
Pathology, continued
corpora
1. 2. 3. 4.
Small spherical or ellipsoid bodies Number increases with age May become calcified as male ages May simulate carcinoma
Pathology, continued