Prostate: what it is and what it is used for

The prostate has an important function in the production of seminal fluid and undergoes some “variations” throughout life. It is therefore good to know the characteristics of this organ, the prevention strategies associated with it and the risk factors that can lead, with advancing age, to the development of a prostate disease.

What is prostate

The prostate is a solid, partly muscular and partly glandular organ, which is found only in the male sex at the base of the urethra. It has a rounded shape and secretes a liquid that is one of the main constituents of sperm.

The activity of the prostate is regulated by hormonal stimuli, in particular by the so-called androgenic hormones. During childhood the prostate gland remains in a state of rest and has small dimensions. With puberty, or with the beginning of testosterone production, it develops rapidly, weighing about 20 grams.

Where is the prostate?

The prostate is located between the base of the bladder and the urogenital diaphragm (also called trine), in front of the rectum (i.e. the last stretch of intestine, which ends with the orifice). In the front part of the prostate is covered by a muscle, the sphincter muscle of the urethra, which controls the leakage of urine and semen from the urethra itself. Posteriorly, the prostate comes into contact with the rectum: their proximity allows, as we will see, to examine the prostate with a rectal exploration.

What is the prostate used for?

The prostate plays an important role in the production of seminal fluid as it provides fundamental components for the survival and mobility of sperm. In the sperm, in fact, in addition to sperm cells there are substances that allow them to be kept in good condition until they reach the egg to be fertilized: proteins, lipids, prostaglandins, sugars (fructose), and enzymes are just some of them.

Together with the seminal vesicles, the prostate guarantees one of the greatest contributions to the formation of seminal fluid, with an intake of about 20-30% for each ejaculation.

The main prostate disorders

We frequently talk about the prostate, often referring to male health: the prostate gland can in fact be subject to some disorders, more or less serious.

For example, from the age of 40-50 the progressive physiological reduction of testicular activity causes a hormonal imbalance that causes the prostate to further increase in volume. This is a fairly common phenomenon: enlargement is usually gradual and progressive, often benign in nature (in this case we speak of benign prostatic hypertrophy). However, sometimes it can cause some annoying symptoms: the prostate, enlarged, can press on the urethra, thus limiting the regular flow of urine and causing often unpleasant symptoms, such as a burning sensation and difficulty urinating.

From 50 years of age, an annual visit with transrectal examination is therefore recommended to monitor the condition of the prostate.

As already mentioned, its position – in the context of the urinary and reproductive tract – makes it particularly delicate, even when a neoplasm develops. Prostate cancer is one of the most common in the male population: in the early stages it is asymptomatic, and may not cause disorders even for many years. In other cases, but as it develops it can involve some symptoms, such as difficulty urinating or, vice versa, the need to urinate often. You may also experience a sensation of pain while urinating and/or ejaculating, and it is possible that blood is present in both urine and semen.

The diagnosis takes place during a urological examination, which is often used to investigate the symptoms from which you suffer. The visit may involve both rectal examination and control of the dosage of PSA, i.e. prostate-specific antigen. This test, done through a blood sample, can also be used to verify the evolution of cases of prostate cancer that have already been treated through surgery, radiotherapy or hormone therapy.

In the event that the urologist deems it necessary, the patient will undergo a prostate biopsy, to evaluate the real presence of a neoplasm and possibly know its characteristics and stage, on which the choice of the most appropriate therapy will depend.

For prostate cancer there is still no real screening program (as is the case for breast cancer) because there is still no confirmation that the PSA test allows to identify the tumor in its early stage: the problem concerns cases of false positives, ie the fact that sometimes altered values are found despite the cancer is not present.

Given the importance of the prostate also in the formation of seminal fluid, it is not surprising that an inflammatory state (prostatitis) can lead to fertility problems. Inflammation of the prostate is quite common, and accounts for about 15-20% of male infertility cases. Often, at the base of infertility associated with a prostate disease, there is the action of some bacteria on the seminal tract. The seminal fluid, in fact, can undergo variations in viscosity, pH or the amount of substances present, such as zinc, fructose and citric acid. These changes can lead to impaired sperm function and, consequently, infertility.

Prostatitis can manifest itself in various forms, which are associated with different treatments. There is for example acute bacterial prostatitis, which is treated with antibiotics. If this remedy is not effective, bacterial prostatitis can become chronic, with recurrent infections that may, however, in some cases, be asymptomatic.

Chronic prostatitis can occur even in the absence of a bacterial infection: in this case we speak of chronic abacterial prostatitis, which represents the most frequent form of prostatitis. It is a condition at times elusive: the inflammation can subside until it disappears and then returns without warning. This pathology is also called pelvic pain syndrome or pelvic myoneuropathy: it is characterized by pelvic pain present for several months. The pain can be very variable – from mild to debilitating – and can present cyclically. Urinary disorders and widespread pain in the pelvic area and lower abdomen are quite common symptoms of this pathology. Ejaculation can be painful, as well as difficulties in having sex. The most used approaches are those oriented towards pharmacological treatment, accompanied by psychological interventions. Finally, it is also possible that prostatitis is completely asymptomatic: the patient does not perceive any symptoms or disorders but presents, in the semen or in the prostate secretion, evident traces of an infection.

Prostate: useful tests

In general, it is suggested to start considering a prostate screening examination around the age of 40, always taking into account any risk factors (such as a family history of prostate disorders).

Examinations, which are performed by a urologist, can be of various nature. Digitorectal exploration of the prostate, for example, is a “tactile” examination, during which the urologist checks the consistency, size and volume of the prostate gland through the rectum.

The examination of the PSA dosage, as anticipated, consists instead of a blood sample and the subsequent evaluation of the level of prostate antigen present. Although there is still no “agreement” on the standard values of normality, the prostate antigen is considered normal when its concentration in the blood is between 2 and 4 ng / ml. However, to interpret the values of this test, it is necessary to always consider the age of the individual: a prostate antigen value of 4 ng / ml can be considered completely normal if detected in a 70-year-old person, while it could be an “alarm bell” if found at 50 years of age. For a further clarifying investigation, the urologist can proceed to a transrectal prostate ultrasound, performed through a special probe.

The importance of prevention

The prostate is a very small component of the human body and, at the same time, extremely important and delicate: its function is fundamental in all mammals to ensure the survival of sperm, thanks to the production of a part of the seminal fluid, but its “hidden” nature means that the health and care of the prostate are considered as a marginal topic. Nothing could be more wrong: it is good to take into account a correct prevention activity by turning exclusively to qualified and specialized medical personnel. As we have seen, a mild symptom should not worry but, at the same time, we cannot underestimate manifestations that could be linked to some pathological condition. Despite the numerous information and prevention campaigns aimed at the public, even today many men do not care about the health of the prostate gland, thus exposing themselves to the risk of developing diseases with serious consequences if not treated for a long time.

First of all, it is advisable to contact your doctor who, if necessary, will be able to refer you to a specialist in urology to proceed with a check of the prostate gland.

In addition to regular visits, as always, one of the key factors to keep the whole organism, including the prostate gland, healthy, is to follow a correct lifestyle. To reduce the risk of inflammation and, consequently, that of disorders, a diet rich in fruits and vegetables, balanced and balanced is recommended. It is also good to carry out a correct physical activity, calibrated on the age of the individual, to maintain the right body weight. A sedentary lifestyle, improper nutrition and some bad habits (such as spending many hours driving a car) can increase the risk of developing prostatic diseases, even quite serious.