By: Dr. Rajeev T P
The prostate is a male reproductive organ. This small gland is located below the bladder. Its main role is producing and fine-tuning semen.
The prostate has a variety of functions. Most important is producing seminal fluid, which is a component of semen. It also plays a role in hormone production. Further it helps in regulating the urine flow.
Prostate problems are common, especially in ageing men. The most common are inflammation of the prostate (prostatitis), enlargement of prostate (BPH ) and prostate cancer.
Symptoms of prostate trouble often appear as difficulty in urinating, which include poor bladder control or weak urine flow.
What is prostate?
The prostate is a small, soft organ. On average, it is roughly the size of a walnut or a ping-pong ball. It weighs around 30 grams and is usually soft and smooth to the touch.
The prostate lies deep in the pelvis, between the penis and the bladder. The urethra, a tube that carries urine and semen out of the body, passes through the prostate. Because the prostate surrounds this tube, prostate problems can affect urine flow.
What does the prostate do?
Helps to produce semen
The primary function of the prostate is to contribute prostatic fluid to semen. The prostate contributes approximately 20–30% of fluid to the total semen volume. The rest comes from the seminal vesicles (50–65%) and the testicles (5%).
Prostatic fluid contains substances that make semen an ideal medium for sperm cells to live in, including enzymes, zinc, and citric acid. One important enzyme is prostate-specific antigen (PSA), which helps make the semen thinner and more fluid.
The fluid in semen helps the sperm travel down the urethra and survive the journey towards an egg, which is essential for reproduction.
Prostatic fluid is slightly acidic, but other components of semen make it alkaline overall. This is to counter the acidity of the vagina and protect the sperm from damage.
Closing the urethra during ejaculation
During ejaculation, the prostate contracts and squeezes prostatic fluid into the urethra. Here, it mixes with sperm cells and fluid from the seminal vesicles to create semen, which the body then expels.
When the prostate contracts during ejaculation, it closes off the opening between the bladder and urethra, pushing semen through at speed. This is why, in normal situations, it is impossible to urinate and ejaculate simultaneously.
Hormone metabolism
The prostate needs androgens, like testosterone, which are male sex hormones, to function correctly.
The prostate contains an enzyme called 5-alpha-reductase, which converts testosterone into a biologically active form called dihydrotestosterone (DHT).
This hormone is important for normal prostate development and function. In the developing male, it is crucial for the development of secondary sex characteristics, such as facial hair.
Structure of the prostate
A capsule of connective tissue that contains muscle fibers surrounds the prostate. This capsule makes the prostate feel elastic to the touch.
The prostate is divided into four zones that surround the urethra like layers of an onion.
The following layers make up the prostate, beginning with the outer capsule and ending inside the prostate:
Anterior zone: Made of muscle and fibrous tissues, this zone is also called the anterior fibromuscular zone.
Peripheral zone: Mostly situated toward the back of the gland, this is where most of the glandular tissue sits.
Central zone: This surrounds the ejaculatory ducts and makes up around 25% of the prostate’s total mass.
Transition zone: This is the part of the prostate that surrounds the urethra. It is the only portion of the prostate that continues to grow throughout life.
Symptoms of prostate problems
Prostate conditions often cause problems with urination or bladder control. These include :
Poor bladder control, including frequent bathroom visits.
Urinary urgency, sometimes with only a small amount of urine.
Difficulty starting the urine stream, or stopping and starting the stream while urinating.
A weak or thin urine stream.
Prostate problems can also lead to problems with sexual function, urinary tract infections, bladder stones, or in extreme cases, kidney failure.
A person should see their doctor if they notice any of the following symptoms:
Pain while urinating or after ejaculation.
Pain in the penis, scrotum, or the area between the scrotum and anus.
Blood in the urine.
A weak urine stream or dribbling at the end of urinating.
Trouble controlling the bladder, such as stopping or delaying urination.
Unable to empty your bladder completely
What conditions affect the prostate?
Several medical problems can affect the prostate. These include:
Prostatitis
Prostatitis is a common swelling or inflammation of the prostate. This is the most common prostate problem in males under 50.
Acute prostatitis is a sudden inflammation of the prostate. This can occur due to a bacterial infection. It appears suddenly and clears up quickly with appropriate antibiotic treatment.
When prostate inflammation lasts for longer than three months, it is known as chronic prostatitis, or chronic pelvic pain syndrome.
Enlarged prostate
Enlargement of prostate, also known as benign prostatic hypertrophy (BPH), is the most common prostate problem in males over 50.
Most commonly, the enlargement occurs in the transition zone.
When the prostate enlarges, it presses and pinches the urethra, narrowing the urethral tube. The narrowing of the urethra and a reduced ability to empty the bladder cause many of the problems associated with this condition. As this condition persists, the bladder may become weaker and be unable to empty properly.
An enlarged prostate makes it difficult to urinate and, in rare, serious cases, can prevent urination totally. This condition called urinary retention requires urgent medical evaluation.
Prostate cancer
Prostate cancer is the most common form of cancer in males after skin cancer. It affects around 1 in 9 males during their lifetime.
Prostate medical tests
Medical professionals can diagnose problems with the prostate using various types of prostate exams.
Common prostate exams include:
Digital rectal examination. The doctor inserts a finger into the rectum and feels the prostate to detect lumps, nodules, and signs of cancer.
Prostate-specific antigen (PSA). Blood tests can assess the levels of this PSA. High levels indicate an increased risk of prostate cancer.
Prostate biopsy. If a doctor suspects cancer, they can take a small sample of prostate tissue for testing. To do this, they insert a needle into the prostate via the rectum.
Prostate ultrasound (transrectal ultrasound) : The doctor inserts a probe into the rectum, positioning it close to the prostate. Doctors usually carry out biopsies with guidance from an ultrasound.
Prostate MRI. This can show prostate anatomy in great detail, including identifying areas suspicious for cancer. New technology allows targeting of these areas through an MRI-ultrasound fusion biopsy.
Food for Good Prostate Health
What you eat can make a difference? There is plenty of strong evidence that good nutrition and an active lifestyle can reduce the likelihood of prostate cancer and slow its progression.
A few modifications you can make to your diet that make a big difference in overall health, as well as prostate health. It is recommended to consume a diet that is high in colourful vegetables, low in sugar and processed carbohydrates, and moderate in animal-based protein (taking advantage of the health benefits of beans, nuts, soy, and certain fish).
1. Tomatoes
Tomatoes contain a powerful antioxidant called lycopene. Research suggests that a diet high in lycopene helps in reducing the risk of developing prostate cancer.
Lycopene decreases cell damage and slows cancer cell production. It’s an antioxidant, meaning it protects cells from damage.
Because lycopene is tightly bound to the cell walls of raw tomatoes, the body has trouble extracting it. Cooked or puréed tomato products are better options, such as the following products:
Tomato paste.
Spaghetti sauce.
Sun-dried tomatoes.
Tomato juice.
2. Broccoli
Broccoli is a vegetable that contains many complex compounds that help protect some people from cancer.
Studies suggest there’s a link between the amount of cruciferous vegetables you eat — a group that includes broccoli — and a lower prostate cancer risk.
Broccoli contains phytochemicals like sulforaphane, which selectively target and kill cancer cells while leaving normal prostate cells healthy and unaffected.
Other cruciferous vegetables include cauliflower, cabbage, brussels sprouts, and kale.
3. Green tea
Green tea has been used for its health benefits for thousands of years. Researchers have conducted many studies on its effects on cancer.
Evidence suggests that special compounds in green tea may reduce the risk of prostate cancer by influencing tumour growth, cell death, and hormone signalling.
The following compounds could explain the health benefits of green tea:
xanthine derivatives
epigallocatechin gallate (EGCG)
epicatechin
4. Legumes and soybeans
Legumes include beans, peanuts, and lentils. Legumes contain biologically active plant compounds known as phytoestrogens.
Isoflavones are one such phytoestrogen. Studies found that people who ate the most phytoestrogens had a 20% reduced risk of prostate cancer
The cancer-fighting effects of phytoestrogens come from their antioxidant properties and effects on hormone regulation and cell death.
5. Pomegranate juice
Like green tea, pomegranates are a rich source of antioxidants.
Pomegranate juice has a reputation as a super fruit due to its high levels of antioxidants. Antioxidants may help prevent chronic diseases related to oxidative stress.
Pomegranate juice and some of its bioactive components help to inhibit the proliferation of prostate cancer cells.
6. Fish
Polyunsaturated fats, including omega-3s and omega-6s, are essential fatty acids found exclusively in the diet. They are not synthesised by the body.
The traditional Western diet has a lot of omega-6 fatty acids but not many omega-3s. Having a balance of omega-3 and omega-6 fatty acids is linked to better health outcomes.
Studies has shown a link between higher omega-3 fat consumption and a lower risk of high-grade prostate cancer and prostate cancer mortality.
Fatty fish have plenty of other health benefits. Try eating fatty fish found in cold waters to increase your omega-3 intake. These include:
salmon
herring
mackerel
sardines
trout
Conclusion
The prostate is a small muscular gland in male reproductive system. It produces an important fluid that helps transport sperm and keeps them safe. The prostate is important for reproduction. Some modifications in diet like drinking green tea, having fatty fish, legumes and vegetables rich in lycopenes and avoiding red meat are important for prostate health. Awareness related to prostate problems is important. If there is a suspicion of prostate related problem, one should consult a doctor immediately
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