The prostate gland is about the size of a walnut and surrounds the neck of a man's bladder and urethra—the tube that carries urine from the bladder. It's partly muscular and partly glandular, with ducts opening into the prostatic portion of the urethra. It's made up of three lobes, a center lobe with one lobe on each side.
As part of the male reproductive system, the prostate gland's primary function is to secrete a slightly alkaline fluid that forms part of the seminal fluid (semen), a fluid that carries sperm. During male climax (orgasm), the muscular glands of the prostate help to propel the prostate fluid, in addition to sperm that was produced in the testicles, into the urethra. The semen then travels through the tip of the penis during ejaculation.
Researchers don't know all the functions of the prostate gland. However, the prostate gland plays an important role in both sexual and urinary function. It's common for the prostate gland to become enlarged as a man ages, and it's also likely for a man to encounter some type of prostate problem in his lifetime.
Many common problems are associated with the prostate gland. These problems may occur in men of all ages and include:
- Benign prostatic hyperplasia (BPH). An age-related enlargement of the prostate that isn't malignant. BPH is the most common noncancerous prostate problem, occurring in most men by the time they reach their 60s. Symptoms are slow, interrupted, or weak urinary stream; urgency with leaking or dribbling; and frequent urination, especially at night. Although it isn't cancer, BPH symptoms are often similar to those of prostate cancer.
- Prostatism. The symptom of prostatism is decreased urinary force due to obstruction of flow through the prostate gland. The most common cause of prostatism is BPH.
- Prostatitis. This inflammation or infection of the prostate gland is characterized by discomfort, pain, frequent or infrequent urination, and, sometimes fever.
- Prostatalgia. This is pain in the prostate gland, also called prostatodynia. It's frequently a symptom of prostatitis.
Cancer of the prostate is a common and serious health concern. According to the American Cancer Society (ACS), prostate cancer is the most common form of cancer in men older than age 50, and the third leading cause of death from cancer.
There are two other types of treatments that can be used for either BPH or prostatectomy. However, there hasn't yet been enough research done to prove their long-term effects.
- High intensity focused ultrasound (HIFU). This procedure uses high-energy sound waves delivered to tissue. The energy that's targeted to tissue causes a heating effect, which then destroys or ablates prostate tissue. This treatment has been used more widely in Europe, and is being studied now in the U.S. Preliminary outcomes appear to indicate that this treatment is safe and fairly comfortable. However, it isn't the best approach for a very large prostate gland and can cause urinary retention.
- Laser prostatectomy or laser ablation. This is a newer procedure, but it can be performed on prostate glands that are larger. A laser works by releasing concentrated light energy in bursts lasting 30 to 60 seconds. It cuts through tissue with a minimum of blood loss. It's also precise enough to dissect away the prostatic lobes (on each side of the prostate gland) from the prostatic capsule. Any dead tissue remaining behind dissolves and eventually passes out through the urine.
While laser prostatectomy appears to be safe and effective, it has some drawbacks. Only trained practitioners are able to perform the procedure appropriately. There is, however, a relatively long post-operative recovery, which lasts several weeks before there's any significant improvement in urinary symptoms. Also, dead tissue can't be examined for signs of cancer cells once it's destroyed.