Dear members,
As desired by Sri. Seshadri. I post a write-up on Prostate Gland now. It will be in two parts as it will be a long one otherwise.
Prostate cancer will be dealt separately in a later post.
Hope this will be of use to many.
Varadarajan


Anatomy of the Prostate Gland

Illustration of the anatomy of the male reproductive tract

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Facts about the prostate gland:

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 is partly muscular and partly glandular, with ducts opening into the prostatic portion of the urethra. It is made up of three lobes: a center lobe with one lobe on each side.
Function of the prostate gland:

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, 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 leaves the body out through the tip of the penis during ejaculation.


Most clinical conditions of the prostate are benign (non-cancerous), including the following:

benign prostatic hyperplasia (BPH) - an age-related condition of the prostate that is not malignant. BPH is the most common non-cancerous 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 is not cancer, BPH symptoms are often similar to those of prostate cancer.
prostatism - the symptom of decreased urinary force due to obstruction of flow through the prostate gland. The most common cause of prostatism is BPH.
prostatitis - inflammation or infection of the prostate gland characterized by discomfort, pain, frequent or infrequent urination, and sometimes fever.
prostatalgia - pain in the prostate gland, also called prostatodynia. It is frequently a symptom of prostatitis.

These problems are quite common and may happen to men of all ages. Prostatitis is mainly a problem of men younger than age 50, and BPH primarily affects men older than age 50

What is erectile dysfunction (ED)?

Impotence, or erectile dysfunction (ED), may result from the total inability to achieve erection, an inconsistent ability to achieve an erection, or the ability to only sustain a brief erection. According to the National Institutes of Health (NIH), up to 30 million men are affected by ED, depending on the definition used.

Although in the past it was commonly believed to be due to psychological problems, it is now known that for most men erectile dysfunction is caused by physical problems, usually related to the blood supply of the penis. Many advances have occurred in both diagnosis and treatment of ED.

What are the risk factors for erectile dysfunction?

According to the American Urological Association, as men age, the level of circulating testosterone decreases, which may interfere with normal erection. While a low testosterone level itself is rarely the cause of ED (5 percent or less), low testosterone can be an additional contributing factor in many men who have other risk factors for ED. Other risk factors for ED include various medical problems such as hypertension (abnormally high blood pressure), diabetes, vascular disease, and high levels of blood cholesterol. Smoking and drug and alcohol abuse also are risk factors for ED.



Prostatitis

What is prostatitis?

Prostatitis is one of several benign (non-cancerous), inflamed conditions of the prostate gland. Acute prostatitis occurs suddenly, with sharp, severe symptoms. Chronic prostatitis develops gradually, recurs often, with the infection lasting for prolonged periods of time. Chronic prostatitis is typically difficult to treat.

Prostatitis and other prostate problems are generally treated by a urologist, a physician who specializes in the treatment of conditions involving the urinary tract in both genders, and conditions involving the genital tract of the male reproductive system.

What are the different types of prostatitis?

The following classifications of prostatitis are offered by the National Kidney and Urologic Disease Information Clearinghouse, a service of the NIDDK:

Acute bacterial prostatitis
Although the least common of all types of prostatitis, acute bacterial prostatitis occurs in men at any age and often with sudden onset and severe symptoms. It is important to seek treatment promptly as this condition is easy to diagnose. Men may find urination difficult and extremely painful. Other symptoms of acute bacterial prostatitis include fever, chills, lower back pain, pain in the genital (between the legs) area, urinary frequency, burning during urination, and/or urinary urgency at night, coupled with aches and pains throughout the body.
Chronic bacterial prostatitis
Although fairly uncommon, chronic bacterial prostatitis is a recurrent infection of the prostate gland that is difficult to treat. Symptoms of the infection are often similar to but less intense than acute bacterial prostatitis. However, symptoms of chronic bacterial prostatitis generally last longer and often fever is absent, unlike during an acute infection.
Chronic prostatitis/chronic pelvic pain syndrome
Chronic prostatitis/chronic pelvic pain syndrome is likely the least understood form of prostatitis, but the most common form of the disease. Symptoms may resolve and then reappear without warning. The infection may be considered inflammatory, in which urine, semen, and other secretions are absent of a known infecting organism but do contain infection-fighting cells, or the infection may be considered noninflammatory, in which inflammation and infection-fighting cells are both absent.
Asymptomatic inflammatory prostatitis
Asymptomatic inflammatory prostatitis may be diagnosed when infection-fighting cells are present, but common symptoms of prostatitis, such as difficulty with urination, fever, and lower back and pelvic pain, are absent. A diagnosis of asymptomatic inflammatory prostatitis is made most often during an examination for other conditions, such as infertility or prostate cancer.

What causes prostatitis?

Prostatitis is an infection that likely occurs due to bacteria that have entered the prostatic ducts from the rectum and/or as a result of a backward flow of infected urine.

Prostatitis is not a contagious condition and is not considered a sexually transmitted disease. It can result, however, from several different sexually transmitted diseases.
Who is at risk for prostatitis?

Although any man can develop prostatitis at any age, there are some conditions that put a man at greater risk for developing this condition, including the following:

Recent bladder, urinary tract, or other infection elsewhere in the body
Injury or trauma to the perineum (the area between the scrotum and the anus)
Abnormal urinary tract
Enlarged prostate
Rectal intercourse
Recent procedure involving the insertion of a urinary catheter or cystoscope

What are the symptoms of prostatitis?

The following are the most common, general symptoms of prostatitis. However, each individual may experience symptoms differently. Symptoms may include:

Urinary frequency and/or urgency
Burning or stinging sensation during urination
Painful urination
Reduced stream volume during urination
Rectal pain and/or pressure
Fever and chills (usually present with an acute infection only)
Lower back and/or pelvic pain
Discharge through the urethra during bowel movements
Sexual dysfunction and/or loss of libido (sex drive)
Throbbing sensations in the rectal and/or genital area

The symptoms of prostatitis may resemble other medical conditions or problems. Always consult your physician for a diagnosis.

How is prostatitis diagnosed?

The most effective treatment for prostatitis depends heavily upon an accurate diagnosis. In addition to a complete medical history and physical examination, diagnostic procedures for prostatitis may include the following:

Urine culture, including triple-void urine specimen collection (also called three-glass urine collection method) - often used in collaboration with the prostate stripping procedure, the three-glass urine collection method involves collecting and evaluating the prostatic fluid and urine for the presence of white blood cells and bacteria.
Digital rectal examination (DRE) - a procedure in which the physician inserts a gloved finger into the rectum to examine the rectum and the prostate gland for signs of cancer.
Semen culture
Prostate massage - a procedure in which prostate fluid is collected for examination. This procedure is usually performed during a digital rectal examination (DRE) and involves the physician "stripping" the prostate gland to drain fluid into the urethra. This fluid is then examined under a microscope to detect the presence of inflammation and/or infection.
Cystoscopy (also called cystourethroscopy) - an examination in which a scope, a flexible tube and viewing device, is inserted through the urethra to examine the bladder and urinary tract for structural abnormalities or obstructions, such as tumors or stones.

Treatment for prostatitis

Specific treatment for prostatitis will be determined by your physician based on:

Your age, overall health, and medical history
Extent of the condition
Your tolerance for specific medications, procedures, or therapies
Expectations for the course of the condition
Your opinion or preference

Treatment may include:

Acute bacterial prostatitis
Treatment of acute bacterial prostatitis usually involves antimicrobial medication for several days, up to two weeks. Treatment is usually effective for this type of prostatic infection, but involves taking the full course of medication to prevent the development of antibiotic-resistant bacteria even when symptoms are absent. Analgesic (pain-relieving) medications may also be prescribed as needed and patients may be advised to increase fluid intake. Hospitalization may be necessary in the most severe cases.
Chronic bacterial prostatitis
Treatment of chronic bacterial prostatitis usually involves antimicrobial medication for four to 12 weeks. This type of prostatitis is difficult to treat and recurrence is possible. If the infection does not respond to the antimicrobial medication, then long-term, low dose antimicrobial medication may be prescribed. Surgery may become necessary.

Always consult your physician for more information regarding the treatment of prostatitis.


Urinary Incontinence

What is urinary incontinence (UI)?

Urinary incontinence (UI) is the loss of urine control, or the inability to hold your urine until you can reach a restroom. According to the National Association for Continence, approximately 25 million adult Americans experience temporary or chronic urinary incontinence. UI can strike at any age. Women over age 50 are the most likely to develop UI. Urinary incontinence may be a temporary condition, resulting from an underlying medical condition. It can range from the discomfort of slight losses of urine to severe, frequent wetting.

What causes urinary incontinence?

Incontinence is not an inevitable result of aging, but is particularly common in older people. It is often caused by specific changes in body function that may result from diseases, use of medications, and/or the onset of an illness. Sometimes, it is the first and only symptom of a urinary tract infection.
What are some of the different types of urinary incontinence?

The following are some of the different types of urinary incontinence:

urge incontinence - the inability to hold urine long enough to reach a restroom. It is often found in people who have conditions such as diabetes, stroke, dementia, Parkinson's disease, and multiple sclerosis, but may be an indication of other diseases or conditions that would also warrant medical attention.
stress incontinence - the most common type of incontinence that involves the leakage of urine during exercise, coughing, sneezing, laughing, lifting heavy objects, or other body movements that put pressure on the bladder.
functional incontinence - leakage due to a difficulty reaching a restroom in time because of physical conditions such as arthritis.
overflow incontinence - leakage that occurs when the quantity of urine produced exceeds the bladder's capacity to hold it.

What are the symptoms of urinary incontinence?

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The following are the most common symptoms of urinary incontinence. However, each individual may experience symptoms differently. Symptoms may include:

inability to urinate
pain related to filling the bladder and/or pain related to urination without a proven bladder infection
progressive weakness of the urinary stream with or without a feeling of incomplete bladder emptying
an increased rate of urination without a proven bladder infection
needing to rush to the restroom and/or losing urine if you do not get to restroom in time
abnormal urination or changes in urination related to a nervous system
abnormality such as stroke, spinal cord injury, multiple sclerosis
leakage of urine that prevents activities
leakage of urine that began or continued after surgery
leakage of urine that causes embarrassment
frequent bladder infections

The symptoms of urinary incontinence may resemble other conditions or medical problems. Always consult your physician for a diagnosis.
How is urinary incontinence diagnosed?

For people with urinary incontinence, it is important to consult a physician for a complete physical examination that focuses on the urinary and nervous systems, reproductive organs, and urine samples. In many cases, patients will then be referred to a urologist, a physician who specializes in diseases of the urinary tract.

Treatment for urinary incontinence:

Specific treatment for urinary incontinence will be determined by your physician based on:

your age, overall health, and medical history
extent of the disease
your tolerance for specific medications, procedures, or therapies
expectations for the course of the disease
your opinion or preference

Treatment may include:

certain behavioral techniques (including pelvic muscle exercises, biofeedback, and bladder training)
medications
surgery (if the incontinence is related to structural problems such as an abnormally positioned bladder or a blockage)
diet modifications (including eliminating caffeine in coffee, soda, and tea, and/or eliminating alcohol)

Managing urinary incontinence:

Specifically designed absorbent underclothing is available - which is no more bulky than normal underwear and can be worn easily under everyday clothing. Also, incontinence may be managed by inserting a catheter into the urethra and collecting the urine into a container. Consult your physician with your questions regarding the management and treatment of urinary incontinence