sexology

PROSTATE

The prostate is a male gland that is located just below the urinary bladder and close enough to the rectum that it can be felt when a finger is inserted. Although the size may vary from man to man, the normal gland is usually about one and one-half to two inches at its widest point, weighs from 15 to 20 grams, and is composed of a glandular and muscular portion. It is usually described as being about the size of a chestnut or walnut. A portion of the urethra (the tube that leads from the urinary bladder) passes through the gland. The ejaculatory ducts, which are produced from the union of the vas deferens and the tubes from the seminal vesicles, run their entire length through the prostate gland and unite with the prostatic urethra. The glandular portion of the prostate produces about 30 percent of the seminal fluid, which is thought to be necessary before sperm can fertilize an egg. Tissue hormones called prostaglandins are produced by the prostate (as well as by many other tissues in the human body) and produce physiological reactions, usually in those tissues adjacent to the location at which they are produced.

Some workers have postulated that women have a "female prostate," which is rudimentary glands (Skene's glands) found around the urethra near the neck of the urinary bladder. These glands are produced from the same embryological tissue that produce the prostate gland. It has been suggested that the "female prostate" is the Grafenberg or G spot, or is at least anatomically related to it. The existence of either the "female prostate" or the G spot has not been adequately demonstrated to the satisfaction of many workers, and certainly not in all women.

The prostate contracts during the various stages of male orgasm. These contractions, along with contractions of other glands and various muscles, cause the semen to spurt from the end of the penis. The prostate is also a source of sexual pleasure for some men who enjoy being recipients of anal sex. The prostate can be stroked by inserting a finger, penis, or some other item into the anus to a depth of about three inches and gently pressing toward the navel. This is actually what a physician does when he or she conducts a digital examination of the prostate. Although these sensations are pleasurable to many men, some find them uncomfortable and, for that reason, are hesitant to submit to a digital examination.

A digital examination of the prostate can reveal changes that are important to the health of the man. The prostate remains about the same size from the time of puberty until about age 50, when it begins to enlarge. This growth can lead to a condition known as benign prostatic hypertrophy (BPH), which affects almost all men after the age of 60. The condition may cause reduction in the size of the prostatic urethra and ejaculatory ducts, thus producing problems of urination and ejaculation. Prostate cancer is the most common cancer of the male sex organs and is the third most common cancer of men. Its cause is unknown. Although it is uncommon in men younger than age 60, some workers believe that virtually all men who reach the age of 80 will have the beginnings of the disease. Because it is such a slow-growing cancer, most men of that age will not show symptoms before they die of some other cause. However, it does cause 17 percent of cancer in men, and, because men are living longer, about 70,000 new cases are reported annually.

Prostatitis (inflammation of the prostate) is an extremely common condition among men. Infectious prostatitis is caused by a bacterium, yeast, or virus and can be sexually transmitted. The condition can be either acute or chronic. Congestive prostatitis is a condition caused by abrupt change in the frequency of sexual activity. Thus, a man who greatly increases his number of ejaculations over a short period of time (this sometimes happens to men who are newly married) or a man who suddenly decreases his number of ejaculations may both develop the condition. This may happen when a spouse becomes ill and sexual contact is no longer possible. Masturbation is sometimes recommended in this case.

The initial symptoms of all of these conditions are general. They are lower-back pain, painful urination, urinary urgency or frequency, pain or discomfort during or after ejaculation, unexpected discharges from the penis, and blood in the urine or semen. Any combination of these symptoms should send the man to his physician, who will palpate the prostate to discover changes in the size, shape, or texture of the gland.

Most problems of the prostate are treated with antibiotics or surgery, especially if the condition is discovered early. Usually, there are no lasting effects from the treatment, although retrograde ejaculation and loss of some erectile ability may be a result of some surgery.