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The prostate anatomy

1.Complicated Neighborhood Relationship:
The prostate is a subsidiary gland organ in male genitourinary system.It is adjacent to the Seminal Vesicles, Vas Deferens, urethra, bladder and rectum, so chronic prostatitis often follows after infections of other genitourinary organs and prostatitis often comes with Seminal Vesiculitis. Because urethra is connected to the outside, bacteria could easily penetrate to the prostate through urethra and cause infection. Negligence of genital sanitation, indulgences on sex, stones of genitourinary organs, piles and abscess around anus could spread the infections to the prostate. Even the infection of the prostate has been cured in time, there are still threats of recurrences because its neighbors are not so friendly.
2.The prostate figure  
The prostate is a variable-sized gland located in the male pelvis, usually the size of a walnut measuring 3-4 centimeters long by 3-5 centimeters in width. On average the gland weighs about 20 grams. It is found behind the pubic bone, in front of the rectum, and below the bladder, surrounded by the pelvic muscles. The prostate surrounds the urethra which carries urine from the bladder to the penis and travels in the center of the gland. The seminal vesicles attach to the prostate and produce material that mixes with prostatic fluid to form semen. The tubes from the testicles carry sperm to the prostate where the
sperm are mixed with the prostate and seminal vesicle fluid. This fluid is then ejaculated during orgasm by a connection to the urethra called the ejaculatory ducts.

Prostate anatomy

     front                                        back

For many years the prostate was thought to exist in "lobes", however, we now refer to the prostate as having various concentric zones. These zones are termed: anterior fibromuscular stroma, peripheral zone, central zone, and transition zone. It is the peripheral zone of the prostate that a doctor can feel by a finger in the rectum. Almost all prostate cancers start in the peripheral zone, thus, the importance of the rectal examination. The transition zone generally accounts for less than 5% of the total prostate
volume. Nonetheless, it is the exclusive site for the development of benign prostatic hyperplasia (BPH) and may therefore become massive. The central zone is involved with the connection of the seminal vesicles to the prostate and is rarely associated with any disease process. The anterior fibromuscular stroma is the anchoring point of the urethral sphincter that controls urination: it does not have any glands and therefore cancer or enlargement does not develop here.

3. The prostate function

  The prostate gland is a walnut-sized gland that surrounds the urethra (the tube that carries urine from the bladder to the penis) and lies at the base of the bladder. This gland secrets about 25% of the seminal fluid that's combined with sperm during ejaculation. The prostatic fluid acts as a lubricant to prevent infection in the urethra and protects and energizes sperm.Normal ejaculation produces about 3 cc of semen. The sperm make up less than 1% of the volume, with the seminal vesicles and prostate producing about 95 % of the total volume. The ejaculate is very rich in unusually high concentrations of potassium, zinc, citric acid, fructose, and prostaglandins.The human prostate is a remarkable organ that has an essential function in human reproduction. It is
made up of many different cell types that have complex and poorly understood interactions with each other. The male hormone testosterone and its related hormones have a major role in the growth and function of the prostate. The zonal anatomy of the prostate combines these cellular elements into a beautiful design for efficient mixing of fluids to allow human reproduction. However, beyond the reproductive years, this same architecture contributes to many of the health problems of means uncontrolled or poorly regulated cellular growth causes damage to vital bodily functions.

4.Anatomic Complexity:

The chestnut-shaped prostate is located deep inside the pelvic floor, sits right below the bladder and is wrapped around the urethra. The prostate is a fibro-muscular exocrine gland, a male accessory reproductive gland of the genitourinary. It is a compound tubuloacinar gland composed of 25-30 small tiny acini or sacs located in the periphery of the prostate, and each glandular unit is connected to the outside by a tiny duct, which opens into the urethra at each side. The prostate is covered by a thin vascularised fibrous sheath, which surrounds a fibromuscular layer continuous with the smooth muscle surrounding the bladder.
When bacteria penetrate into the acini and grow there, the swelling and inflammation caused by the infection closes off the acini, causing it not to "shed" bacteria, and protecting the bacteria inside from antibiotics. That is the reason why antibiotics are not effective in treating chronic prostatitis. With E&D Treatment, antibiotics are able to penetrate the membrane of the prostate, thus killing the bacteria inside the acini and reopen the acini. Dead bodies and pus are then flushed out of the body through urethra.

5.Pathological Complexity:
It is normal that bacteria live in penis urethra and the membranous urethra. Normally, they could also live in the prostate. A portion of chronic prostatitis is nonbacterial; for example, Chlamydia, Mycoplasma, virus, yeast or autoimmune diseases could be one of the causes. If treated by antibiotics, patients' health will be impaired and it could take a long time without a permanent cure. Some of the patients develop tiny calculus in the prostate and couldn't easily be resolved by oral antibiotics. Blockage of prostate glands by calculus could also induce the recurrence of infection.
The clinical reasons for bacterial prostatitis are:
1)Bacteria enter the urethra and reach the prostate
2)Blood infection, tooth infection, tonsil infection, upper respiratory tract infection, skin disease
3)Pathological changes near the prostate (rectum and anus infection through lymphatic glands)
4)Acute prostatitis to chronic prostatitis
5)Complications from Cystitis or Pyelonephritis
6)Excessive drinking, cold, excessive sex life and harmful sexual habits, damage in perineum, chronic constipation.
7)Penis urethra blockage and difficult urination.
All of the above could lead to nonbacterial hyperemia of the prostate and create a perfect environment for the invasion and propagation of bacteria.

6.Complex Relationships between Immunity and Pathogens:
The severity of chronic prostatitis depends on immunity of the body and strength of pathogen. The level of defense of the immune system significantly determines whether one will get infection, the severity of infection and the difficulty of treatment.
  The common factors on the level of defense are heavy drinking, frequent masturbation, long distance cycling, siting too long, excessive fatigue, getting a cold and negative thought.
Different pathogens have different strength on human body. For example, Staphylococcus epidermis and E. coli are called conditional pathogens. These pathogens could infection our body only when the immune system is very weak. Conversely, the strongest pathogens could infect almost everyone, such as Chlamydia, Mycoplasma and Gonococcus. The traits of a particular pathogen, amount of invaded pathogen and the growth of them are also the factors. Spicy and high-protein food promotes the growth of pathogen and increases the chance of getting prostate infection.
  The majority of chronic prostatitis cases are mixed infection. Bacterial and nonbacterial prostatitis has an unusual close relationship and could swap reciprocally, that is exactly the core problem of treating chronic prostatitis. Effective treatment and prevention are not possible if one is ambiguous of the relationship between the two of them.

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