This authoritative book the largest selling book on prostate problems on the market will tell you which symptoms are important and what you should do about them. A complete guide to prostate health that includes information on the latest research, this book cuts through the medical jargon and gets right to the facts, answering such essential questions as:Are prostate problems an inevitable part of the aging process? What are the symptoms of an enlarged prostate? Does treatment for prostate disease necessarily result in impotence? Can too little sex cause a prostate problem? What is the likelihood of developing prostate cancer? What is the PSA test, and how accurate is it? What are the medical and surgical options available for prostate cancer? What are the pros and cons of each treatment? What should a man do to maintain prostate health? And Much More!
|Publisher:||Random House Value Publishing, Incorporated|
|Product dimensions:||5.77(w) x 8.57(h) x 0.77(d)|
About the Author
Sandra Salmans is a former staff writer for the New York Times and Newsweek. She is the author of two other books published by the People's Medical Society. Author home, New York City
Read an Excerpt
A Primer on the Prostate
Q: First things first. What is the prostate?
A: Probably not what you think it is. Most people, if they've heard of the prostate at all, think it's a male sex organ. It's not, although it's inthe vicinity. The prostate is actually a gland of the male reproductive system, located in front of the rectum and at the base of the bladder (the organ that stores urine). The prostate surrounds a part of the urethra, the tube that carries urine from the bladder out through the penis.
Sometimes people who have a vague idea what the prostate is -- who know, anyway, that it's not a sex organ -- confuse it with the prostatic urethra. That's the portion of the urethra that's within the prostate. And while we're on the subject of anatomy, here's a little more: The prostatic urethra ends at the external urethral sphincter, the muscle you voluntarily contract when you're urinating and want to stop the flow suddenly. There's another sphincter at the opening of the bladder, which operates involuntarily. Both function as valve mechanisms that provide urinary control in men.
Q: What does a prostate look like?
A: In an adult male, the prostate is about the size and shape of a large walnut and weighs about 20 grams, or a little less than one ounce. If you looked at it under a microscope, you'd see a mass of muscle, glands and connective tissue.
The outer surface of the prostate is covered by thick muscle, often called the prostatic capsule because it encapsulates, or encases, the gland.
While there isn't any actual demarcation within the prostate itself, doctors often speak of the gland as beingmade up of “lobes” or “zones.” The central zone surroundsthe urethra. A larger, peripheral zone envelops the central zone. And a small but medically important transitional zone lies within the central zone, adjacent to the urethral sphincter. When they examine the prostate for disease, doctors refer to these lobes or zones.
Q: So if the prostate's not a sex organ, what does it do?
A: As we said, it's a gland, because the definition of gland is something that produces secretions. But it's a pretty sexy gland, and its main role in life is sexual reproduction. Around the same time that a boy's testicles develop the ability to produce sperm, the prostate gland becomes mature enough to produce the seminal fluid that will support the sperm. There are lots of small glands within the prostate, and they're producing and storing secretions more or less continuously. In fact, the prostate makes about 90 percent of the milky semen in which spermatozoa travel outside the body during orgasm and ejaculation.
Q: So the sperm travel through the prostate?
A: It's a bit more complicated than that. At the risk of giving you another lesson in the birds and the bees, here's precisely what happens. We go into more detail than you need right now, because some of the anatomical parts we name here are going to play roles later in this book.
As every schoolboy knows, the testes manufacture sperm. The sperm are stored in a structure called the epididymis. During orgasm, another structure, called the vas deferens -- best-known as the subjects of the contraceptive operation called vasectomy -- push the sperm into the prostatic urethra. The sperm swim in fluid from the seminal vesicles, which are two saclike structures directly behind the base of the bladder. At the same time, the muscles of the prostate contract, pouring fluid into the prostatic urethra.
This broth of fluids is then propelled out, or ejaculated, by the spasmodic contractions of the muscles that surround the urethra. During sexual intercourse, the semen carries the sperm into the woman's vagina and uterus, and up into the fallopian tubes in order to fertilize an egg.
Q: Does the prostatic fluid serve any otherpurpose?
A: It supplies some nourishment to the fragile sperm. It's also thought that the fluid helps make the vaginal canal less acidic. All that increases the likelihood of conception.
Q: So ...no prostate, no sex, no baby?
A: It's a common misconception, if you'll excuse the pun, that men who develop prostatic problems can't have erections. The specter of impotence seems to loom over every unin-formed discussion of prostate. The good news is thatthe vast majority of men who are treated for prostatic disease are able to perform as well sexually as they did before. The bad news is that there's a minority of men whose sexual performance is permanently impaired. As for conception, obviously if there's no semen, there's no easy way of getting sperm to egg. But there are other ways, and we address all these important issues later in more detail.
Q: Sounds like the prostate can be trouble-some.Is that true?
A: In Chapter 2, we discuss all the things that can go wrong with the prostate gland. Suffice it to say, for now, that the prostate causes more misery for men than just about any other structure in the body. And sexual performance is affected less than other, more humdrum functions -- notably urination. More than half of all American men eventually develop enlarged prostates, some of which ultimately require surgery or other treatment. Approximately one in eight American men will be diagnosed with prostate cancer during his lifetime, and some 40,000 die each year from the disease. All that trouble from a seemingly innocuous little gland!