Health and Prostate

The Department of Urology of the New York Hospital
(Given January 31, 1941)

Introduction

One out of every four men over the age of 70 years has some deviation from the normal as regards the anatomical structure of the prostate gland. This fact was established by the author in a series of 250 consecutive autopsies on males at Bellevue Hospital. In addition, the prostate is subject to attack by various organisms in youth and young manhood, adding to the general incidence of prostatic disease. In later years, adenomatous hypertrophy and carcinoma and other malignancies enter the picture. The prostate gland is, therefore, an organ of considerable importance from the pathological standpoint, and must be reckoned with at all ages after puberty — and, indeed, even before puberty because sarcoma of the prostate occurs at any age.

Anatomical and Physiological Considerations

The prostate gland consists of five lobes: two lateral, a middle, an anterior and a posterior. There are two accessory structures: (1) the subcervical group of tubules, occurring under the mucosa at the vesical orifice, and (2) Homes’ gland, located in the mucosa of the middle of the trigonum vesicae. The various lobes of the gland send their ducts (averaging 63 in number) to open into the posterior urethra.

In adult life, the prostate is normally about as large as an English walnut. Located at the neck of the bladder, in a particularly strategic position for causing obstruction, even slight disturbances in the prostate assume exaggerated proportions.

The only proved function of the prostate gland is the production of a chemical substance which dilutes the testicular and seminal vesicular secretions and separates and activates the spermatozoa. The formation of an internal secretion has not been proved.

Injuries to the Prostate Gland

The prostate is well protected, but may be injured by external violence with fracture of the symphysis. More common are operative injuries and internal traumatism resulting from instrumentation.