Anatomy and Physiology The prostate gland is a walnut-sized gland and a pyramid-shaped organ with apex (contact to the

urethra and directed downward) and basis (contact to the bladder and directed upward). The prostate lies below the urinary bladder and is located in front of the rectum. The prostate weighs about 20 g (3 cm long, 4 cm wide, 2 cm thick). There are considerable prostate size variations. The seminal vesicles are located at the base of the prostate. It is located anterior to the rectum and just distal to the urinary bladder. It is in continuum with the urinary tract and connects directly with the penile urethra. It is therefore a conduit between the bladder and the urethra. Inner Gross Anatomy of the Prostate The prostatic urethra runs through the prostate gland, dividing the prostate into a left and right lateral lobe. The paired ejaculatory duct perforates the prostate and opens into the middle of the prostatic urethra at the seminal colliculus (Verumontanum). The prostate consists of about 30 glands with single ducts, which empty into the prostatic urethra. Zonal Anatomy of the Prostate Transition zone: It surrounds the urethra between bladder neck and colliculus, about 5-10% of the prostate volume. Benign prostatic hyperplasia is a reason for a dramatic increase of the transition zone volume and leads to lower urinary tract symptoms (LUTS). Central zone: It occupies the 25% of the prostate volume. The central zone originates probably from the Wolffian duct. The central zone forms a funnel (sagittal section) or ring-like (horizontal) zone, which contains the ejaculatory ducts. Peripheral zone: It has the 70% of the prostate volume, peripheral sections of the prostate gland.

Anterior fibromuscular stroma: The anterior fibromuscular stroma, 5% of the prostate volume, is located anterior to the urethra and extends into the transition zone. Physiology of the Prostate Prostatic secretion The prostatic fluid is thin, slightly acidic (pH 6.4) and forms about 20% of semen volume. It contains spermine (for the motility of sperms), spermidine, prostataglandins (for uterus stimulation), zinc (affects testosterone metabolism of the prostate), citric acid (buffer), immunoglobulins, phosphatases and proteases (liquefaction of the semen). Control of urine or semen flow The prostate acts as a kind of valve, preventing urine flow during the ejaculation and or permitting urine flow in between. Micturition is made possible under parasympathetic activity and low sympathetic activity, this leads to the relaxation of the bladder neck. Ejaculation is controlled by the sympathetic nervous system. The activation of prostatic alphareceptors leads to the contraction of the smooth muscle stroma of the bladder neck; this causes the expulsion of the prostate gland content and closes the bladder neck for an antegrade ejaculation. Injury of the sympathetic nerves (e.g. due to retroperitoneal lymphadenectomy) leads to retrograde ejaculation.