The prostate gland.
  • Largest accessory gland of the male reproductive system.

  • Has a rich fibro muscular stroma
Location  

At the bladder neck, surrounding the initial portion of the urethra

Prostatic sheath

  

This is the fascial sheath of the prostate
It is continous with:
a) Superior fascia of the urogenital diaphragm inferiorly.
b) Recto vesical septum posteriorly.
Relations  
Superiorly
  • Urinary bladder
Inferiorly
  • Urogenital diaphragm
Anteriorly
  • Pubis
Posteriorly
  • Seminal vesicles
  • vas deferens
  • Rectum
Through it
  • Prostatic urethra.




Surfaces  
  • Base, facing  upwards, apex facing downwards
  • Posterior and anterior
  • Infero lateral
Lobes  
  • The prostatic urethra and the ejaculatory ducts divides the prostate into the median and lateral lobes.
  • The median is antero superior to the ejaculatory ducts.
  • The lateral lobes, form the mai mass of the gland are continuous posteriorly and are separated by the prostatic urethra.

Blood supply

  
  • Internal pudendal
  • Inferior vesical
  • Middle rectal
The veins from the prostatic venous plexus, located between the capsule of the prostate and the prostatic sheath. The plexus drains into the internal iliac veins. It also communicates with :
- vesical venous plexus
-vertebral venous plexus

 

Lymphatics

  
  • Mainly from the internal iliac and sacral lymph nodes. Some go the external iliac lymph nodes.
 

Innervation

  
  • Autonomic , from inferior hypogastric plexys.

Clinical correlates

  

Benign prostatic hypertrophy occurs in many old men, and is among the commonest causes of urinary retention in old men. Prostatectomy, removal of the prostate is the surgical treatment.

Cancer of the prostate is one of the most commost tumors of men. It spreads via both blood and lymoh vessels
It metastatises to the vertebral column (and CNS) and pelvis through the valveless venous communications between the prostatic venous plexus and vertebral venous plexuses.
The cancer cells can also reach the inferior vena cava and spread to all parts of the body.

Rectal examination of the prostate is the preferred method since the posterior surface of the prostate is in contact with the rectum. Only the anterior rectal wall and the rectovesical septum intervene.

Summary of Pelvic Viscera