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Prostate issues and sex

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The prostate gland is an organ only found in the male species and men in particular. There has been a lot said about the prostate gland in the last few years. As doctors, we have known about it for a long time, but the general public seems as if it is just waking up to the prostate and the issues surrounding it.{{more}} Therefore, as you would expect, like Viagra, there are a lot of taboos and misunderstandings surrounding it. This week, I will look at the facts regarding the prostate.

The prostate gland is situated at the start of the urine passage at the exit of the bladder. It is like a signet ring around the area. As concise as that description is, it is still difficult for most people to visualize it, because it is deep inside the pelvis. The gland is pea-sized in boys before puberty, but becomes marble sized after puberty. It continues to increase very slowly over the next 20 years, to be the size of a Jamaican plum (the yellow plum) in his mid-30s. This is when you can begin to appreciate its size if a rectal examination is done. This is also why so little is known of the prostate, because it is not easy to touch like the ears, eyes or mouth. By the time you hit 50, the prostate is about the size of a Bequia plum (the red plum) and most men are beginning to realize that they have one, as they are beginning to have urinary symptoms. Few men would have been diagnosed with a “swollen prostate” and fewer still with “prostate cancer,” as this condition is rare at this age. By age 70, things have changed; most men would have had one or more prostate events, like an infection or a stoppage of the water, or have significant prostate symptoms. About 1 in 5 would have been diagnosed as BPH and half of these would be on treatment. About 4 in a hundred would have the diagnosis of prostate cancer, even though all the above figures are a tip of the iceberg, as most men do not go to doctors, so many do not know what they have. Indeed, a significant number of men say that if they have cancer they do not want to know.

The above outlines the changes in the prostate as men age, but many will ask what is the function of the prostate. The prostate is essential to our survival, as it produces a secretion during sex when men ejaculate. This secretion is actually part of the ejaculate or “cum” and it helps to keep the semen neutral and the sperms active. Let me explain: when you ejaculate or “cum”, most of the secretions come from the seminal vesicles and the prostate. The seminal vesicles are situated on top of the prostate, on either side of the neck of the bladder, in a Y-shaped configuration where the 2 arms of the Y are the seminal vesicles on either side of the bladder neck and the down-piece of the Y representing the prostate. Where the 3 join at the centre of the Y is where the “cum” leaves the glands and seminal vesicles and enters the urine passage. Incidentally, the vas deferens enters the urine passage at the same area in the Y. See diagram below. The secretion from the seminal vesicle is alkaline and thick and the secretion from the prostate is acid and watery. The seminal vesicles produce slightly more secretions than the prostate and together they account for more than 90% of the secretions; hence the testicles produce only a drop of the semen. This drop of secretions from the testicles contains about 100 million sperms and the secretions from the prostate and seminal vesicles help to nourish the sperms and keep them alive. In other words, the only known function of the prostate and seminal vesicles are to produce secretions that nourish and activate the sperms. So, if the prostate and seminal vesicles are not functioning for any reason, then the man will be infertile if the sperm count is normal. We will start to discuss prostate diseases next week.

For comments or question contact:
Dr Rohan Deshong
Tel: (784) 456-2785
email: [email protected]

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