The Prostate: Function and Diseases
From the size of an almond in puberty, due to hormonal signals, the prostate grows in size. It grows to the size and shape of a walnut and weighs about 20 grams. Almost all of this mass develops during puberty in response to hormonal changes associated with maturation. The prostate literally doubles in size during puberty.  If a man is lucky, and some are, the prostate never again undergoes any changes in size. The prostate is located in front of the rectum, has three lobes or sections, enclosed side by side in a capsule. The small urinary tube that empties the bladder, passes over the middle lobe. Anything that happens there to swell the prostate --- infection, inflammation, cancer, hypertrophy – can enlarge these lobes and thus obstruct the flow of urine , causing a wide spectrum of misery and discomfort. The Prostate's function is to produce fluid for semen, which transports sperm.

If you are visiting this site most likely you or someone you know is suffering from a prostate problem. The most common symptoms include: * difficulty initiating urination * weak urinary stream * frequent urination   • often with urgency   • often accompanied with incontinence * waking several times at night to urinate * sexual dysfunction and decreased libido The most common conditions are: * benign prostatic hyperplasia (BPH) * prostatitis * prostate cancer

• BPH or benign prostatic hyperplasia is a non-cancerous enlargement of the prostate. Symptoms result when the enlargement squeezes the urethra where it runs through the prostate. This non-cancerous enlargement of the prostate gland causes unpleasant symptoms such as urinary frequency, urgency, and weak urinary flow.2 BPH is the most common of prostate conditions among men. It is more common among older men, because as a man ages, his prostate naturally enlarges. Starting at about age 40, levels of a hormone called prolactin begin increasing in men, this stimulates an increased production of the enzyme 5-alpha reductase. This in turn increases the metabolism of testosterone, resulting in an increase of the metabolic byproduct di-hydro-testosterone or DHT. Dihydrotestosterone (DHT) is a steroid sex hormone that is produced from testosterone via the enzyme 5-alpha-reductase. DHT is the most potent naturally occurring androgen (male hormone)—in fact, scientists have estimated that DHT’s growth-promoting effects on prostate tissue are 10 times more potent than testosterone.1 Dihydrotestosterone is crucial to the development of normal male characteristics. Elevated levels of DHT in adult men, however, may have numerous deleterious or unwanted effects.3 Unfortunately for men between the age of 40 and 59, nearly 60% can be shown to already be suffering from benign prostatic hyperplasia. This usually does not present a noticeable problem until after the age of 50. By the age of 80, however, some 85% of all men suffer from one or more symptoms of BPH. As the prostate enlarges, the layer of tissue surrounding it stops it from expanding, causing the gland to press against the urethra.The bladder wall becomes thicker and irritated. The bladder begins to contract when it contains small amounts of urine, causing more frequent urination. Eventually, the bladder weakens and is unable to empty itself and urine remains in the bladder. The narrowing of the urethra and partial emptying of the bladder lead to many of the problems associated with BPH. It is important to note that BPH does not necessarily lead to cancer; however, a man can and may have BPH and cancer at the same time.

• Prostatitis is an inflammation of the prostate and is not contagious. The inflammatory process can be infectious or inflammatory in the origin. Prostatitis is caused by a bacterial infection in only 5% to 10% of all cases. The bacteria is similar to those which cause other types of urinary infections. Most patients however, have no evidence of bacteria in their prostates yet are thought to carry microorganisms such as Chlamydia or Ureaplasma. Approximately 50 % of men diagnosed with prostatitis are prescribed antibiotics for the treatment of the complex of symptom prostatitis despite the fact that they have no evidence of any actual infection. It is important to note that prostatitis sometimes develops from untreated BPH.

• Prostate cancer is a malignant tumor that often begins in the outer part of the prostate. As a prostate tumor grows, it may spread to the inner part of the prostate. Treatment options for prostate cancer include monitoring, hormonal therapy, radiation, brachytherapy and surgery.

Generally two tests are used to detect when men are at higher risk of prostate cancer and other prostate diseases. These are the digital rectal exam (DRE) and the prostate-specific antigen test (PSA test). A high PSA can indicate a greater chance of developing prostate cancer. However, a high PSA does not necessarily mean cancer is present; many men with BPH also have elevated PSA levels.

Evaluation of prostate cancer can be performed with standard MRI.
MRI accuracy is 89%. Despite the fact that MRI tends to overstage the tumer. Most physicians feel MRI does not provide added information over the results available from surgically invasive prostate biopsy pathology and PSA data.4