Prostate: Structure, Function & Screening

The prostate has various functions in the male body:

• Secreting a fluid that is important for the sperm: A special secretion is produced in the prostate. This mixes with the secretion from the seminal vesicle and the sperm cells produced in the testicles. Together, this forms the seminal fluid. Prostate secretions and the proteins in it are essential for sperm motility and hence also for fertility.

• Closing the urethra: If ejaculation occurs, the prostate together with the bladder sphincter closes the urethra in the direction of the bladder so that seminal fluid does not enter the bladder.

• Closing the seminal ducts: The muscles of the inner zone close the prostate during urination so that urine does not flow into it.

• Involvement in hormone metabolism: The male sex hormone testosterone is converted in the prostate into dihydrotestosterone (DHT), a biologically active form of the hormone that can then act in the body. DHT is involved in the development of body hair, for example.

Most of the time, the prostate and its functions go unnoticed. It usually only becomes a problem when symptoms appear. In young men, a healthy prostate is about the size of a chestnut. In the course of life, the gland grows in many men, which in turn can lead to a constricted urethra and problems while urinating. In this case, we talk of a benign prostate enlargement (benign prostatic hyperplasia, in short: BPH). More than one in four men over the age of 50 has such a significant enlargement that treatment (for example with medication or, in the case of significant enlargement, possibly involving surgery) is necessary to alleviate the symptoms.¹

To prostrate enlargement

Other problems with the prostate can include::

• Prostatitis: This is an inflammation that can occur when bacteria get into the prostate. Prostatitis is typically accompanied by pain, especially when urinating. Around 15 per cent of all men are affected at least once in their lives.²  Treatment often involves painkillers and antibiotics (for bacterial infections).
• Prostate stones: Small calcium deposits can form from the secretions of the prostate, which are deposited in the prostate. They usually do not cause any problem, but sometimes there is pain in the pelvic area and/or problems when urinating. In this case, therapy with medications or surgical removal of the stones (as part of treating an enlarged prostate) may be considered.
• Prostate cancer: Prostate cancer is a malignant tumour that develops inside the prostate. It is the most common form of cancer in men in Germany.³ Symptoms (e.g. blood in the urine or severe pain) usually only appear once the cancer has spread, for example to the urethra. It is therefore very important to undergo medical examinations for detecting prostate cancer in early stages.

Do you suffer from prostate problems caused by inflammation of the prostate or age-related enlargement? APOGEPHA medicines contain a combination of herbal ingredients that help alleviate typical symptoms of the disease.

In order to identify prostate changes at an early stage, early detection tests are available. You can also take action yourself when it comes to prostate screening and ensure the health of your prostate.

Early detection tests for the prostate at a glance

• Physical examination (palpation): During a digital rectal examination, a doctor carefully feels the prostate with a finger, starting from the anus. In addition to prostate abnormalities (such as an enlargement or lump), any changes in the rectum and anus can also be detected, such as tears in the mucous membrane. The examination itself only takes a few seconds and is usually painless. However, digital rectal examination alone is considered relatively inaccurate, which is why a PSA test is then used in case of abnormalities. The physical examination is recommended once a year for men aged 45 and above.  The costs for this are borne by the health insurance company. If there is a family history (prostate cancer in the close family circle), regular physical examinations should be carried out from the age of 40 onwards.
• PSA test: This involves analysing the amount of a special protein – the prostate-specific antigen (PSA) – in the blood of the person (male) being examined. If the value is high, this may indicate prostate cancer. As there may also be other causes (for example, prostatitis or benign enlargement) for a high value, this alone is not very meaningful and further tests may be required. The PSA test is an individual health service and the patient has to bear the costs. The costs for the test and the medical consultation comes to around 25 to 35 euros. If the PSA test was prescribed by the doctor following a physical examination, the health insurance company will cover the costs.

If prostate cancer is suspected after physical examination and a PSA test, other methods are used, such as a transrectal ultrasound (imaging procedure via the rectum that shows the condition of the prostate) and taking and analysing a tissue sample from the prostate (prostate biopsy). In this way, prostate cancer can be diagnosed or ruled out with a high degree of probability.

What you can do yourself for prostate screening

The term "screening" generally refers to all measures that help to prevent an illness. You can keep your prostate healthy using the following measures:

• Eat a balanced diet with less meat (especially red meat) and instead opt for a large portion of plant-based foods such as vegetables.
• Try to reduce any excess weight in the long term. If your weight is normal, try to maintain this weight in the future.
• Incorporate plenty of exercise and regular sporting activity into your daily routine to stay fit and active.
• Drink only small quantities of alcohol. It is even better for your body to avoid it altogether. Also avoid smoking (e-)cigarettes.

If you pay attention to these aspects and undergo the recommended early detection tests, you are already doing a lot in terms of screening for your prostate. If you still have doubts, your doctor can advise you individually.

Quellen

• ¹ “Benign prostate enlargement”. Cologne University hospital, https://urologie.uk-koeln.de/erkrankungen-therapien/gutartige-prostatavergroesserung/. Accessed on 28 June 2024
• ² "Inflammation of the prostate (prostatitis) - symptoms and treatments". Prostate Help Germany, https://www.prostata-hilfe-deutschland.de/prostata-news/prostataentzuendung-prostatitis. Accessed on 28 June 2024.
• ³ “Prostatakrebs (Prostatakarzinom)” (Prostate cancer (prostate carcinoma)). Cancer Information Service, German Cancer Research Centre, https://www.krebsinformationsdienst.de/prostatakrebs. Accessed on 28 June 2024.