PROSTATIC DISORDER

any of the abnormalities and diseases that afflict the prostate gland in the male reproductive system. The prostate gland is dependent on the hormonal secretions of the testes for growth and development. When production of the male hormone (androgen) decreases, the prostate begins to degenerate. Boys who are castrated before reaching puberty do not develop an adult-sized or functioning prostate. Normally changes occur in the prostate as a man ages. Between the fourth and sixth decades there is atrophy of the smooth muscles and an increase in fibrous scar tissue, collagen fibres (protein strands), and numbers of lymph cells. When a man passes the age of 60 years, the organ is largely replaced by fibrous tissue. In men over the age of 60 years, enlargement (hyperplasia) of the prostate is relatively common. In the vast majority of cases it causes no symptomatic difficulties, though infection may occur, as may rupturing of blood vessels. Enlargement may cause compression of the urethra with progressive obstruction of the flow of urine, incomplete emptying, or inability to void; there may also be a constant dribbling of urine. The bladder is never totally emptied, however, and the remaining urine becomes stagnant and infection sets in. The stagnant urine may cause the precipitation of stones in the bladder; the bladder muscle thickens to overcome this obstruction. If urine begins to back up in the kidney, progressive damage may ensue, which can lead to kidney failure and subsequent uremia (the toxic effects of kidney failure). Cancer of the prostate is one of the most common cancers. It may manifest itself in three forms: (1) cancer producing symptoms leading directly to the prostate, (2) hidden cancer that causes no prostatic symptoms but spreads to certain other parts of the body, and (3) latent cancer, where a slow-growing mass is found, usually at autopsy. Latent tumours are found in 25 percent of the male population over the age of 40 years. The cancerous prostate is usually hard and dry and shows small islands of yellow cancer cells distributed throughout the tissue. The cancer may spread from the prostate to the floor of the bladder and to all of the reproductive ducts leading into the prostate. The pelvic and spinal lymph nodes are involved early, as well as the bones of the pelvis. Cancer may spread to the liver, lungs, or bone by way of the blood system; about 70 percent of the cases show bone involvement. Infections of the prostate are common and are usually caused by bacteria that inhabit the stool. Gonorrhea, a venereal disease, may also affect the prostate. Treatment is usually administration of antibiotics.