To Pee Or Not To Pee?
The prostate (gland) is kinda like wifi – we have only a vague idea of what either of them does and we only appreciate how wonderful they are oncewe a problem with them!
Of course, when I say “we”, I mean “men” because women don’t have a prostate for reasons that, hopefully, will become obvious later.
Prostates beaver away silently, shunning the limelight, usually only starting to shout “notice me” sometime after their owner’s fortieth birthday.
That newly attention-seeking prostate may have become cancerous - it’s the commonest cancer in British men, affecting 1 in 8 of them (mostly the over-sixties), and the second most common cancer in American men, second only to skin cancer (I'm pretty sure that reflects the lack of sunshine British men are exposed to!).
Despite those scary statistics, most husbands, brothers and uncles won’t develop prostate cancer but almost all of them will have their life impacted by an enlarged prostate – half of all men will be affected by age 60 and an astonishing 80% of all 70-year-olds are believed to have puffy nuisance of a prostate.
Living with an enlarged prostate has a whole host of consequences, everything from overly frequent but incomplete bladder emptying to embarrassing urinary dribbling and even, urinary tract and bladder infections.
Which begs the question, if prostates are so potentially pestiferous, what’s could be so brilliant about these glands that despite their mischief-making, evolution hasn’t got rid of them?
To answer that, we need to know where to find both the prostate and its key collaborators.
The prostate gland (not actually, a single gland but a bunch of 30 to 50 tiny glands) is tucked up beneath the bladder, collectively about the size and weight of a small plum.
A medical professional checking up on a prostate gland does so somewhat indirectly, inserting a finger into the rectum and pressing forward to feel the prostate on the other side of the rectal wall.
(Bearing in mind this hiding place and the above technique, am I the only person impressed that anatomists first identified this gland more than 2000 years ago?!)
Our geeky science diagram also shows the prostate’s partners – the testis, vas deferens, seminal vesicle, penis and urethra
Found them?
In males, the urethra has two responsibilities – moving urine from the bladder to the urinal and propelling semen out of the body during ejaculation.
Semen aka seminal fluid is produced as the result of a group effort by:
The testes which provide the sperm - a surprisingly low 5 - 10% of semen by volume.
The prostate and seminal vesicles which contribute the remaining 90-95%, mostly liquid.
Despite everything we’re told about the importance of men producing “good swimmers”, without that liquid even the Michael Phelps of sperm could never complete the journey through the 10-13” of reproductive plumbing (7-8” of male urethra, followed by 3-5” of female vagina).
But semen’s so much more then merely a sperm delivery system.
Semen contains some amazingly helpful substances (thanks again to the prostate and seminal vesicles), which help sperm survive in the very acidic environment of the vagina (around the same acidity as acid rain!), assist in sperm activation (vital for egg fertilization), and even appear to damp down the mother’s immune system, increasing the likelihood of a pregnancy being established.
Anyone enthusiastic to know more about the numerous components of semen can click here but I’ll name drop only one rather famous chemical addition - prostate specific antigen (PSA).
Often raised in men with prostate cancer, PSA was originally discovered by scientists looking for an aspect of male reproductive physiology to target as a male contraceptive. That didn’t pan out but those studies did reveal that PSA plays a key role in breaking down semen (a naturally gloopy fluid) into a thinner liquid that moves more easily, transporting more sperm to the right place at the right time!
It’s only at the point of ejaculation that all these components of semen are put together. At that crucial moment, the testes push millions of sperm into the bottom end of the vas deferens, the seminal vesicles eject their chemical cocktail into the top end of the vas deferens and the vas deferens propels everything then into the urethra.
(Just in case anyone needed a reminder of all these bits and pieces!)
At the same time, muscle within the prostate gland contracts, squeezing the prostate’s contributions into the urethra to mix with those from the testes and seminal vesicles.
And just as everything’s arriving and mixing in the urethra, that squeezing prostate also clamps shut the junction between the urethra and the bladder so a prostate owner never has to decide not to urinate whilst ejaculating!
It’s all taken care of for him.
This urethral clamping not only makes it impossible for urine to leave the bladder during ejaculation, it also ensures that semen can’t move backwards into the bladder - the only direction it can go is down the urethra and out!
As I don’t possess a prostate I might be underestimating most men’s gratitude for this gland but I strongly suspect that most men spend very little time giving thanks for these prostate actions!
But whilst prostate owners fail to appreciate its importance, by giving it the name, prostate, from the from the Greek for protector and guardian, science has shown it the utmost love and respect.
The prostate gland doesn’t protect and guard its particular owner against viruses or scary predator but those vital roles it plays during sex? Those make the prostate a protector and guardian of the human legacy, the survival of our species!
Finally, a little care’s needed to unravel the relationship between the prostate and urinary flow.
An enlarged prostate is often a pest - as it grows it starts to press on the bladder and the urethra, creating an almost constant “urge to go” but then preventing proper bladder emptying by squashing that urethral piping.
Men who have surgical removal of, typically, a cancerous prostate, may have difficulties controlling their urine flow after prostate surgery, many temporarily but some permanently. However, this is almost certainly a biproduct of unavoidable surgical damage to nerves and tissues in that area, rather than a consequence of a missing prostate.
For someone with a healthy, normally-sized prostate, any role the prostate plays in regulating urinary flow is tiny compared with its reproductive functions.
As always, B&B exists to shout to the world how amazing our bodies are, we’re not about giving medical advice.
But something just doesn’t feel right down there?
Feel your flow isn’t as fast and furious as it used to be?
Your partner’s frequent nocturnal bathroom visits waking you up?
Make that appointment!
Stay curious,
Doctor P
