We are starting a series of articles devoted to such an urgent medical problem as inflammation of the prostate gland, or prostatitis. The first article will focus on the etiology (cause of development) of this disease.
At the beginning, we would like to briefly clarify for the general reader what the prostate gland is and what role it plays in the male body.
The Prostate Gland: Structure, Functions, and Importance for Men’s Health
Definition and main functions
The prostate gland (prostate) is an unpaired exocrine gland of the male reproductive system, whose anatomical location determines its primary functions. It has a specific shape, enlarges with age, and partially changes its appearance. The prostate consists of glandular and muscular tissue. The glandular tissue produces hormones and prostatic fluid, while the muscular tissue regulates the lumen of the urethra.
The size of the organ largely depends on the man’s body type. On average, the dimensions of the prostate are as follows: width – 3.5 cm, length – 3 cm, thickness – about 2 cm. Its weight does not exceed 20 g. The prostate resembles a walnut or a large chestnut in shape. Its narrower pole surrounds the initial part of the urethra, while the broader part adjoins the lower portion of the bladder and encircles its neck.
The functions of the prostate are multifaceted. The organ is responsible not only for stable sexual performance and fertility of sperm but also prevents the backflow of seminal fluid into the bladder and ensures proper urination. In other words, the functioning of both the urinary and reproductive systems largely depends on it. Two main functions of the prostate are distinguished: barrier and secretory. Let’s look at them in more detail.
The essence of the barrier function of the “second male heart”
The prostate acts as a dividing “checkpoint” that separates ejaculation from urination: the muscular part of the organ prevents seminal fluid from entering the bladder, functioning as its involuntary sphincter. In addition, it regulates urination quality, retains urine, and ensures its normal outflow at the right time.
The prostate also protects the male reproductive tract from infections. It prevents microorganisms that enter from the urethra from spreading to the upper urinary tract, protecting them from various infectious diseases.
The secretory function of the gland and its role in male sexual activity
The secretory function of the prostate is performed by the glandular tissue and includes:
- production of prostatic fluid, which determines sperm quality
- production of biologically active substances – prostaglandins, which are involved in the blood supply of the pelvic organs and ensure normal erection
- synthesis of male sex hormones: testosterone, enzymes, vitamins, immunoglobulins, citric acid, and prostate-specific antigen
Thanks to its developed innervation, the prostate also creates pleasant sensations during sexual intercourse. The secretion it produces liquefies ejaculate and ensures normal sperm motility.
So, what is the prostate in men? It is a vital organ, whose functional capacity determines a full sexual act, stable erection, quality urination, and male fertility.
The specific location of the prostate and its direct connection with the urethra make it vulnerable to infectious and inflammatory diseases, particularly prostatitis.
One of the pioneers in the study of prostatitis, Stamey T. (1980), believed that half of all men suffer from prostatitis at least once in their lifetime. More recent international studies (Robertson C. et al., 1999) confirmed this assumption: 35% of surveyed men reported prostatitis symptoms within the last year.
The impact of prostatitis on quality of life is significant and comparable to that of myocardial infarction, angina pectoris, and Crohn’s disease (Wenninger K., 1996).
Prostatitis. Risk Factors
Prostatitis has been spreading rapidly, with a trend toward younger patients. If previously the disease mainly affected men aged 35 and older, today even men over 20 are at risk. What factors can cause inflammation of the prostate, seemingly so well protected in the depth of the pelvis?
Predisposing factors for prostatitis:
- structural features of the prostate that lead to secretion stasis in the excretory ducts
- venous network features that promote blood stasis
- hormonal disorders (congenital conditions, uncontrolled use of hormonal drugs)
- peculiarities of nerve-reflex connections with the rectum and bladder
- age-related changes in the prostate and hormone levels
- congenital immune deficiency
Contributing factors for prostatitis:
- Chronic perineal trauma (e.g., prolonged horseback riding, cycling)
- Excessive sexual activity
It should be noted that excessively intense sexual activity negatively affects the prostate’s functional activity. Sexual ability, intensity, and character vary from man to man. Sexual activity largely depends on physical condition, mental state, and numerous external factors. Therefore, it is impossible to establish a universal “norm” for sexual frequency. Each man should determine it individually, based on his own capabilities and well-being. It is also important to remember that during intercourse and orgasm, all body systems are under increased strain, requiring higher nervous and energy expenditure.
The body can fully restore these expenditures if sexual activity remains within reasonable limits. However, if a man leads an excessively active sexual life beyond his physiological and psychological needs, it is called sexual excess. Moreover, daily sexual activity may sometimes be driven not by natural needs but by artificial psychological or mechanical stimulation. Such rhythm of sexual life, practiced systematically or for long periods with minimal breaks, may negatively affect prostate function. Too frequent intercourse leads to neurasthenia, functional sexual disorders, circulatory problems, glandular exhaustion, and reduced semen production. This may result in infertility and impotence.
Prostatitis. Causes
Smoking and alcohol
These two factors negatively affect the entire body, but alcohol, in particular, has a harmful effect on the prostate, causing swelling. Some men try to artificially enhance sexual arousal with alcohol. However, while alcohol may increase desire, it actually reduces sexual performance.
Alcohol and smoking also suppress the immune system, significantly lowering the body’s defense mechanisms. As a result, bacteria can penetrate the prostate almost unhindered, provoking inflammation.
Infections
Infectious agents, both gram-positive and gram-negative flora (E. coli, Proteus, Enterobacter, Klebsiella, and others). Untreated chronic diseases in men may trigger infections to spread hematogenously or lymphogenously to the prostate. Common causes include tonsillitis, bronchitis, herpes, sinusitis, and even caries. Pathogenic bacteria can also enter the prostate from the rectum or through the urethra.
In recent years, the list of infectious diseases has been expanded with so-called “mutant diseases.” The reason lies in environmental degradation, poor nutrition, and excessive use of medications, which weaken the body’s defenses and cause mutations of pathogens such as ARVI and herpes simplex virus. These mutated agents lie dormant until they trigger prostatitis, urethritis, and other diseases. Even minor hypothermia can activate them.
The most dangerous cause of prostatitis is sexually transmitted infections (chlamydia, ureaplasmosis, candidiasis, mycoplasmosis, gonorrhea, trichomoniasis, etc.). Initially, they cause urethritis (inflammation of the urethra). Without timely treatment, the inflammation spreads to the prostate itself, then to the pelvic organs, and eventually ascends to the kidneys, causing pyelonephritis.
Bacteria and viruses
- Mycobacterium tuberculosis
- Viruses (most often genital herpes – herpes simplex virus type 2, less commonly influenza virus)
- Immunological disorders (including autoimmune)
- Chemical damage due to urine reflux
- Neurogenic disorders
Lifestyle and habits
Hypothermia
Hypothermia of the pelvic area. This can happen to anyone, but is especially common among winter fishing enthusiasts, extreme sports lovers, or those exposed to cold drafts for long periods. Prolonged exposure to cold or drafts can trigger or exacerbate chronic prostatitis.
Sedentary or inactive lifestyle
Today, many professional drivers and truckers suffer from this “occupational” disease. Office work and prolonged sitting also reduce pelvic blood circulation, causing congestion in the prostate. When engorged with blood, the prostate “suffocates.” Remember the medical axiom: where there is congestion, there is inflammation.
Mental and physical strain
Depression, stress, chronic fatigue, and persistent sleep deprivation contribute to the development of prostate inflammation. Heavy physical exertion and overstrain during active sports can also negatively affect the prostate.
Irregular sexual life
Irregular sexual activity is another risk factor. During ejaculation, the prostate is naturally massaged. Without regular contraction, stagnation develops in the gland, leading to tissue swelling and increased internal pressure.
As a result, lymphatic and blood circulation are disrupted, followed by impaired nerve regulation of the gland, ultimately leading to chronic inflammation. That is why stagnant (chronic non-bacterial) prostatitis is also called “bachelor’s disease.” Irregular sexual activity, unfulfilled sexual desires, and inconsistent patterns (periods of excess followed by abstinence) also cause pelvic blood stagnation and accumulation of secretions in the prostate.
The primary cause of prostatitis is infection entering the gland, facilitated by the anatomical structure of the prostate. Infection may penetrate from the urethra, rectum, or via lymphatic and blood routes.
Prostatitis. Treatment
Inflamed prostate tissues undergo structural changes, disrupting cellular and glandular functions, which may result in serious consequences, including reduced libido, impotence, chronic pelvic pain syndrome, and urinary disorders. This is why it is so important to notice symptoms early and seek medical attention. The problem is that men are often afraid of this disease and, even noticing the symptoms, try to delay visiting the doctor.
Unfortunately, male psychology is such that if something is wrong “below the belt,” admitting it — let alone seeing a doctor — is not something they rush to do. Instead, they face these problems alone.
Yet such problems do not resolve on their own.
Sometimes men think their specific discomfort — perineal pain, painful and frequent urination, premature ejaculation — is temporary and will pass by itself. Some are, however, alarmed.
They realize that any prostate disorder, if left untreated, can eventually lead to impotence. They understand this, but still delay treatment. After a year or two, they are diagnosed with chronic prostatitis.
In many cases, prostatitis can be prevented. To do this, it is important to clearly understand what it is and the possible causes of the disease.
If any symptoms appear, you should immediately consult a urologist, because early detection and properly chosen treatment can guarantee recovery from prostatitis.
