Lecture notes for medical students

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2. Introduction

3. Introduction
• Prostate is a fibromuscular glandular organ
surrounding the prostatic urethra.
• It lies just below urinary bladder and above
urogenital diaphragm.
• Samosa / Inverted pyramid shaped.

5. Anatomy

6. Anatomy
• A normal prostate gland is approximately
20 g in volume, 3 cm in length, 4 cm wide,
and 2 cm in depth.
• Surrounded by a fibrous capsule.
• Outside capsule- a fibrous sheath which is
part of visceral layer of pelvic fascia.

7. Transverse section

8. Parts

9. Parts
• Base
• Apex
• 4surfaces-
– Anterior
– Posterior
– 2lateral

10. Embryology

11. Embryology
• Embryologically, the prostate, seminal
vesicles, and ductus (vas) deferens originate
from 2 separate structures-
– The prostate arises from a budding collection of
tissue in the urogenital sinus.
– The seminal vesicles and the ductus deferens
are formed from the mesonephric duct.

12. Embryology
• The prostate develops from epithelial
outgrowths form the prostatic segment of
the urethra that grows into the surrounding
mesenchyme.
• This outgrowth and branching start at week
10 during embryo growth;

13. Embryology
• by week 12, there are 5 groups of tubules
that form the lobes of the prostate.-
• The first group makes up the middle lobe
• the second and third groups make up the
right and left lateral lobes;
• the fourth group is the posterior lobe that
starts from the floor of the urethra;
• fifth group is the anterior lobe.

14. Arterial Supply

15. Arterial Supply
Branches of-
1.Inferior Vesical artery.
2.Middle Rectal artery

16. Venous Drainage

17. Venous Drainage
• Veins form Prostatic venous plexus
between capsule and fibrous sheath.
• This plexus receives-
– Deep dorsal vein of penis
– Many visceral veins
• The plexus drains into Internal iliac veins.

18. Lymphatic Drainage

19. Lymphatic Drainage
• Into Internal iliac nodes

20. Nerve Supply

21. Nerve Supply
• Supplied by Inferior hypogastric plexus.

22. Relations

23. Relations

24. Relations
Anterior
• Symphysis Pubis
• Extraperitoneal fat in retroperitoneal space
(Cave of Retzius)
• Puboprostatic ligaments

25. Relations
Posterior
• Rectum
• Denonvillier’s fascia (Rectovescical
septum)
• The ejaculatory ducts pierce the upper part
to open into prostatic urethra at Veru.

26. Relations
Superior
• Neck of urinary bladder.
– The urethra enters center of the base .

27. Relations
Inferior
• Apex lies on urogenital diaphragm.
– The urethra leaves just above the apex on
anterior surface.

28. Relations
Lateral
• Embraced by the anterior fibres of levator
ani.

29. Lobes

30. Lobes
Incompletely divided into five lobes-
1. Anterior lobe (Isthmus)
2. Middle (Median)
3. Posterior
4. And 5 Rt and Lt. Lateral lobes seperated
by median groove.

31. Lobes

32. Verumontanum
• the openings of the prostatic ducts

33. Verumontanum
• The seminal colliculus or verumontanum,
of the prostatic urethra is a landmark near
the entrance of the seminal vesicles.
• Distinctive median elevation of urothelium
• The landmark is important in classification
of several urethral developmental disorders.
The margins of seminal colliculus are the
following:
• the orifices of the prostatic utricle
• the slit-like openings of the ejaculatory
ducts.

34. Microscopic Anatomy

35. Microscopic Anatomy
• The glands of the peripheral zone lined by
columnar epithelium, lie in the
fibromuscular stroma, and their ducts,which
are long and branched, open into
posterolateral grooves on either side of the
verumontanum.
• The glands of the CZ and TZ are shorter
and unbranched.

36. Zonal Anatomy
• Peripheral zone (PZ), which lies
mainly posteriorly and from which most
carcinomas arise, and a
• Central zone (CZ), which lies posterior to
the urethral lumen and
• Periurethral transitional zone (TZ), from
which most benign prostatic hyperplasia
(BPH) arises.

37. Zonal Anatomy

38. Sphinctors

39. Sphinctors
• Proximal smooth mucle urethral sphincter
• Distal striated urethral sphincter muscle

40. Physiology

41. Physiology
• Prostate produces a thin milky fluid
containing citric acid and acid phosphatase
which is added to the seminal fluid at the
time of ejaculation.

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