Prostate: Difference between revisions

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* The narrowed '''apex is the most inferior portion of the prostate gland,''' reaching the urogenital diaphragm. '''The apex of the prostate is continuous with the striated urethral sphincter'''

* '''The prostate is fixed to the pubic bone anteriorly by the puboprostatic ligaments near the apex of the prostate'''

* '''~~70%~~ of ~~the prostate’s composition is glandular elements, 30% is fibromuscular stroma.'''~~

* '''Composed of (2):'''

** The non-glandular anterior fibromuscular stroma is found extending from the bladder neck to the striated sphincter

**'''Fibromuscular stroma'''

** '''Glandular elements divided into 3 anatomic zones:'''

**'''Glandular elements'''

**# '''Peripheral zone'''

**#* '''Largest zone''' (~~≈70% of the glandular prostate tissue~~)

**#* '''Most (70%) prostate cancers occur in the peripheral zone'''

**# '''~~Central zone'''~~

**#* ≈25% of the glandular prostate tissue

**#* '''Surrounds the opening of the ejaculatory ducts'''

**# '''~~Transitional zone'''~~

**#* '''Smallest zone''' (3-5% of the glandular prostate tissue)

**#* '''Separated from the rest of the glandular compartments of the prostate by a distinct fibromuscular band'''

**#* '''Benign prostatic hyperplasia most commonly occurs in this zone'''

**#* '''≈20% of prostate cancers occur in the transitional zone'''

~~Insert figure~~

=== Fibromuscular stroma ===

* '''≈30% of the prostate's composition'''

* Non-glandular component

* Continuous with the detrusor fibres of the bladder neck and tapers distally toward the striated sphincter area[https://www.baus.org.uk/_userfiles/pages/files/Publications/Transrectal%20Ultrasound%20%20Prostatic%20Biopsy%20FINAL.pdf]

*Tightly adherent to the glandular tissue of the prostate[https://www.baus.org.uk/_userfiles/pages/files/Publications/Transrectal%20Ultrasound%20%20Prostatic%20Biopsy%20FINAL.pdf]

**Not described as a seperate entitiy on US

=== Glandular elements ===

* '''≈70% of the prostate's composition'''[[File:Prostate zones.png|alt=Prostate Anatomy Zones|thumb|710x710px|Mikael Häggström, M.D. Author info - Reusing images- Conflicts of interest: NoneMikael Häggström, M.D., CC0, via [[commons:File:Prostate_zones.png|Wikimedia]] Commons]]

* '''Divided into anatomic zones (largest to smallest) (3):'''

*# '''Peripheral zone'''

*#* '''≈70% of the glandular prostate tissue'''

*#* '''Most (≈70%) prostate cancers occur in the peripheral zone'''

*# '''Central zone'''

*#* '''≈25% of the glandular prostate tissue'''

*#* '''Surrounds the opening of the ejaculatory ducts'''

*# '''Transitional zone'''

*#* '''≈3-5% of the glandular prostate tissue'''

*#*In the young adult male, only constitutes about 5-10% of male prostate; with age and the development of BPH, the TZ can occupy a large part of the glandular prostate[https://www.baus.org.uk/_userfiles/pages/files/Publications/Transrectal%20Ultrasound%20%20Prostatic%20Biopsy%20FINAL.pdf]

*#*Anterior to the peripheral zone

*#* '''Separated''' '''from the rest of the glandular compartments of the prostate by a distinct fibromuscular band'''

*#* '''Benign prostatic hyperplasia most commonly occurs in the transitional zone'''

*#* '''≈20% of prostate cancers occur in the transitional zone'''

== Pelvic fasciae ==

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== Vasculature ==

=== ~~'''~~Arterial Supply~~'''~~ ===

=== Arterial Supply ===

* The blood supply to the prostate enters at the 4 and 8 o'clock positions.

@@ Line 11: / Line 11: @@
 * The narrowed '''apex is the most inferior portion of the prostate gland,''' reaching the urogenital diaphragm. '''The apex of the prostate is continuous with the striated urethral sphincter'''
 * '''The prostate is fixed to the pubic bone anteriorly by the puboprostatic ligaments near the apex of the prostate'''
-* '''70% of the prostate’s composition is glandular elements, 30% is fibromuscular stroma.'''
+* '''Composed of (2):'''
-** The non-glandular anterior fibromuscular stroma is found extending from the bladder neck to the striated sphincter
+**'''Fibromuscular stroma'''
-** '''Glandular elements divided into 3 anatomic zones:'''
+**'''Glandular elements'''
-**# '''Peripheral zone'''
-**#* '''Largest zone''' (≈70% of the glandular prostate tissue)
-**#* '''Most (70%) prostate cancers occur in the peripheral zone'''
-**# '''Central zone'''
-**#* ≈25% of the glandular prostate tissue
-**#* '''Surrounds the opening of the ejaculatory ducts'''
-**# '''Transitional zone'''
-**#* '''Smallest zone''' (3-5% of the glandular prostate tissue)
-**#* '''Separated from the rest of the glandular compartments of the prostate by a distinct fibromuscular band'''
-**#* '''Benign prostatic hyperplasia most commonly occurs in this zone'''
-**#* '''≈20% of prostate cancers occur in the transitional zone'''
-Insert figure
+=== Fibromuscular stroma ===
+* '''≈30% of the prostate's composition'''
+* Non-glandular component
+* Continuous with the detrusor fibres of the bladder neck and tapers distally toward the striated sphincter area[https://www.baus.org.uk/_userfiles/pages/files/Publications/Transrectal%20Ultrasound%20%20Prostatic%20Biopsy%20FINAL.pdf]
+*Tightly adherent to the glandular tissue of the prostate[https://www.baus.org.uk/_userfiles/pages/files/Publications/Transrectal%20Ultrasound%20%20Prostatic%20Biopsy%20FINAL.pdf]
+**Not described as a seperate entitiy on US
+=== Glandular elements ===
+* '''≈70% of the prostate's composition'''[[File:Prostate zones.png|alt=Prostate Anatomy Zones|thumb|710x710px|Mikael Häggström, M.D. Author info - Reusing images- Conflicts of interest:  NoneMikael Häggström, M.D., CC0, via [[commons:File:Prostate_zones.png|Wikimedia]] Commons]]
+* '''<span style="color:#ff0000">Divided into anatomic zones (largest to smallest) (3):</span>'''
+*# '''<span style="color:#ff0000">Peripheral zone</span>'''
+*#* '''≈70% of the glandular prostate tissue'''
+*#* '''<span style="color:#ff0000">Most (≈70%) prostate cancers occur in the peripheral zone</span>'''
+*# '''<span style="color:#ff0000">Central zone</span>'''
+*#* '''≈25% of the glandular prostate tissue'''
+*#* '''<span style="color:#ff0000">Surrounds the opening of the ejaculatory ducts</span>'''
+*# '''<span style="color:#ff0000">Transitional zone</span>'''
+*#* '''≈3-5% of the glandular prostate tissue'''
+*#*In the young adult male, only constitutes about 5-10% of male prostate; with age and the development of BPH, the TZ can occupy a large part of the glandular prostate[https://www.baus.org.uk/_userfiles/pages/files/Publications/Transrectal%20Ultrasound%20%20Prostatic%20Biopsy%20FINAL.pdf]
+*#*Anterior to the peripheral zone
+*#* '''Separated''' </span>'''from the rest of the glandular compartments of the prostate by a distinct fibromuscular band</span>'''
+*#* '''<span style="color:#ff0000">Benign prostatic hyperplasia most commonly occurs in the transitional zone</span>'''
+*#* '''<span style="color:#ff0000">≈20% of prostate cancers occur in the transitional zone</span>'''
 == Pelvic fasciae ==
@@ Line 53: / Line 65: @@
 == Vasculature ==
-=== '''Arterial Supply''' ===
+=== Arterial Supply ===
 * The blood supply to the prostate enters at the 4 and 8 o'clock positions.