Anatomy and physiology of the prostate and benign prostatic hyperplasia

Abstract

The prostate is the shape of an inverted pyramid and lies between the urinary bladder and the pelvic floor. The base is the superior surface and lies at the bladder neck. The anterior border forms the posterior wall of the retropubic space and is attached to the pubic bones by the puboprostatic ligaments. The posterior surface is anterior to the rectum, and the inferolateral surfaces are surrounded by the puboprostaticus fibres of the levator ani muscle. The ejaculatory ducts pass through the posterior surface just inferior to the bladder and open into the prostatic urethra about halfway along its length. It is a fibromuscular and glandular organ that surrounds the prostatic urethra, the fibromuscular element being in direct continuity with the detrusor muscle of the bladder. The true capsule of the prostate is a thin layer of connective tissue at the periphery of the gland. This is surrounded by a condensation of pelvic fascia known as the false capsule. The main blood supply is from the prostatic branch of the inferior vesical artery. The venous drainage is via a plexus between the two capsules. Lymph vessels drain to the internal iliac nodes (Fig. 1).