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Prostate

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72-444: The prostate is an accessory gland of the male reproductive system and a muscle-driven mechanical switch between urination and ejaculation . It is found in all male mammals. It differs between species anatomically, chemically, and physiologically. Anatomically, the prostate is found below the bladder , with the urethra passing through it. It is described in gross anatomy as consisting of lobes and in microanatomy by zone. It

144-417: A "glandular flesh upon which rests the neck of the bladder," and Vesalius as a "glandular body". The first time a word similar to prostate was used to describe the gland is credited to André du Laurens in 1600, who described it as a term already in use by anatomists at the time. The term was however used at least as early as 1549 by French surgeon Ambroise Pare . At the time, Du Laurens was describing what

216-410: A combination of trigger point and psychological therapy has proved effective for category III prostatitis as well. An enlarged prostate is called prostatomegaly, with benign prostatic hyperplasia (BPH) being the most common cause. BPH refers to an enlargement of the prostate due to an increase in the number of cells that make up the prostate ( hyperplasia ) from a cause that is not a malignancy. It

288-436: A person does not have symptoms; when they do occur, symptoms may include urinary frequency, urgency, hesitation and other symptoms associated with BPH. Uncommonly, such cancers may cause weight loss, retention of urine, or symptoms such as back pain due to metastatic lesions that have spread outside of the prostate. A digital rectal examination and the measurement of a prostate-specific antigen (PSA) level are usually

360-407: A posterior. It is posterior to the ureter , anterior to the internal iliac vein , anterior to the lumbosacral trunk , and anterior to the piriformis muscle . Near its origin, it is medial to the external iliac vein , which lies between it and the psoas major muscle . It is above the obturator nerve . The arrangement of branches of the internal iliac artery is extremely variable. Typically,

432-464: A procedure. A perineal approach will not involve lymph node removal and may result in less pain and a faster recovery following an operation. A TURP procedure uses a tube inserted into the urethra via the penis and some form of heat, electricity or laser to remove prostate tissue. The whole prostate can be removed. Complications that might develop because of surgery include urinary incontinence and erectile dysfunction because of damage to nerves during

504-467: A urethral branch, supplying the urethral prostate; and a capsular branch, which travels around the capsule and has smaller branches, which perforate into the prostate. The veins of the prostate form a network – the prostatic venous plexus , primarily around its front and outer surface. This network also receives blood from the deep dorsal vein of the penis , and is connected via branches to the vesical plexus and internal pudendal veins . Veins drain into

576-511: Is an enlargement of the vas deferens in its terminal portion. These are typical tubular glands in ruminants , horses and dogs; absent in the cat and poorly developed in boars. The function of the white serous secretion is not known. The secretory endpieces of these glands are lined with simple columnar epithelium ; the main ducts are lined with stratified columnar epithelium. These glands do not occur in carnivores , but are present in some form in horses, ruminants and swine. Seminal fluid,

648-404: Is located in the pelvis. It sits below the urinary bladder and surrounds the urethra . The part of the urethra passing through it is called the prostatic urethra , which joins with the two ejaculatory ducts . The prostate is covered in a surface called the prostatic capsule or prostatic fascia . The internal structure of the prostate has been described using both lobes and zones. Because of

720-429: Is surrounded by an elastic, fibromuscular capsule and contains glandular tissue, as well as connective tissue . The prostate produces and contains fluid that forms part of semen , the substance emitted during ejaculation as part of the male sexual response . This prostatic fluid is slightly alkaline , milky or white in appearance. The alkalinity of semen helps neutralize the acidity of the vaginal tract , prolonging

792-415: Is twice as large as the external iliac , and is the direct continuation of the common iliac . It ascends along the side of the bladder , and runs upward on the back of the anterior wall of the abdomen to the umbilicus , converging toward its fellow of the opposite side. Having passed through the umbilical opening, the two arteries, now termed umbilical , enter the umbilical cord , where they coil around

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864-492: Is very common in older men. It is often diagnosed when the prostate has enlarged to the point where urination becomes difficult. Symptoms include needing to urinate often ( urinary frequency ) or taking a while to get started ( urinary hesitancy ). If the prostate grows too large, it may constrict the urethra and impede the flow of urine, making urination painful and difficult, or in extreme cases completely impossible, causing urinary retention . Over time, chronic retention may cause

936-507: The Skene's gland and the male prostate act similarly by secreting prostate-specific antigen (PSA), which is an ejaculate protein produced in males, and of prostate-specific acid phosphatase , the Skene's gland is sometimes referred to as the "female prostate". Although homologous to the male prostate (developed from the same embryological tissues), various aspects of its development in relation to

1008-410: The bulbospongiosus and urethral muscles . All domestic species have these glands except the dog, and their mucus secretion serves to clear the urethra of urine and to lubricate it and the vagina . The product may also serve as an energy source for the spermatozoa . In some species, branched tubular mucous glands are found along the length of the urethra , especially dorsal to the lumen of

1080-422: The inferior vesical artery , internal pudendal artery , and middle rectal arteries . These vessels enter the prostate on its outer posterior surface where it meets the bladder, and travel forward to the apex of the prostate. Both the inferior vesical and the middle rectal arteries often arise together directly from the internal iliac arteries . On entering the bladder, the inferior vesical artery splits into

1152-468: The medial compartment of the thigh . The vesicular branches of the internal iliac arteries supply the bladder. It is a short, thick vessel, smaller than the external iliac artery , and about 3 to 4 cm in length. The internal iliac artery arises at the bifurcation of the common iliac artery , opposite the lumbosacral articulation, and, passing downward to the upper margin of the greater sciatic foramen , divides into two large trunks, an anterior and

1224-406: The prostatic acid phosphatase . In the developing embryo , at the hind end lies an inpouching called the cloaca . This, over the fourth to the seventh week, divides into a urogenital sinus and the beginnings of the anal canal , with a wall forming between these two inpouchings called the urorectal septum . The urogenital sinus divides into three parts, with the middle part forming the urethra;

1296-412: The semen . Its secretion forms up to 30% of the semen. Semen is the fluid emitted ( ejaculated ) by males during the sexual response . When sperm are emitted, they are transmitted from the vas deferens into the male urethra via the ejaculatory duct , which lies within the prostate gland. Ejaculation is the expulsion of semen from the urethra. Semen is moved into the urethra following contractions of

1368-493: The spermatozoa , to clear the urethral tract prior to ejaculation , serve as the vehicle of transport of the spermatozoa in the female tract, and to plug the female tract after placement of spermatozoa to help ensure fertilization . Although the glands are usually described as being branched tubular or branched tubuloalveolar , they vary in their organization and in their distribution in different species. Each of these branched tubular glands lined by simple columnar epithelium

1440-459: The vesical and then internal iliac veins . The lymphatic drainage of the prostate depends on the positioning of the area. Vessels surrounding the vas deferens , some of the vessels in the seminal vesicle, and a vessel from the posterior surface of the prostate drain into the external iliac lymph nodes . Some of the seminal vesicle vessels, prostatic vessels, and vessels from the anterior prostate drain into internal iliac lymph nodes . Vessels of

1512-463: The "male G-spot ". Prostatitis is inflammation of the prostate gland. It can be caused by infection with bacteria, or other noninfective causes. Inflammation of the prostate can cause painful urination or ejaculation, groin pain, difficulty passing urine, or constitutional symptoms such as fever or tiredness . When inflamed, the prostate becomes enlarged and is tender when touched during digital rectal examination . The bacteria responsible for

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1584-479: The 1966 Nobel Prize in Physiology or Medicine . The role of the gonadotropin-releasing hormone (GnRH) in reproduction was determined by Andrzej W. Schally and Roger Guillemin , who both won the 1977 Nobel Prize in Physiology or Medicine for this work. GnRH receptor agonists, such as leuprorelin and goserelin , were subsequently developed and used to treat prostate cancer. Radiation therapy for prostate cancer

1656-408: The 19th century. The first treatments of prostate cancer were surgeries to relieve urinary obstruction. Samuel David Gross has been credited with the first mention of a prostatectomy, as "too absurd to be seriously entertained" The first removal for prostate cancer (radical perineal prostatectomy ) was first performed in 1904 by Hugh H. Young at Johns Hopkins Hospital ; partial removal of the gland

1728-484: The anterior lobe or isthmus, the posterior lobe, the right and left lateral lobes, and the middle or median lobe. Inside of the prostate, adjacent and parallel to the prostatic urethra, there are two longitudinal muscle systems. On the front side ( ventrally ) runs the urethral dilator ( musculus dilatator urethrae ), on the backside ( dorsally ) runs the muscle switching the urethra into the ejaculatory state ( musculus ejaculatorius ). The prostate receives blood through

1800-468: The artery divides into an anterior division and a posterior division, with the posterior division giving rise to the superior gluteal, iliolumbar, and lateral sacral arteries. The rest usually arise from the anterior division. Because it is variable, an artery may not be a direct branch, but instead might arise off a direct branch. In recent years the development of techniques like prostate artery embolisation and angiografy led to an increased understanding of

1872-431: The bladder to become larger and cause a backflow of urine into the kidneys ( hydronephrosis ). BPH can be treated with medication, a minimally invasive procedure or, in extreme cases, surgery that removes the prostate. In general, treatment often begins with an alpha-1 adrenergic receptor antagonist medication such as tamsulosin , which reduces the tone of the smooth muscle found in the urethra that passes through

1944-577: The body is usually treated also with hormone therapy, to deprive a tumour of sex hormones (androgens) that stimulate proliferation. This is often done through the use of GnRH analogues or agents (such as bicalutamide ) that block the receptors that androgens act on; occasionally, surgical removal of the testes may be done instead. Cancer that does not respond to hormonal treatment, or that progresses after treatment, might be treated with chemotherapy such as docetaxel . Radiotherapy may also be used to help with pain associated with bony lesions. Sometimes,

2016-417: The choice of operation type and details of the procedure of the chosen technique. The effects on postoperational urination and ejaculation vary correspondingly. It is possible for some men to achieve orgasm solely through stimulation of the prostate gland, such as via prostate massage or anal intercourse . This has led to the area of the rectal wall adjacent to the prostate to be popularly referred to as

2088-401: The common iliac is short, and vice versa. The place of division of the internal iliac artery varies between the upper margin of the sacrum and the upper border of the greater sciatic foramen . The right and left hypogastric arteries in a series of cases often differed in length, but neither seemed constantly to exceed the other. The circulation after ligature of the internal iliac artery

2160-410: The decision may be made not to treat prostate cancer. If a cancer is small and localised, the decision may be made to monitor for cancer activity at intervals ("active surveillance") and defer treatment. If a person, because of frailty or other medical conditions or reasons, has a life expectancy less than ten years, then the impacts of treatment may outweigh any perceived benefits. Surgery to remove

2232-425: The females. This helps to assure that no other males will mate with that female, allowing her eggs to be fertilized by the current male's own sperm. Internal iliac arteries The internal iliac artery (formerly known as the hypogastric artery ) is the main artery of the pelvis . The internal iliac artery supplies the walls and viscera of the pelvis , the buttock , the reproductive organs , and

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2304-417: The first investigations done to check for prostate cancer. PSA values are difficult to interpret, because a high value might be present in a person without cancer, and a low value can be present in someone with cancer. The next form of testing is often the taking of a prostate biopsy to assess for tumour activity and invasiveness. Because of the significant risk of overdiagnosis with widespread screening in

2376-532: The general population, prostate cancer screening is controversial. If a tumour is confirmed, medical imaging such as an MRI or bone scan may be done to check for the presence of tumour metastases in other parts of the body. Prostate cancer that is only present in the prostate is often treated with either surgical removal of the prostate or with radiotherapy or by the insertion of small radioactive particles of iodine-125 or palladium-103 , called brachytherapy . Cancer that has spread to other parts of

2448-540: The grammatically correct prostator (singular) and prostatores (plural) because the gender of the Ancient Greek term was taken as female, when it was in fact male. The fact that the prostate was one and not two organs was an idea popularised throughout the early 18th century, as was the English language term used to describe the organ, prostate , attributed to William Cheselden . A monograph , "Practical observations on

2520-540: The infection may be detected by a urine culture . Acute prostatitis and chronic bacterial prostatitis are treated with antibiotics . Chronic non-bacterial prostatitis, or male chronic pelvic pain syndrome is treated by a large variety of modalities including the medications alpha blockers , non-steroidal anti-inflammatories and amitriptyline , antihistamines , and other anxiolytics . Other treatments that are not medications may include physical therapy , psychotherapy , nerve modulators , and surgery . More recently,

2592-408: The lifespan of sperm . The prostatic fluid is expelled in the first part of ejaculate, together with most of the sperm, because of the action of smooth muscle tissue within the prostate. In comparison with the few spermatozoa expelled together with mainly seminal vesicular fluid, those in prostatic fluid have better motility , longer survival, and better protection of genetic material. Disorders of

2664-406: The longer ducts. Basal cells surround the luminal epithelial cells in benign glands. The glands are formed as many follicles, which drain into canals and subsequently 12–20 main ducts, These in turn drain into the urethra as it passes through the prostate. There are also a small amount of flat cells, which sit next to the basement membranes of glands, and act as stem cells. The connective tissue of

2736-437: The male prostate are widely unknown and a matter of research. Male accessory gland Male accessory glands ( MAG ) are the seminal vesicles , prostate gland , and the bulbourethral glands . These glands are found only in mammals . In insects, male accessory glands produce products that mix with the sperm to protect and preserve them, including seminal fluid proteins . Some insecticides can induce an increase in

2808-529: The movement of spermatozoa and to form a vaginal plug . Additionally, in bulls, the secretion contains high amounts of fructose and citric acid . Concretions may be present in the secretory end pieces as well as parts of the duct system. The prostate and Cowper's glands are the only male accessory glands in marsupials. The lining of these paired, compound, tubuloalveloar glands is simple columnar epithelium . A capsule of dense connective tissue contains some smooth muscle as well as skeletal muscle of

2880-421: The normal prostate. About 150 of these genes are more specifically expressed in the prostate, with about 20 genes being highly prostate specific. The corresponding specific proteins are expressed in the glandular and secretory cells of the prostatic gland and have functions that are important for the characteristics of semen , including prostate-specific proteins , such as the prostate specific antigen (PSA) , and

2952-412: The only species apart from humans seen to have a significant incidence of prostate cancer. The prostate is the only male accessory gland that occurs in cetaceans , consisting of diffuse urethral glands surrounded by a very powerful compressor muscle. The prostate gland originates with tissues in the urethral wall. This means the urethra , a compressible tube used for urination, runs through the middle of

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3024-401: The operation, particularly if a cancer is very close to nerves. Ejaculation of semen will not occur during orgasm if the vasa deferentia are tied off and seminal vesicles removed, such as during a radical prosatectomy. This will mean a man becomes infertile . Sometimes, orgasm may not be able to occur or may be painful. The penis length may shorten slightly if the part of the urethra within

3096-428: The pelvis to the umbilicus. In two-thirds of a large number of cases, the length of the internal iliac varied between 2.25 and 3.4 cm.; in the remaining third it was more frequently longer than shorter, the maximum length being about 7 cm. the minimum about 1 cm. The lengths of the common iliac and internal iliac arteries bear an inverse proportion to each other, the internal iliac artery being long when

3168-438: The product of this gland, serves as a vehicle for the transport of spermatozoa . Grossly the prostate gland can be divided into two parts: the body and the disseminate part. Low cuboidal to low columnar epithelium provides the lining for this compound, tubuloalveolar gland which consists primarily of serous secretory end pieces. The secretion of this gland is more serous in dogs and more mucous in bulls. It serves to promote

3240-456: The prostate and transurethral microwave thermotherapy . These outpatient procedures may be followed by the insertion of a temporary stent , to allow normal voluntary urination, without exacerbating irritative symptoms. Prostate cancer is one of the most common cancers affecting older men in the UK, US, Northern Europe and Australia, and a significant cause of death for elderly men worldwide. Often,

3312-407: The prostate can also be removed from within the urethra, called transurethral resection of the prostate (TURP). Open surgery may involve a cut that is made in the perineum , or via an approach that involves a cut down the midline from the belly button to the pubic bone . Open surgery may be preferred if there is a suspicion that lymph nodes are involved and they need to be removed or biopsied during

3384-537: The prostate include enlargement , inflammation , infection , and cancer . The word prostate is derived from Ancient Greek prostátēs ( προστάτης ), meaning "one who stands before", "protector", "guardian", with the term originally used to describe the seminal vesicles . The prostate is a exocrine gland of the male reproductive system . In adults, it is about the size of a walnut , and has an average weight of about 11 grams (0.39 oz), usually ranging between 7 and 16 grams (0.25–0.56 oz). The prostate

3456-408: The prostate include proteolytic enzymes , prostatic acid phosphatase , fibrinolysin , zinc , and prostate-specific antigen . Together with the secretions from the seminal vesicles, these form the major fluid part of semen. The prostate's changes of shape, which facilitate the mechanical switch between urination and ejaculation, are mainly driven by the two longitudinal muscle systems running along

3528-609: The prostate is also removed. General complications due to surgery can also develop, such as infections , bleeding , inadvertent damage to nearby organs or within the abdomen, and the formation of blood clots . The prostate was first formally identified by Venetian anatomist Niccolò Massa in Anatomiae libri introductorius (Introduction to Anatomy) in 1536 and illustrated by Flemish anatomist Andreas Vesalius in Tabulae anatomicae sex (six anatomical tables) in 1538. Massa described it as

3600-432: The prostate is called prostatectomy, and is usually done as a treatment for cancer limited to the prostate, or prostatic enlargement. When it is done, it may be done as open surgery or as laparoscopic (keyhole) surgery . These are done under general anaesthetic . Usually the procedure for cancer is a radical prostatectomy , which means that the seminal vesicles are removed and the vasa deferentia are also tied off. Part of

3672-445: The prostate is made up of fibrous tissue and smooth muscle . The fibrous tissue separates the gland into lobules. It also sits between the glands and is composed of randomly orientated smooth-muscle bundles that are continuous with the bladder. Over time, thickened secretions called corpora amylacea accumulate in the gland. About 20,000 protein-coding genes are expressed in human cells and almost 75% of these genes are expressed in

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3744-419: The prostate itself also drain into the obturator and sacral lymph nodes . The prostate consists of glandular and connective tissue . Tall column-shaped cells form the lining (the epithelium ) of the glands. These form one layer or may be pseudostratified . The epithelium is highly variable and areas of low cuboidal or flat cells can also be present, with transitional epithelium in the outer regions of

3816-422: The prostate needs male hormones ( androgens ), which are responsible for male sex characteristics. The main male hormone is testosterone , which is produced mainly by the testicles . It is dihydrotestosterone (DHT), a metabolite of testosterone, that predominantly regulates the prostate. The prostate gland enlarges over time, until the fourth decade of life. The prostate secretes fluid, which becomes part of

3888-403: The prostate varies, ranging from tubuloalveolar (as in humans) to branched tubular . The gland is particularly well developed in carnivorans and boars, though in other mammals, such as bulls, it can be small and inconspicuous. In other animals, such as marsupials and small ruminants , the prostate is disseminate, meaning not specifically localisable as a distinct tissue, but present throughout

3960-411: The prostate vascularisation. Regarding the arterial supply M. de Assis et al. has suggested an anatomic classification for the origin of the inferior vesical artery The following are the branches of internal iliac artery: In individuals who are biological females, the ovarian artery (a branch of the abdominal aorta) and uterine arteries form anastomoses . In the fetus , the internal iliac artery

4032-457: The prostate, making it easier for urine to pass through. For people with persistent symptoms, procedures may be considered. The surgery most often used in such cases is transurethral resection of the prostate , in which an instrument is inserted through the urethra to remove prostate tissue that is pressing against the upper part of the urethra and restricting the flow of urine . Minimally invasive procedures include transurethral needle ablation of

4104-486: The prostate; enlargement of the prostate can constrict the urethra so that urinating becomes slow and painful. Prostatic secretions vary among species. They are generally composed of simple sugars and are often slightly alkaline. In eutherian mammals, these secretions usually contain fructose . The prostatic secretions of marsupials usually contain N-Acetylglucosamine or glycogen instead of fructose. Because

4176-547: The prostatic urethra. These are the urethral dilator ( musculus dilatator urethrae ) on the urethra's front side, which contracts during urination and thereby shortens and tilts the prostate in its vertical dimension thus widening the prostatic section of the urethral tube, and the muscle switching the urethra into the ejaculatory state ( musculus ejaculatorius ) on its backside. In case of an operation, e.g. because of benign prostatic hyperplasia (BPH), damaging or sparing of these two muscle systems varies considerably depending on

4248-458: The protein content of the male accessory glands of certain types of insects. This has the unintended effect of increasing the number of offspring they produce. The accessory glands of male mammals secrete fluid for nourishment of sperm and sexual attraction . The male accessory glands are the ampullary gland, seminal vesicle , prostate , bulbourethral gland , and urethral gland . The products of these glands serve to nourish and activate

4320-502: The relatively homogeneous cut surface of an adult prostate in no way resembled "lobes" and thus led to the description of "zones". Prostate cancer was first described in a speech to the Medical and Chiurgical Society of London in 1853 by surgeon John Adams and increasingly described by the late 19th century. Prostate cancer was initially considered a rare disease, probably because of shorter life expectancies and poorer detection methods in

4392-475: The relevant part of the urethra; in other animals, such as red deer and American elk , it may be present as a specific organ and in a disseminate form. In some marsupial species, the size of the prostate gland changes seasonally. The prostate is the only accessory gland that occurs in male dogs. Dogs can produce in one hour as much prostatic fluid as a human can in a day. They excrete this fluid along with their urine to mark their territory . Additionally, dogs are

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4464-414: The smooth muscle of the vas deferens and seminal vesicles, following stimulation, primarily of the glans penis . Stimulation sends nerve signals via the internal pudendal nerves to the upper lumbar spine ; the nerve signals causing contraction act via the hypogastric nerves . After traveling into the urethra, the seminal fluid is ejaculated by contraction of the bulbocavernosus muscle . The secretions of

4536-433: The treatment of the diseases of the prostate gland" by Everard Home in 1811, was important in the history of the prostate by describing and naming anatomical parts of the prostate, including the median lobe. The idea of the five lobes of the prostate was popularized following anatomical studies conducted by American urologist Oswald Lowsley in 1912. John E. McNeal first proposed the idea of "zones" in 1968; McNeal found that

4608-419: The umbilical vein, and ultimately ramify in the placenta . At birth, when the placental circulation ceases, the pelvic portion only of the umbilical artery remains patent gives rise to the superior vesical artery (or arteries) of the adult; the remainder of the vessel is converted into a solid fibrous cord, the medial umbilical ligament (otherwise known as the obliterated hypogastric artery) which extends from

4680-455: The upper part is largest and becomes the urinary bladder , and the lower part then changes depending on the biological sex of the embryo. The prostatic part of the urethra develops from the middle, pelvic, part of the urogenital sinus, which is of endodermal origin. Around the end of the third month of embryonic life, outgrowths arise from the prostatic part of the urethra and grow into the surrounding mesenchyme . The cells lining this part of

4752-404: The urethra differentiate into the glandular epithelium of the prostate. The associated mesenchyme differentiates into the dense connective tissue and the smooth muscle of the prostate. Condensation of mesenchyme , urethra , and Wolffian ducts gives rise to the adult prostate gland, a composite organ made up of several tightly fused glandular and non-glandular components. To function properly,

4824-409: The urethra. The exact function of their product is not clear. The male accessory gland is also prevalent in some species of butterflies and moths. An example is the cotton leafworm, or Spodoptera litura , in which the males transfer MAG to the females during copulation. This results in a wide range of post-mating behavior in the females, the most noteworthy being the decrease in sexual receptivity in

4896-488: The variation in descriptions and definitions of lobes, the zone classification is used more predominantly. The prostate has been described as consisting of three or four zones. Zones are more typically able to be seen on histology , or in medical imaging , such as ultrasound or MRI . The "lobe" classification describes lobes that, while originally defined in the fetus, are also visible in gross anatomy, including dissection and when viewed endoscopically. The five lobes are

4968-535: Was conducted by Theodore Billroth in 1867. Transurethral resection of the prostate (TURP) replaced radical prostatectomy for symptomatic relief of obstruction in the middle of the 20th century because it could better preserve penile erectile function. Radical retropubic prostatectomy was developed in 1983 by Patrick Walsh. In 1941, Charles B. Huggins published studies in which he used estrogen to oppose testosterone production in men with metastatic prostate cancer. This discovery of "chemical castration " won Huggins

5040-568: Was considered to be a pair of organs (not the single two-lobed organ), and the Latin term prostatae that was used was a mistranslation of the term for the Ancient Greek word used to describe the seminal vesicles , parastatai ; although it has been argued that surgeons in Ancient Greece and Rome must have at least seen the prostate as an anatomical entity. The term prostatae was taken rather than

5112-471: Was first developed in the early 20th century and initially consisted of intraprostatic radium implants. External beam radiotherapy became more popular as stronger X-ray radiation sources became available in the middle of the 20th century. Brachytherapy with implanted seeds (for prostate cancer) was first described in 1983. Systemic chemotherapy for prostate cancer was first studied in the 1970s. The initial regimen of cyclophosphamide and 5-fluorouracil

5184-445: Was quickly joined by multiple regimens using a host of other systemic chemotherapy drugs. The prostate is found only in mammals. The prostate glands of male marsupials are proportionally larger than those of placental mammals. The presence of a functional prostate in monotremes is controversial, and if monotremes do possess functional prostates, they may not make the same contribution to semen as in other mammals. The structure of

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