Domain

Explanation

Prostate?

• The word prostate 前列腺 comes from the Greek, meaning the gland standing beside the bladder
• The prostate is only present in men, hence prostate problems are men's problems

腺

• Prostate is a walnut-shaped gland 胡桃一般 of the male reproductive system with the following:

1. Organ: a storehouse for a series of tiny, spongy glands; the minilobes (from these glands) empty their contents into the urethra 尿道 (tube that discharges urine 尿 from bladder 膀胱 to the penis 陰莖) through a system of branching ducts & tubes
2. Size & shape: before puberty 青春期, a boy's prostate is as small as a pea (or groundnut) 豆一般大小; at puberty, something happens - a surge of male hormone testosterone & the small prostate begins to grow 長 until around age 21 - into the size of a walnut, about 1.5inches or 3.8cm in diameter; the prostate remains this size through young adulthood; then another thing happens - between ages 40-50 (anatomically observed), the prostate starts to grow or enlarge again, but indefinitely 無限期腫脹 à i.e. the prostate keeps on growing from mid-40s onwards à the enlargement begins with innermost cells surrounding the urethra, which runs through the centre of the prostate at a 35-degree angle à the enlargement is actually a slow strangulation of the urethra that slows & even cuts off urine flow, resulting in incontinence
3. Location: strategically located just between the bladder (stores urine) & the urethral sphincter (helps to control flow of urine) with the prostatic urethra running through the centre of the prostate at a 35-degree angle à the prostate covers the urethra completely like a ring à if this ring is loose, flexible & soft, urine can easily flow through (best, no problem) à if this ring becomes smaller, tighter & rigid, more to difficult for urine to pass through (bad problem)
4. Encirclement of prostatic urethra: 前列腺完全圍繞尿道; the prostatic urethra carries urine from the bladder into the urethra (tube that discharges urine from bladder to the penis), but passing through the tunnel formed by the prostate (muscular gland that totally encircles the prostatic urethra, hence its name)
5. Functions: to manufacture part of the fluid that makes up semen 精液 à semen = sperms (~3%) 精子 + seminal fluids (~70%, from the seminal vesicles, located just above the prostate, with ducts into the prostate) + prostate fluids (~27%) 前列腺液 à sexual function: during climaxing: semen is gathering in the prostate à during orgasm 性高潮 with ejaculation 射精, the prostate's muscles contract at 1.25-2.5 Hz to pump the semen out of the prostate & into the urethra (a muscular valve slams shut in the bladder neck to prevent urine coming out & semen from going into the bladder - retrograde ejaculation 反向射精) à semen (liquid) ejaculates out through the penis à within first 5 minutes, semen coagulates into a semi-solid (it sticks) à after 5-10 minutes, PSA (prostate-specific antigen 前列腺抗原, important substance made by prostate & used to detect for prostate abnormalities & cancers) acts on the semen causing it to become liquid again
6. Prostatic fluid secretions 前列腺液体: fluids produced by prostate, composing of prostaglandins, spermine fructose, glucose, citric acid, zinc 鋅 (impt. to prevent prostate problems), proteins & enzymes (immunoglobulins, proteases, esterases & phosphatase) à buffer to help sperms survive & remain active in hostile vaginal environment à sperm nourishment à may be as disease fighters that cleanse the urethra, repulsing attack by harmful substances in the body that enters the urinary tract (semen may be good for urine tract)

• Prostate is not for urine control à only the urethral sphincter is responsible for urine control
• But prostate can critically obstruct the flow of urine
• Urine flow 通尿: blood, water & bodily fluids are filtered by the kidneys 腎 à produces about 2 quarts or 0.5gallons or 4 pints or 2 litres of urine à goes into ureters à enters the bladder (designed to expand or collapse depending on amount of fluids) through ureteral orifices à when urinating à urine goes first through the prostatic urethra (surrounded completely by the prostate) à urethral sphincter contracts & expands to pull urine out through the penis à notice that this is a one-way flow of urine; there is no U-turn & it is a single way à any obstruction or abnormal outgrowth along the urine path would block the whole flow à in men, the prostate that grows too large 前列腺腫脹 is an imminent problem
• Urology 泌尿科: study of urinary problems by urologists 泌尿專科醫生

Anatomy of prostate

解剖學

• There are 5 anatomical zones in the prostate:

1. Anterior: 30%, smooth muscles
2. Peripheral: 75% of the prostate glands à most likely for abnormalities & cancers to occur 前列腺癌
3. Central: 25% of glands
4. Preprostatic tissue: prevent semen from flowing backwards into the bladder (opp. To retrograde ejaculation)
5. Transition: surrounds the urethra & is the sole site of BPH (benign prostatic hyperplasia) 前列腺腫脹

正常前列腺

• Noting the following aspects of prostate:

1. Encircles the urine tract 圍繞尿道: do not control urine, but can obstruct or stop its flow 天生金箍罩(孫悟空)
2. A pump 精液迸 for semen ejaculation, but without a prostate, men can still be sexually active, potent & fertile (so long as sperms can exit the penis & into the vagina)
3. Nerves 神經 connect to the prostate that relay messages from the brain: research & surgeries (radical prostatectomy for prostate cancers) using the "nerve-sparing" 神經節約法 or "Walsh procedure" almost proves that cutting off the prostate can be done to remove cancer prostate, retain urine control & minimise reproductive system dysfunction; with less blood with maximum knowledge of venous drainage; better precision surgeons know exactly where the scalpel could & could not go); regain potency & erectile function 勃起 (by preserving the microscopic bundles of nerves on either side of the prostate) à nerves: left & right neurovascular bundles that run to the corpora cavernosa (spongy, erectile odies in the penis) à preserving these nerves enable men for penal erections, hence intercourse 性愛 ability, after cutting off the cancer prostate
4. Hormones 荷爾蒙 & prostate tissue history/age 細胞組織/年齡 control its changes & growth: e.g. testosterone (castrated men without any testes do not produce testosterone, hence no prostate changes); estrogens (retards growth, but estrogen (women) therapy leads to impotence & enlarged breasts); PSA (stimulates growth):

前列腺病症

• 老, 多荷爾蒙, 遺傳, 情緒低落, 污染, 環境, 飲食, 不動
• More prostate problems if:

1. Age: older men, esp. >40, non-castrated (castrated men before puberty without testes have no prostate problems at all)
2. Hormones: more testosterone, antigens, PSA, DHT (dihydrotestosterone, manufactured from testosterone), less estrogen
3. Hereditary genetics: higher risks if family members also have prostate problems
4. Emotions: more stressful, hectic, worried, unhappy & sad; less peaceful, happy & calm
5. Pollution: exposure to various chemicals (like asbestos); initiates (DNA) & activates (cancers)
6. Environment: more radiation (microwave, X-ray, wireless), less sunlight, less vitamin D
7. Diet: high-fat, high-tobacco, high-alcohol
8. Exercise: no or low exercise

• Problems in the prostate don't manifest themselves with symptoms easily traceable to prostate functions à complex problems, complex solutions
• Urinary trouble generally is the first sign that something is not right in the prostate 第一征兆: 泌尿問題
• Within each of the 3 main prostate problems below, note the following aspects:

1. Causes & risk factors
2. Signs & symptoms
3. Treatments
4. Prevention

• Currently, there are 3 main types of prostate problems (2 benign, 1 malignant):

1. Prostatitis (benign: ok, not life-threatening) 前列腺炎: an inflammation of the prostate gland à annoying & sometimes dehabilitating à almost any pelvic pain, lower back pain, perineal pain (between anus & scrotum) & testicular pain à 4 different types that requires very different treatments, hence diagnosis is important à lifestyle & diet changes, medications & sometimes, surgeries 良性: 無生命危險
2. BHP (Benign Prostatic Hypertrophy) 前列腺腫脹: enlargement of the inner portion (transition zone, anatomy) of the prostate lining the urethra à happens almost inevitably like wrinkles & gray hair à 50% of men in fifties, 80% of men in eighties à lifestyle & diet changes, medications & surgeries 良性: 無生命危險
3. Prostate cancer (malignant: life-threatening) 前列腺癌: cancer (Oncology) or tissue mutation & abnormalities originating from the prostate à very deadly & the more developed the country, the more men develop prostate cancer (~13%) & the more men die from it (~3%) à one of the most fatal cancers of men à metastastes: spread of cancer out of the prostate & into other parts of the body à if bones are cancer-infected: tremendous, consistent & unrelenting pain; need for pain management à medications & surgeries 惡性: 有生命危險

Prostatitis

前列腺炎

• Can be divided into 4 types:

1. Acute bacterial prostatitis: bacteria infection à hits suddenly with onset of symptoms à must complete antibiotic treatment, else worse
2. Chronic bacterial prostatitis: bacteria infection à milder symptoms à same complete antibiotic treatment
3. Nonbacterial prostatitis: most common, but a mystery (unknown causes) à antibiotics useless à white blood cells present in prostate fluid (suggests problem of some sort) à often found in younger, sexually active men à suggests sexual transmission
4. Prostatodynia: same symptoms as nonbacterial prostatitis à different diagnosis à caused by things like muscle spasms in the bladder neck, urethra, perineum or pelvis à stress-related: use muscle relaxants

• Remedies: zinc-rich diet (no coffee, gin, whiskey, red wine, spicy foods), no stress, no heavy lifting, no prolonged driving, no vigorous exercise, use cold-pressed linseed oil
• Not always curable, but always treatable 不能痊癒, 也能治療

BHP

前列腺腫脹

• Inevitable enlargement & stiffening of prostate transition zone directly squeezing on the urethra:

1. Glandular tissue enlargement 腫脹
2. Smooth muscle tissue tightening 繃緊

• Causes:

1. Age: mostly >40
2. Hormones: no BHP if castrated, esp. before puberty à no testes à no testosterone
3. Genetic inheritance: from parents &/or grandparents

• Symptoms:

1. Weak urinary stream
2. Urinate frequently at night: nocturia
3. Hesitancy in urinating or straining to start
4. Starting & stopping
5. Dribbling
6. Sudden urgent urination
7. Incomplete urination
8. Incontinence

• Same symptoms as more serious problems like: prostate cancer, urinart tract infection, bladder cancer, bladder stones, neurogenic bladder or a urethral stricture (scar tissues block urethra)
• Doctors' evaluations: digital rectal exam, urinalysis (urine blood & infection); blood tests (PSA) & kidney functions
• Treatments:

1. Surgery: kidney damage, urinary retention (not able to urinate), urinary tract infections, bladder stones, bleeding when urinating, severe incontinence
2. Mechanical: stents, stiff tubes lining the prostatic urethra; like what is done in heart surgery with balloons to hold arteries open
3. Medical: shrinking prostate; keeping smooth muscle tissue from tightening the urethra using drugs

Prostate cancer

前列腺癌

• Deadly, painful & dysfunctional 惡性, 惡痛, 失控
• Symptoms very similar to BHP above:

1. Nocturia
2. High frequency, but small amounts of urination
3. Hesitation
4. Intermittency: start-stop

• Causes:

1. Hereditary
2. Poor emotions
3. Exposure to chemicals: industries like welding, ironing & hazard chemicals
4. Poor nutrition

• Screening & diagnosis
• Treatments:

1. Radical prostatectomy: cutting off cancer prostate; stitching back urinary system & preserve sexual function (nerve bundles lining prostate)
2. Radiation: X-ray
3. Cryoablation
4. Hormone therapy: shut down hormones that feed prostate & nourish cancer à reduce testosterone & DHT à estrogens, LHRH agonists à total adrogen ablation
5. Castration: physical (remove testes); chemical drugs for castration (testes still present)
6. Chemotherapy
7. Aggressive pain management: shown to help patients live longer

• 4 components of normal sexual function:

1. Libido: less testosterone, less sex drive
2. Erections: nerve bundles on either side of the prostate à release chemicals to allow blood into & prevent blood coming out of the penis
3. Ejaculation: none or little, if other glands, testicles, seminar vesicles, prostate &/or muscle valve are destroyed or cut off or severed
4. Orgasm: orgasm happens in the brain, as long as sensation is intact; libido present, without erection or ejaculation (no prostate)

• Help for impotence:

1. Proper surgery has little influence on normal sensation, normal sex drive & normal orgasm
2. But, erectile dysfunction may occur à impotence: age, medical conditions (diabetes, hypertension, alcohol, tobacco, drugs & problems)
3. Help: drugs, medications, diet, exercise, even mechanical tools

Prevention

防患未然

• Directly addressing the prostate problems, the following prevention measures are evident:

1. Age: start as young as possible - start NOW
2. Hormones: less testosterone, antigens, PSA, DHT à means less production of these hormones à less physiological activities that stimulates their production: less fats, less excitements, less agitation, less lust
3. Hereditary genetics: monitor family background à be aware of most susceptible prostate diseases à check yourself regularly & conscientiously à cultivate good prevention
4. Emotions: why not happy, peaceful & calm?
5. Pollution: be aware (but not sensitive) of your surroundings (home, work, leisure) à if safe, ok à if not safe, take precautions like SARS
6. Environment: more sunshine, more natural ingredients, substances & scenarios à less technological stuff or with proper care, segregation & protection
7. Diet: Actions of Foods; Foods for Men; eat like pregnant; no animal fat (cheese, meat, eggs à more hormones stimulated); more fruits, vegetables (e.g. beta-carotene rich dark-green vegetables like broccoli & spinach); deep yellow & orange vegetables & fruits like carrots & cantaloupe; tomato à whole grains, peas, beans, lentils, soy milk, antioxidants (mushrooms, spices), zinc , DLPA amino acid, plant products
8. Exercise: more, regular, sustainable exercises à learning, muscles, diet-exercise, bodymind, Kegal exercise

• Healthy prostate program: treatment using research

1. Carefully gather information by talking to patient
2. Examine entire patient, not just prostate
3. Perform necessary tests
4. Rule out serious problems like cancers
5. Handle patient's pain & discomfort as necessary
6. Begin treatment for most likely problem

• Happy prostate:

1. Bring out & Address worries about self-worth & sexual powers
2. Turn confrontations into consultations
3. Turn bad situations to good
4. Turn failure into a challenge
5. Turn difficulties into an opportunity for self-assessment
6. Don't let lack of opportunity hold you back
7. Prevent disasters by planning fallbacks
8. Know setbacks are normal, even for the most successful of us
9. Keep your eyes firmly on your goals
10. Never give in

• Healthy prostate program: prevention

1. Be aware: monitor & pay attention to your own body; let the doctor know your full medical history - be honest
2. Regular checkups: digital rectal exam (DRE), PSA & ultrasound
3. Sexual smarts: abstinence à monogamy with monogamous partner à protection, check for signs of diseases & infections à no symptoms no proof of complete health
4. Keep body resistance high: mind-body connection à daily mental medicine prescription: think good thoughts & avoid unhappy ones à avoid alcohol, salt (no pickled food), saccharin, tobacco, fats, (fried), refined foods (cakes, pies, candies, cereals, TV dinners

News

• MEDLINEplus
• GERD
• Links
• MEDLINEplus: Prostate Diseases
• Center for Prostate Disease Research
• Benign Prostate Disease

忠告

• The prostate is a part of the body as the body is a part of us
• Prostate problems are our problems
• 良食, 衛生, 愉快, 鬆弛
• Only with a conscientious, ever-cautious attitude would the prostate free us from its strangling demise

Domain

Explanation

What?

• This is a reference guide to dysfunction & diseases affecting the sexual lives of people, both men & women
• Research indicates that coupling activities are primal to human instinct & survival, thus requires special care & concern
• This needs special focus on the anatomical, medical & emotional aspects of sexual healthcare

Dysfunction?

• The original, normal sexual functions are disrupted, damaged or decreased unwillingly due to environmental, social or personal bio-chemical physiology
• Dysfunction can be:

1. Either disease-related or non-disease-related
2. Either short-term (temporary) or long-term (chronic)

• Sexual dysfunction would be the disruptions & mismatch of sexual functions & sexual intentions
• Causes, symptoms, treatments, prevention

Diseases?

• Diseases are harmful bodily disruptions that can be either infected (microbes-related) or metamorphosed (mutations)
• Sexual diseases are related directly with the sexual lives of people, their health, their environment & their interactions
• These are spread mainly through sexual activities, but can also be transmitted through other means, like pregnancy
• Hence,
• On one hand, people are reluctant to have healthy discussion & indeed go for prevention & treatment, due to social cultural obstacles, taboos & segregation
• On the other hand, these people need to recognise for themselves the risks of exposure, potential problems, difficulties & their abilities to handle such problems

Intentions?

• A straight-talk reference like this liberates us from the confines of the first obstacle to concentrate healthy & guided attention & indeed the heart to perceive wayward sexuality in the real, harmonious & sustainable light
• For affected: engage in active progress to bring the lives back onto the sustainable health
• For unaffected: engage in active maintenance to improve health & for prevention
• Prevention is forever better than Cure

TOC

• STD information centre: intro, FAQ;
• News: BBC; fights; All About Sexual Diseases
• MEDLINEplus: Sexually Transmitted Diseases
• Men: Google; Yahoo; prostate health; baldness
• Women: Google; Yahoo; STDs; Estronaut; Menstruation; Peri-Menopause