In addition, some of the contents of the abdomi-

which are lined by a simple columnar epithe-

nal cavity may protrude into the spermatic cord

lium and open into the urethra. The glands are

causing an indirect inguinal hernia.

embedded into a fibromuscular stroma and are

surrounded by a capsule.

Accessory Sex Glands

Due to papillary projections of the mucosa

into the lumen, secretory alveoli are irregular in

shape.Round eosinophilic bodies,called corpora

The male reproductive system includes three

amylacea, represent a characteristic feature of

different accessory sex glands, namely, the pros-

secretory alveoli. These bodies may undergo cal-

tate, a pair of seminal vesicles, and a pair of bul-

cification and may appear in semen. The glandu-

bourethral glands (Fig. 4.1).

lar epithelium is columnar to cuboidal depending

on the secretory activity, hormonal situation,

and age and contains basal cells, which represent

Prostate

progenitors of the secretory cells (Fig. 4.14).

The secretory cells contain granules, which

The prostate is homologous to Skene´s glands

among other molecules produce prostate-spe-

found in many females. It measures approxi-

cific acid phosphatase. The secretion, therefore,

mately 2 × 3 × 4 cm and surrounds the urethra

is acidic (pH 6.4). It constitutes approximately

just below the urinary bladder to which it is

30% of the seminal fluid and contains many

fixed. Within the prostate, the urethra merges

enzymes, as well as citric acid, prostaglandins

with the ductus ejaculatorii which open into the

that stimulate smooth muscles of the female

colliculus seminalis. While the ventral apex of

genital tract to enhance the migration of sperm,

the prostate reaches the diaphragma urogeni-

zinc which is involved in the testosterone metab-

tale, the ventral part is located at the pubic bone

olism, spermine which accounts for the typical

and the dorsal part lies in direct vicinity to the

smell of the seminal fluid and fibrinolysin which

ampulla of the rectum. Therefore, the prostate is

liquifies the semen. Secretion is regulated by

palpable during rectal examination approxi-

dihydrotestosterone (DHT).

mately 4 cm from the anus.

Blood supply via arteria rectalis media and

From inside to outside, according to Mc

arteria vesicalis inferior (dorsal and lateral) and

Neal,11 the prostate can be divided into three

arteria pudenda interna (ventral). Veins open

concentric zones (Fig. 4.13). The central zone

into the plexus vesicoprostaticus. Lymphatic

surrounds the ejaculatory ducts and contains

drainage occurs via nodi lymphatici iliaci interni

mucosal glands, the transition zone surrounds

et externi. Nerves originate from the plexus

the proximal part of the urethra and contains

prostaticus.

submucosal glands, and the peripheral or sub-

Clinic: The anatomical model of Mc Neal11 is

capsular zone surrounds the distal part of the

important. Benign prostatic hyperplasia (BPH)

urethra and contains the main glands. The latter

is the disease of the periurethral zone, whereas

comprises 30–50 tubuloalveolar glands that

prostatitis and prostate cancer (PCa) are mainly

empty into 15–30 independent excretory ducts,

located in the peripheral zone. BPH occurs in

older men due to an enlargement of the transi-

tion zone. Hyperplastic tissue may constrict the

urethra and impede the urine flow. PCa repre-

Ductus ejaculatorius

sents the second most malignant tumor in men

Transition zone

Central zone

older than 50 years.

Seminal Vesicles

Peripheral zone

Seminal vesicles or glandulae vesiculosae are

Urethra

located posterior-inferior to the urinary bladder

and lateral to the ampulla of the ductus defer-

Figure 4.13. organization of prostate, according to mc neal.11

ens. Beneath an outer layer of connective tissue

sagittal section, from left.

lies the muscularis consisting of an outer