2. Prostate, seminal vesicle and ejaculatory duct
Dr. Nimir
Dr. Safaa
Dr Rania Gabr

3. Objectives: Discuss the site, size, shape and relation of prostate.
Describe the fasciae covering and related to the prostate (true and false capsules).
Discuss its blood, nerve supply and lymphatic drainage.
Define the seminal vesicles.
Discuss their site, relation, blood supply, venous drainage, lymphatic drainage & innervation.
Define the ejaculatory duct.
Describe its site, beginning and termination.

4. Prostate
The prostate is a fibromuscular glandular organ that surrounds the prostatic urethra .
Glandular part : 2/3rd
Fibromuscular part: 1/3rd
Size:
The prostate 3 cm long,
4 cm wide.
Site:
-Lies between the neck of the urinary bladder above
and the urogenital diaphragm below

5. Relations Superiorly: Inferiorly:
Neck of the urinary bladder
Urethra enters the center of the base of the prostate
Inferiorly:
Urogenital Diaphragm
Urethra leaves prostate just above its apex on the anterior surface
Ejaculatory ducts pierce the posterior surface.

6. Relations Anteriorly: Posteriorly: Laterally: Symphysis pubis.
Puboprostatic ligaments (Pubic bones)
Posteriorly:
Rectal ampulla.
Rectovesical septum/Recto- prostatic fascia(fascia of Denonvilliers).
Laterally:
Anterior fibers of the levator ani.

8. Capsule of the Prostate Gland
True capsule:
Prostate is surrounded by a fibrous capsule which contains prostatic plexuses of nerves and veins
False capsule:
Visceral layer of pelvic fascia forms a fibrous prostatic sheath outside the true capsule

9. Prostate Gland Apex Base Anterior surface Posterior surface
Inferolateral surfaces

10. Anatomical lobes of Prostate Gland
The prostate is incompletely divided into five lobes :
1. Anterior lobe
Lies in front of urethra
Muscular
Devoid of glandular tissue
2. Median or Middle lobe
Lies between urethra and the ejaculatory ducts
Glandular
Prostatic
urethra

11. Anatomical lobes of Prostate Gland
3. Posterior lobe
Lies behind urethra and below ejaculatory ducts
Glandular
4. Right lateral lobe
Lies on the side of the urethra
5. Left lateral lobe

12. Blood supply of Prostate Gland
Arterial supply:
Branches of Internal Iliac artery
Branches from inferior vesical artery
Branches from middle rectal artery
Branches from Internal pudendal artery
Venous drainage
Veins form prostatic plexus
Drain into internal iliac vein

15. Lymph Drainage
Internal iliac nodes.
Nerve Supply
Inferior hypogastric plexuses.
The sympathetic nerves stimulate the smooth muscle of the prostate during ejaculation.

16. Prostatic Urethra
The prostatic urethra is about 1.25 in. (3 cm) long and begins at the neck of the bladder.
It is the widest and most dilatable portion of the entire urethra.
On the posterior wall is a longitudinal ridge called the urethral crest

17. - On each side of this ridge is a groove called the urethral sinus; the prostatic glands open into these grooves.
On the summit of the urethral crest is a depression, the prostatic utricle, which is an analog of the uterus and vagina in females.
Below the opening of the utricle are the openings of the two ejaculatory ducts.

18. Benign Prostatic Hypertrophy (BPH)
Occurs in middle age
Median or Middle lobe is involved
Projects into urinary bladder
Obstructs prostatic urethra and internal urethral orifice

19. Prostatic Cancer Occurs in old age (after 55 years usually)
Posterior and lateral lobes are involved
Palpated during PR examination
Can spread to iliac and sacral lymph nodes and can spread to vertebral column and brain through venous channels
Management
Prostatectomy
TURP (Transurethral resection of prostate)

20. Seminal Vesicles Lobulated organ 2 inches (5 cm) long
Lies on the posterior surface of the urinary bladder
Inferiorly, Seminal vesicle joins the vas deferens to form ejaculatory ducts on each side

21. Posteriorly,:
the seminal vesicles are related to the rectum.
Each seminal vesicle consists of a much-coiled tube embedded in connective tissue.

22. Blood Supply Arteries The inferior vesicle and middle rectal arteries.
Veins:
The veins drain into the internal iliac veins.
Lymph Drainage:
The internal iliac nodes.

23. Ejaculatory Ducts
The two ejaculatory ducts are each less than 1 in. (2.5 cm) long
Formed by the union of the vas deferens and the duct of the seminal vesicle.
The ejaculatory ducts pierce the posterior surface of the prostate and open into the prostatic part of the urethra, close to the margins of the prostatic utricle.

25. THANKS