Sex Hormone Changes That Occur With Aging
We do not know why the prostate gland enlarges during multiple growth spurts. However, there are two theories that attempt to explain this phenomenon. Both theories believe hormonal changes over time are responsible.
- Changes in the normal balance of sex hormones. With advancing age, the amount of the male hormone testosterone , decreases relative to the amount of circulating estrogen , the main female reproductive hormone which also circulates in the male.
There is some evidence to suggest that this relative increase in circulating estrogen may strengthen the effect of the testosterone derivative DHT, which promotes cell growth in the prostate gland and is formed when testosterone is acted upon by a specific enzyme. As a consequence of estrogen and DHT acting together, cell growth and glandular enlargement are promoted.
- Changes in the role of DHT. Prostate gland development requires the conversion of testosterone into DHT , in the presence of a specific enzyme called 5-alpha reductase. As aging occurs, the amount of DHT in the prostate gland remains high, even through the circulating testosterone level drops.
Some evidence supports the idea that this high level of prostate DHT may by itself promote cell growth and lead to enlargement.
Study Design And Statistics
Two body imagers with 10 years of experience reading prostate MRIs were assigned the task of measuring total prostatic volume using T2-weighted MRI on the 140 patient cohort. They were provided with a spreadsheet showing only the patient hospital identification numbers. After determining the total prostate volumes, these spreadsheets were returned to the administrator. Intra-rater reliability was tested only on the experts data. Re-measurement of prostate volume was done between 3 and 9 months after primary measures. Inter-rater reliability for continuous variables for volumes was analyzed for actual paired case-to-case correlation using the Pearson product moment and Lins Coefficient of Concordance. Linear regression was calculated to find r2 values, Y intercepts, p values and 95% confidence intervals . These were calculated from the open access statistical programs at the National Institute of Water and Atmospheric Research and QI Macro Statistics® . Measurements of the administrator were used as a proxy for gross pathological specimen weight for the determination of rater accuracy. Correlations were analyzed by linear regression and graphed. A comparison of means was also done after the data was available to establish data normality. Significance was defined as p0.05.
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Comparison Of Measured Prostate Volume And Trus Estimated Prostate Volume
We further examined the percent-difference in volumes between measured and estimated volumes using the three formulas for our primary cohort . In comparison to the measured volume, the ellipsoid formula revealed an underestimation of the volume by a mean of 8.80cc , whereas the bullet formula overestimated prostate volumes by 1.97cc . Finally, when comparing measured prostate volumes to TRUS-estimated volumes using our new formula with 0.66 as the coefficient, there was an overestimation by a mean of 2.76cc .
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What Is The Normal Size Of The Prostate
The prostate is an organ located below the bladder and in front of the rectum which is only present in the male body, fulfilling a key role in the formation of seminal fluid. The prostate secretes an alkaline fluid, white in appearance, that makes up to 30% of the volume of semen.
Over the years this gland can slightly increase in size, resulting in a condition known as prostatitis or inflammation of the prostate. For this reason many men wonder what the normal size of the prostate is and at what point it is considered enlarged. Read this OneHowTo article if you want more information about the normal size of the prostate.
Prehistory And Early Civilizations
Perceptions of penis size are culture-specific. Some prehistoric sculptures and petroglyphs depict male figures with exaggerated erect penises.Ancient Egyptian cultural and artistic conventions generally prevented large penises from being shown in art, as they were considered obscene, but the scruffy, balding male figures in the Turin Erotic Papyrus are shown with exaggeratedly large genitals. The Egyptian god Geb is sometimes shown with a massive erect penis and the god Min is almost always shown with an erection.
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Size Preferences Among Sexual Partners
In a small study conducted by University of TexasPan American and published in BMC Women’s Health, 50 undergraduate women were surveyed by two popular male athletes on campus about their perceptions of sexual satisfaction and it was concluded that the width of a penis feels better than the length of a penis, when subjects are asked to choose between the two . It was also concluded that this may show that penis size overall affects sexual satisfaction since women chose between the two options they were given.
In a cover story by Psychology Today, 1,500 readers were surveyed about male body image. Many of the women were not particularly concerned with penis size, and over 71% thought men overemphasized the importance of penis size and shape. Generally, the women polled cared more about width than men thought, and less about length than men thought, although the strength of caring for either among women showed a similar pattern.
Another study, conducted at Groningen University Hospital, asked 375 sexually active women the importance of penis size the results of which showed that 21% of women felt length was important and 32% felt that girth was important.
According to studies, when asked to estimate the length of their partners penis, most would say a size significantly smaller than what their partner was recorded to be. Suggesting that perception of size is not entirely accurate.
If You Have Any Problems
If you have any discomfort when urinating, any pain in the area around the prostate or any indication of a problem, the recommendation is to visit a urologist who can examine you to determine the source of discomfort or the problem.
It is important to visit a urologist whenever you feel the smallest discomfort, as the problem could get worse with time.
This article is merely informative, oneHOWTO does not have the authority to prescribe any medical treatments or create a diagnosis. We invite you to visit your doctor if you have any type of condition or pain.
If you want to read similar articles to What is the Normal Size of the Prostate, we recommend you visit our Family health category.
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Viiiasusceptible Populations Or Individuals
Evidence that individuals might show a different response to the same chemical exposure was first established in studies that showed a differential response in the prostate weight of mice following prenatal estradiol exposure the difference depended upon the intrauterine position of the developing mouse. Specifically, males situated in utero between two females showed a significantly greater increase in their adult prostate weight than those males situated between two males when exposed prenatally to estrogens. Minor differences in the local concentrations of intrauterine estradiol, which appeared to be gender-specific, were determined as the basis for different adult outcomes. This phenomenon should be taken into consideration when dealing with xenoestrogen exposure. For example, the positional effect has been shown to act additively with fetal BPA exposure in determining the age at which puberty initiates in female offspring. In this regard, one major issue that has arisen in the field of environmental endocrine disruption is that wildlife populations and outbred rodent strains are composed of nonidentical individuals and thus vary in their susceptibility to any particular noxious agent. This was made clear by a study showing that different strains of mice responded very differently to estradiol exposure.
Laura N. Vandenberg, in, 2014
Digital Rectal Examination Standardization For Inexperienced Hands: Teaching Medical Students
Leonardo Oliveira Reis
1Faculty of Medical Sciences, University of Campinas, Unicamp, Rua Tessália Vieira de Camargo 126, Cidade Universitária Zeferino Vaz, 13083-887 Campinas, SP, Brazil
2Faculty of Medicine, Center for Life Sciences, Pontifical Catholic University of Campinas, PUC-Campinas, 13060-904 Campinas, SP, Brazil
Academic Editor:
Abstract
1. Introduction
After anamnesis, clinical evaluation with physical examination is fundamental to proceed with patient investigation, determining the necessary complementary exams and even defining treatments.
Classically, the initial approach to men presenting with low urinary tract symptoms is accomplished by digital rectal examination , prostate specific antigen , international prostatic symptom score , and postvoid residue by ultrasonography .
The DRE technique is a simple and well-established maneuver however, this propaedeutic method and mainly its optimal quantification of prostate volume still remain empirical knowledge, with no scientific reasoning and standardization. PV has a direct correlation with natural history of prostate enlargement and subsequent risk of a poor outcome .
This preliminary study evaluates the impact of DRE standardization on inexperienced hands and sets how the designed method correlates with the comprehensive evaluation of men presenting with LUTS to assess the acquisition and validity of DRE skills, mainly PV assessment.
2. Methods
2.1. DRE Standardization
2.2. Model Validation
3. Results
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Middle Ages And Renaissance
Portrait of Lodovico CaponiAngelo Bronzinocodpiece
In medieval Arabic literature, a longer penis was preferred, as described in an Arabian Nights tale called “Ali with the Large Member”. As a witty satire of this fantasy, the 9th-century Afro-Arab author Al-Jahiz wrote: “If the length of the penis were a sign of honor, then the mule would belong to the Quraysh” .
The medieval Norsemen considered the size of a man’s penis as the measure of his manliness, and a thirteenth-century Norse magic talisman from Bergen, a wooden stave inscribed with writing in runic script, promises its wearer: “You will fuck Rannveig the Red. It will be bigger than a man’s prick and smaller than a horse’s prick.” A late fourteenth century account of the life of Saint Óláfr from the Flateyjarbók describes a pagan ritual which centered around a preserved horse’s penis used as a cult artifact which members of the cult would pass around in a circle, making up verses in praise of it, encouraging it and the other members of the group to behave in sexually suggestive ways.
During the Renaissance, some men in Europe began to wear codpieces, which accentuated their genitals. There is no direct evidence that it was necessarily worn to enhance the apparent size of the wearer’s penis, but larger codpieces were seen as more fashionable.
Can Prostate Surgery Affect Penis Size Or Sensitivity
Prostate surgery is very unlikely to affect penis size. The only likely case this would occur if an individual underwent surgery for ED after prostate surgery. Implants will often cause a slight shortening of the penis.
Sensitivity, however, is an issue. In order to allow men to urinate, they have to operate on the prostate.
Its right next to the bundle of nerves that relay the sensation to the brain, causing a lot of the physical pleasure that men experience during sex.
It used to be the case that a prostatectomy would almost always damage those nerves, causing a permanent decrease or even loss of sensation. It would often be 8 months to a year before men reported any sense of sexual desire after the surgery.
However, nerve-sparing surgeries, particularly robotic prostatectomies, can avoid that nerve group far more effectively.
Its never a guarantee, but a majority of men who have undergone a nerve-sparing procedure can expect to regain the majority of the sexual desire and sensation they had before the operation.
For less-involved surgeries, men can expect to regain their sexual function a lot sooner. TURPs, ReZum, Aquablation or various other novel surgeries are all less likely to damage nerves and have faster recovery periods.
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How To Understand Psa Levels
As men get older, they almost all develop enlargement of the prostate. Invariably, PSA rises as a result. PSA comes both from the prostate gland and potentially, in some cases, from prostate cancer. This is what confuses things. PSA can come from both cancer and the benign prostate gland. So when checking PSA, the question should never be, Is it above a pre-specified arbitrary threshold such as 2.5 or 4.0? The question should be, Is the PSA elevated above what should be expected based on the size of the prostate?
The size of a mans prostate can be estimated by a digital rectal examination by a well-trained doctor. However, in my experience, very few physicians are skillful at estimating the prostate size by digital examination. Therefore, in most cases, prostate size can only be determined by measuring it with an ultrasound or MRI. Ultrasounds can be performed in the doctors office by a urologist. MRI is usually performed at a specialized imaging center. Modern prostate MRI imaging technology, termed 3-T multi-parametric MRI, is gaining in popularity and becoming more widely available.
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Sex After Prostate Surgery And Achieving Orgasm
Sex after prostatectomy is an important concern for most men. The total removal of the cancerous tissues is the primary goal, but the quality of life after prostate surgery is also important. Worrying about ED makes men be nervous and anxious when thinking about undergoing radical prostatectomy.
However, whilst most patients focus on erectile dysfunction, orgasm is somehow under-considered. But is it possible to achieve orgasm after prostatectomy? Erections and orgasm are equally important for a healthy sex life.
The good news is that sex after prostate surgery is very possible and enjoyable for most men. This is due to the newest robotic technologies that are nerve-sparing and preserve the sexual function.
Dr. Samadis robotic prostate surgery, SMART Surgery, was explicitly designed to spare the tiny nerve bundles surrounding the prostate in order to preserve sexual potency.
Men who undergo Dr. Samadis robotic prostate surgery have a reasonable chance of regaining complete erectile function for sex after prostate surgery.
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Does Bph Increase Your Risk Of Developing Prostate Cancer
Based on research to date, the answer is no. However, BPH and prostate cancer have similar symptoms, and a man who has BPH may have undetected cancer at the same time.
The American Cancer Society recommends that men make an informed decision with their health care provider whether to be screened for prostate cancer. For men at average risk, this discussion should start at age 50. They also say that for men who are at high risk, such as African-American men and men with a family history of prostate cancer, screening should be considered at age 45. Men at an even higher risk, such as having more than one relative with a history of prostate cancer at an early age, should consider earlier testing.
The American Urological Association recommends against routine screening for men age 40 – 54 who have an average risk of prostate cancer. Those with a higher risk are encouraged to discuss prostate cancer screening tests with their doctor. The association recommends that men ages 55 – 69 should weigh the risks and benefits of screening and treatment. For those who choose screening, the AUA suggests that they may be screened every two years rather than annually. Tests used to screen for prostate cancer include a blood test for a substance called prostate-specific antigen and the digital rectal exam . The AUA does not recommend PSA screening in men over age 70 or any man with less than a 10-15-year life expectancy.
Are There Any New Developments In The Treatment Of Prostate Cancer
Doctors often successfully treat prostate cancer. Sometimes, however, the disease returns . An FDA-approved radiotracer for PET/CT called Axumin® helps detect and locate cancer that recurs following radiation therapy or surgery.
Conventional imaging, such as MRI or ultrasound, cannot locate recurring prostate cancer when it is small. PET/CT with Axumin® can detect recurring cancer when PSA levels are low and when the cancer is small.
Identifying the exact location and extent of the disease at an early state is vital. It allows doctors to specifically target the cancer and limit exposure to healthy tissues.
Prostate-specific membrane antigen is a protein that helps develop prostate cancer. A PSMA scan uses PET imaging and a radiotracer to locate recurrent cancer. Doctors are studying Lutetium-177 PSMA therapy in clinical trials for use in treating prostate cancer. Neither of these procedures has FDA approval yet. For more information about the clinical trials, visit .
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Large Prostate With Significant Symptoms
For patients who have moderate or severe symptoms that have failed medical therapy from very enlarged prostates, the optimal treatment is often surgery. For very enlarged prostates, there are four main surgical options: