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vary much in size and in the extent to which their cavities are ramified and
sacculated, some being quite simple. Besides these there are larger recesses or
lacuna, opening by oblique orifices turned forwards, or down the canal. These are
most abundant along the floor of the urethra, especially in its bulbous part. One
large and conspicuous recess, situated on the upper surface of the fossa navicularis,
is named the lacuna magna. A median fold of the membrane rising from the inferior
surface of this part of the urethra has been named the valve of the fossa navicularis.

Stratified concrements like those met with in the prostate (see below) are also found in old
subjects in the glandular recesses of the urethra (Robin and Cadiat).

Cowper's glands. In the bulbous portion of the urethra, near its anterior end,
are the two openings of the ducts of Cowper's glands. These small glandular
bodies (fig. 261, c) are seated above the bulb, behind the membranous portion of
the urethra, between the two layers of the triangular ligament, the inferior layer
supporting them against the urethra. The arteries of the bulb pass above, and the
transverse fibres of the compressor urethrae beneath these glands. They form two
small firm rounded masses, about the size of peas, and of a deep yellow colour.
They are compound racemose glands, composed of several small lobules held
together by a firm investment. This latter, as well as the walls of the ducts,
contains muscular tissue. The epithelium of the acini consists of clear columnar
cells, with a reticular protoplasm, staining like the cells of mucous glands. The
ducts are lined with cubical epithelium. The ducts unite outside each gland to
form a single excretory duct (fig. 261, c d). These ducts run forward near each
other for about an inch or an inch-and-a-half, first in the spongy substance and
then beneath the mucous membrane, and terminate in the floor of the bulbous
part of the urethra by two minute orifices opening obliquely. The glands secrete
a viscid fluid, the use of which is not known ; they appear to diminish in old age ;
sometimes there is only one present, and it is said both may be absent.

Occasionally there is a third glandular body in front of and between Cowper's glands ;
this has been named the anterior prostate or ante-proxtatic gland.

. The muscles in connection with the urethra and penis have been already described with

the muscles of the perinasum in Vol. II., Part 2.


The prostate gland (figs. 262, 263, 264) is an organ connected with both the
urinary and male genital ducts, but it primarily belongs to the latter, being one
of the accessory male organs of generation. It atrophies in the adult after the
testicles are excised, and when these organs are removed in infancy it remains un-
developed. In animals it enlarges, like the testicles, during the breeding season.

It is a firm, glandular, and muscular body, comparable in size and shape to a
chestnut, situated in the pelvis, and traversed by the first part of the urethra and
by the common ejaculatory ducts. It has a base, an apex, an anterior, a posterior
and two lateral surfaces. The base is situated immediately below the neck of the
bladder, while the apex is above the superior layer of the triangular ligament. Its
posterior surface, which is flat and larger than the anterior, lies against the second
part of the rectum so that it can readily be felt by passing the finger into that
organ. The anterior surface is convex and is placed about half-an-inch behind the
lower part of the pubic symphysis from which it is separated by some fat, a plexus



of veins and the pubo-prostatic ligaments. The lateral surfaces are convex and
prominent, and are covered by the anterior portions of the levatores ani muscles,
which pass backwards on each side from the pubis and the superior layer of the
triangular ligament and embrace the sides of the prostate, but are separated from
the gland by a plexus of veins. The urethra passes through the prostate from its
base to its apex in the median plane and rather nearer the anterior than the posterior
surface, being generally about a quarter of an inch ((5mm.) from the former and



p. s., pubic symphysis ; o. i, obturator interims muscle ; L. A., levator ani muscle ; p. v., prostatic
plexus of veins ; F, retro-pubic pad of fat ; u, upper part of prostatic urethra ; H, anterior wall of rectum ;
v. D. , vas deferens ; s. v., seminal vesicle.

nearly half an inch (12mm.) from the latter. The prostate is also pierced by the
two common ejaculatory ducts which enter at a median depression situated at
the upper part of the posterior surface and, passing downwards and forwards in

THE MIDDLE. (Alien Thomson.)

u, the urethra into which the eminence of the caput gallinaginis
rises from below ; s, the utricle cut through ; d e, the ejaculatory
ducts ; m, superiorly, the deep sphincter muscular fibres ; m, lower
down, intersecting muscular bands in the lateral lobes of the
prostate ; p, glandular substance.

close contact with one another, open on the posterior
wall of the prostatic portion of the urethra, In a

median section (fig. 262) the prostate is therefore seen to be divisible into three
parts, one in front and two behind the urethra. Of the two posterior portions,
one lies above and in front, and the other below and behind, the channel for the
ejaculatory ducts.

The prr state is usually described as consisting of three lobes, two lateral and one
median. The laleral lobes form the great mass of the gland and are united with one


another in front of the urethra, and also behind the urethra below the ejaculatory
ducts. The middle lobe lies behind the upper portion of the urethra, below the apical
portion of the trigone of the bladder and above the common ejaculafeory-ducts. At
the sides it passes without any line of demarcation into the lateral lobes. This
part of the prostate is of considerable surgical interest since, when enlarged, it
may seriously interfere with micturition. Its title to be regarded as a distinct
" lobe " is disputed. Sometimes it projects backwards, as a rounded prominence,
between the bladder and the vasa deferentia, but, according to H. Thompson, this only
occurs when it is pathologically enlarged. According to J. Griffiths it contains, in
some subjects, glandular tissue, the ducts of the glands being distinguishable from
those of the lateral lobes by opening on the posterior surface of the upper part of
the prostatic urethra in and near the middle line. In other cases neither glandular
tissue nor ducts are present in this position. The prostatic part of the urethra
receives not only the openings of the seminal and prostatic ducts, but also, as has
already been more particularly described, that of a small blind recess, called the
sinus pocularis or prostatic utricle, which passes backwards in close relation with the
ejaculatory ducts.

Size and Weight. The longest diameter of the prostate is the transverse
which measures near the base of the organ about one and a half inches (30 mm.), its
vertical extent is about one and a quarter inches (30 mm.), and its antero-posterior
nearly three-quarters of an inch (18 mm.) These diameters, however, are liable to
alteration according to the condition of the bladder and rectum. Thus distension
of the bladder tends to diminish its vertical extent, while a dilatation of the lower
part of the rectum will compress the organ from before backwards, and increase its
vertical and transverse diameters. Its average weight may be estimated, according
to H. Thompson, at about four and a half to four and three-quarter drachms
(20 - 5 grammes, Bischoff).

Structure. The prostate gland is covered externally by a dense fibrous coat,
which is continuous with the recto-vesical fascia, and with the superior layer of the


OF THE PROSTATE. (Heitzmann).
M, muscular tissue ; E, epithelium ; (7, concretions.

triangular ligament. This fibrous cap-
sule, which includes much plain muscular
tissue, is divisible into two layers, be-
tween which the prostatic plexus of
veins is enclosed (Adams). From the.
capsule trabeculae extend through the
gland towards the colliculus seminalis.
The glandular substance is associated
with a large quantity of plain muscular
tissue, which forms the principal part of
the stroma of the organ. This muscular
tissue forms an external layer below the
fibrous capsule, and extends everywhere
through the glandular substance : there
is also a strong layer of circular fibres
continuous posteriorly with those of the
bladder, and in front with the thin layer surrounding the membranous part of the
urethra. The part of the prostate in front of the urethra is almost entirely
muscular ; in the hinder part the muscular substance is in greatest quantity near
the bladder.


The glandular substance is spongy and yielding ; its colour is reddish grey, or
sometimes of a brownish hue. Jt consists of numerous tubular alveoli, which unite
into a smaller number of excretory ducts. The epithelium is shortly columnar or
vertical throughout, and there is a second layer of small cells next to the basement
membrane. In the upper part of the gland the acini are smaller and more saccular ;
in the middle and lower parts the tubes are longer and convoluted at their ends.
The capillary bloodvessels form a close network, as in other similar glands, on the
ducts and acini, and the different portions of the gland are united by areolar tissue,
and supported by processes of the deep layer of the fibrous capsule and by the
muscular stroma. The ducts open by from twelve to twenty or more orifices upon
the floor of the urethra, chiefly in the hollow on each side of the colliculus seminalis.

Vessels and Nerves. Arteries. The prostate is supplied by branches of
the vesical, hccmorrhoidal, and pudic arteries. Its veins form a plexus imbedded
in the fibrous covering round the 'sides and front of the gland, which is highly
developed in old subjects. The veins communicate in front with the dorsal vein
of the penis, and behind with branches of the internal iliac vein. Lymphatics
ramify with the veins, between the two layers of the fibrous capsule. The nerves,
which are derived from the hypogastric plexus, consist of both medullated and non-
medullated fibres, and are interspersed with ganglion cells. Pacinian bodies have
also been observed on the superficial nerves.

Secretion. Examined after death, the prostatic fluid has a milky aspect, due to the
admixture of a large number of epithelial cells, but probably, during life, it is more trans-
parent. It is not a mucous secretion but, according to Adams, the fluid has an acid reaction,
and presents, under the microscope, numerous granules, epithelial cells and nuclei. Some of
the granules are composed of lecithin (Fiirbringer, Jena. Sitzungsb., 1881).

Peculiarities according- to age. The prostate is very small at birth and it remains
comparatively so until puberty, when in common with the other generative organs it under-
goes a considerable increase in size. Thus, according to Gross, it weighs at birth 13 grains,
at the 4th year 23 grains, at the 12th 43 grains, at the 14th 58 grains, and at the 20th
260 grains (17 grammes).

The glandular tissue of the prostate is developed by epithelial outgrowths from the
posterior wall of the urethra at the sides of the orifices of the primitive genital ducts, both
Mullerian and Wolffian (Griffiths). These gland tubules grow outwards to form the lateral
lobes of the prostate, and by their extension forwards and inwards, may meet in the median
plane in front of the urethra. The amount of gland tissue in front of the urethra is very
small in the child, and in some cases it is not developed in this situation at any period of
life. Griffiths considers that the median lobe, when present, is not formed by a fusion of the
lateral lobes behind the urethra, but arises independently by median outgrowths from the
upper part of the posterior wall of the urethra. The prostate exhibits a marked tendency to
undergo in old age, and its tubules frequently contain small laminated bcdies
which gradually become calcified (fig. 265, c.).


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