American Medical Association Family Medical Guide - American Medical Association [553]
If a hematocele, spermatocele, or varicocele continues to grow and is causing discomfort, your doctor will probably recommend surgery to remove it. If you have a varicocele and are having problems with fertility, your doctor will perform surgery to remove the varicose veins from the spermatic cord. All types of fluid accumulation in the scrotum can recur after surgery.
Disorders of the Prostate Gland
The prostate gland is a collection of small glands; it weighs about an ounce and is about the size of a walnut. It is covered with a layer of muscle and fibrous tissue called the prostatic capsule. The prostate sits directly below the bladder and in front of the rectum, and surrounds the neck of the bladder and the upper part of the urethra (the muscular tube that carries urine from the bladder out of the body).
The main function of the prostate gland is to produce part of the seminal fluid, the fluid that supports sperm in the semen. During orgasm, fluid from the prostate is squeezed into the urethra as sperm and other substances enter the urethra from the seminal vesicles and vas deferens. When combined, these substances form semen, which carries sperm through the urethra and out of the penis during ejaculation.
Healthy prostate gland
After age 40, men are more prone to two types of prostate disorders—an enlarged prostate and cancer. Because the prostate gland surrounds the urethra, nearly all disorders of the prostate gland cause symptoms related to urination, such as a weak or interrupted urinary stream or a frequent or urgent need to urinate. The three most common prostate problems are inflammation (prostatitis), enlargement (benign prostatic hyperplasia), and prostate cancer.
Prostatitis
Prostatitis is inflammation of the prostate gland. The three basic forms of prostatitis are bacterial prostatitis, nonbacterial prostatitis (also called chronic pelvic pain syndrome), and asymptomatic inflammatory prostatitis. Prostatitis can occur with or without an infection.
The two types of bacterial prostatitis (also called infectious prostatitis) are acute bacterial prostatitis and chronic bacterial prostatitis. Acute bacterial prostatitis is a rare but serious disease caused by bacteria in the prostate gland. The bacteria may have come from an infection elsewhere in the body. Chronic bacterial prostatitis occurs primarily in older men who have an enlarged prostate (see next page). It is a recurring infection of the prostate gland that usually results from previous bacterial infections that were not eliminated completely.
Nonbacterial prostatitis is the most common but least understood form of the condition. It may be inflammatory or noninflammatory. In the inflammatory form, there is no evidence of an infecting microorganism but infection-fighting cells are present. In the noninflammatory form, there is no evidence of either infection or infection-fighting cells.
In asymptomatic inflammatory prostatitis, a man has infection-fighting cells in his semen but has no symptoms. Asymptomatic inflammatory prostatitis is usually diagnosed when a doctor is testing the prostate for other disorders.
Symptoms
The initial symptom of both bacterial and nonbacterial prostatitis is often pain in and around the base of the penis and behind the scrotum. Your rectum may feel full, and you may have an urge to have a bowel movement. Later, you may experience a strong, frequent urge to urinate but find it difficult and painful to urinate. You may pass only a small amount of urine and have blood in your urine. Other possible symptoms include pain at