1. 1 | P a g e Prostate , , , , , , , - - , , : : 30 4 32 700 700 20 One who stands before Protector Guardian 2002 (Female Paraurethral Glands or Skene's Glands) (Orgasm) ... (Exocrine) 20 3 .., 4 .. 2 .. (Pubic Symphysis) , , (Urinary Bladder) (Rectum) (Apex) (Striated External Urethral Sphincter)

2. 2 | P a g e , , (Fascia) (Anterior and Anterolateral Fascia) (Penis) (Deep Dorsal Vein) (Denonvilliers) (RrectoVesical Fascia) (Connective Tissue) seminal vesicles (PuboProstatic Ligaments) (Levator Ani Muscle) 6 .. (Ductus Deferens) (Ejaculatory Duct) 3. 3 | P a g e 1- (Anterior lobe) 2- (Posterior lobe) 3- (Lateral lobes) 4- (Median lobe) 1968 . 1- (Transition zone)2- (Central zone)3- (Peripheral zone) 4- (Anterior Fibromuscular Zone) (Glandular Tissue) 10 % 20 % 70% 30% (FibromuscularStroma) (Transition zone) (Urethra) (2.5 ..) (2 ..) (Posterior Urethera) (Epithelium) (Transitional) (Adenoma) (Lateral Lobes) (Median Lobe) (Urethral crest) , (Sinus or Grove) , - (Seminal Colliculus Verumontanum) , , (Prostatic Utricle) , 4. 4 | P a g e (Central zone) 25% 2.5% , (Peripheral zone) 70% (Per Rectal Examination) 70% (Chronic Prostatitis) Anterior Fibro-muscular Zone (or Stroma) (5%) (Inferior Vesical Artery) , Internal Iliac (Hypogastric) Artery , , (Urethral Artery) , - 5 7 (Benign Prostatic Hyperplasia) , - (superior Vesical Artery) (Artery of the ductus) (Deep Dorsal Vein) , , 5. 5 | P a g e - (Anterior Prostatic Fascia) (Endopelvic Fascia) , , (Internal Iliac Vein) (S2-S4) , (L1-L2) 7 .. , (PreProstatic Sphincter) ( ) - - , , (Transitional Epithelium) (Urethra) , 6. 6 | P a g e (Urethra) (Prostatic Urethra) , (Trigone) , (Membranous Urethra) (Penile (Cavernous) Urethra) (External Urethral Meatus) 3 . . 9 .. 30 .. (Stereocilia) , , (Peristaltic Waves) (Epididymis) (Ampulla) , 7. 7 | P a g e 20 (Acini) , (PSA) (PSA) - -3 kallikrein-3 (KLK3) -3 (KLK3 gene) (Arousal) - (Orgasm) (Urethra) (Coiled) (Greek: upon + testicle) (Vas Deferens) ( ) , , - 1.028(pH)7.35-7.503 0.15 (2-5%)- 200-500 1.5-2 ( 65-75%) (1.5-6.5 /), , , , , , , , 0.6-0.9 (25-30%) (PSA), , , , , , , , (13540 /) 0.15 (1%), , , 8. 8 | P a g e ( ) pH 4 ( ), ( ) , , , , (PSA) ... (Clotting enzyme) (gel) ... ... ... -2 ( ) ... ... , 15-30 6-7 ... - ... , , , , , , , , , - , , 9. 9 | P a g e ... (Prostate Specific Antigen) , , Y X 10. 10 | P a g e (Malignant Tumor) , , (Lungs, Liver and Bones) 2009 192,280 27,360 17.6% 20.6% 2.8% 4.7% 20 - 40 (Screening Test) (Benign Prostatic Hyperplasia) BPH , , , , 40 80 80 50%-80% 80% 65 , 1.4 , , 11. 11 | P a g e ... Digital (done with the finger) Rectal Examination , , , ( Pelvic) (, ) , , , (Pelvic Bones) (Screening Tests) ( ) (Screening Tests) (PSA) (Digital Rectal Examination) 12. 12 | P a g e 40 (PSA) (PSA) (PSA) , 4 , ... ... , (Over Diagnosis), (Biopsy) (U.S. Preventive Services Task Force) ... 2009 - 40 ... (Digital Rectal Examination) ( , , , ), ... ( ) 10 75 ... 4 ... 2.5 , ... (PSA velocity) - ... (PSA velocity) ... 4 10 (Borderline) , , , ... ... 10 ... , ... ... 30 40 13. 13 | P a g e... - ... , (Prostatitis) ... 48 ... ... 4 10 , 20 25 , , , ... ... ... ... PSA Ratio - ... ... , ... ... PSA Ratio ... ... ... ... , ... ... ... ... ... ... ... ... 0 2.5, 0 3.5, 0-4.5 70 0 6.5 ... 4 , Age(in years)PSA Range (measured in ng/ml)4002.04202.24402.34602.54802.65002.85203.05403.25603.45803.66003.86204.16404.46604.66804.97005.37406.0780-6.8... - ... , ... ... ... ... , ... 14. 14 | P a g e 3 (PCA3) - 3 (PCA3) 3 (PCA3) ... 3 , - , , ... (10-20 ng/ml) - ( ) .. ... - .. ... , (Lymph Nodes) , , ... , (Cystoscopy) - (Cystoscopy) , , 15. 15 | P a g e (Staging) , I - II I ... III IV - 2002 ... (Tumor, Node, Metastases) (T stage) , (N stage) (M stage) ... (T) Tx: T0: T1: T1a: 5% T1b: 5% T1c: ... T2: T2a: T2b: , T2c: T3: T3a: T3b: T4: 16. 16 | P a g e T2c T2c (N) NX: N0: N1: (M) MX: M0: M1: M1a: M1b: M1c: , 17. 17 | P a g e , 1- 2- ( 3- -, , , , , - , , 36% - 90% , , (30%-70% ) (3%-10% ) - (Incontinence of Urine) (Impotence) 98% 60% , 70 % , , - 18. 18 | P a g e , 8 (), () - , 19. 19 | P a g e (Conventional External Beam Radiotherapy EBRT) 6 7 (Brachytherapy) , , , - , (Androgenic) ( ) LH-RH (Luteinizing Hormone-Releasing Hormone) - LH-RH LH-RH - - - (Gynecomastia) (Hot Flashes) LH-RH (Lupron) (Zoladex) - (Eulexin) (Casodex) LH-RH 20. 20 | P a g eLH-RH , - ( ) 10% () (Cryotherapy) (Cryotherapy) , (Fistula) ( () ) HIFU HIFU , 800-1000 C ... , (Emcyt) (Castrate-Resistant Prostate Cancers) (Taxotere) , 21. 21 | P a g e , , , - ( ), - () ( ) http://www.virtualmedicalcentre.com/treatment/cryotherapy-for-prostate-cancer/93