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The word prostate comes from the Greek word “prostates”. It means standing in front, guard and protector. In a healthy man, the size of a normal prostate is approximately the size of a large walnut. The weight of the prostate is between 10 and 20 grams. It is located at the base of the urinary bladder and also surrounds the urethra.

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Figure 1: Anatomical structure of the prostate

Nöbetçi Prostat

Figure 2: Finger examination of the prostate (Rectal touch).

It protects the urinary tract and semen tract from many infective agents until the end of middle age in men. It provides the most suitable conditions for fertilization by protecting the sperm (male germ cell), which is the reproductive cell in men with reproductive function, from environmental factors. By making the environment in which sperm is alkaline, it protects it from the acidic environment in the vagina and causes it to live longer.

Prostate, which remains stable after birth; It grows with the change of hormonal structure in adolescence and reaches its normal size at the age of 20. The prostate, which remains in its normal size from 20 to 40 years of age, starts to grow again after 40 years of age. This second growth, which is an undesirable growth, occurs with the contribution of the changing hormonal structure and genetic background.

Prostate diseases, which are the most common disease group in men in the world, are seen mostly as prostate infections at young ages, while they appear more as benign prostatic enlargement (BPH) or prostate cancer (Pca) after the age of 50.

With the rapid aging of the population, we are starting to see BPH and especially prostate cancer more frequently. Prostate cancer is currently the most common cancer in men, and it comes second after lung cancer in terms of death. Therefore, it becomes a very important social and medical problem in the aging society. After the age of 50, almost half of the men start voiding problems that affect their quality of life.

Benign Enlargement of the Prostate (BPH):

Advancing age and the presence of functional testicles are the most effective factors identified for benign enlargement of the prostate. As can be understood from this sentence, as the world population ages, there will be an increase in the number of people who need treatment for prostate diseases. At the age of 80, 75% of men have benign prostatic enlargement at the cellular level.

lower urinary tract complaints; hesitation in the act of urination, intermittent urination, dripping after voiding, forked urination, urinating by straining, prolonged urination time, increased frequency of daily urination, urgent need to void, urinary incontinence with the urgent need to void, waking up with the need to void at night, painful urination and urinary incontinence. These complaints may be a symptom of BPH, which causes obstruction in the urinary bladder outlet.

There are many treatment alternatives in BPH, which can be diagnosed with a simple prostate check-up. Such as lifestyle regulation, drug therapy, green light laser therapy.

Prostate Cancer (Pca):

Another issue that should be emphasized while talking about prostate diseases is prostate cancer. Prostate cancer is the most common type of cancer in men worldwide. A man’s lifetime risk of developing prostate cancer is 15%, so the risk of death is 2.9%. Among the risk factors, family history, western style diet, black race can be counted.

Prostate specific antigen (PSA) is the most commonly used parameter in the diagnosis of prostate diseases. PSA, a protein produced only by the prostate in the body, increases by passing into the blood during prostate diseases. Therefore, any deterioration that may occur in the prostate tissue causes an increase in PSA. These include inflammation of the prostate, prostate cancer, and benign enlargement of the prostate.

Early diagnosis gains importance in this disease, which has a high chance of being cured and disease-free while it is limited in the prostate. Even if there is no complaint after the age of 40 in those with a family history and 50 in those without, an annual prostate examination and PSA blood level measurement may be sufficient for early diagnosis. Digital examination of the prostate (rectal touch) is a stand-alone diagnostic examination independent of PSA values. This irritating examination method, which allows direct access to the prostate, which is a hidden organ, is a necessary screening method especially for prostate cancer (Figure 2).

Based on the developments in prostate cancer treatment in recent years, life expectancy has increased and serious reductions in the clinical stages of the patients have begun to be observed. Especially in early stage prostate cancer, patients can get rid of cancer completely thanks to both surgery and radiotherapy opportunities.

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Robotic Prostate Surgery