La prostate est un organe génital masculin situé à un carrefour stratégique entre la voie urinaire et la voie génitale. Elle peut être le siège de trois affections principales: le cancer de la prostate, l’adénome de la prostate, et l’infection de la prostate ou prostatite.
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La prostate, présente uniquement chez l’homme, fait partie du système reproducteur masculin. Située en avant du rectum, juste sous la vessie, elle a classiquement la taille et la forme d’une châtaigne, mesurant environ 3 à 4 cm de long et 3 à 5 cm de large. Chez l’homme jeune, la prostate fait environ 20 g.
Les vésicules séminales sont des glandes accessoires qui sont appendues à la prostate. La prostate et les vésicules séminales produisent le liquide séminal. Les canaux déférents qui proviennent des testicules amènent dans la prostate les spermatozoïdes qui sont mélangés au liquide séminal pour former le sperme qui passe dans l’urètre au moment de l’éjaculation.
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La prostate entoure la partie initiale de l’urètre, le canal par où l’urine s’évacue de la vessie et qui se termine au bout de la verge. Elle n’a donc aucun rôle urinaire mais elle entraîne des symptômes urinaires car elle entoure donc l’urètre et peut le comprimer quand elle augmente de volume.
La prostate comprend en fait 4 zones : antérieure, périphérique, centrale et transitionnelle. C’est dans la zone périphérique, facilement palpable au toucher rectal, que se développent le plus souvent les cancers de la prostate. La zone de transition, qui entoure l’urètre, est l’endroit où se développe habituellement l’hyperplasie bénigne de la prostate (adénome), l’affection bénigne qui survient progressivement chez l’homme à partir d’un certain âge.
Prévention du cancer de la prostate :
L’Association Française d’Urologie, de même que l’Académie de Médecine, recommandent un diagnostic précoce de cette maladie.
En pratique, tous les hommes de plus de 50 ans – et même dès 45 ans en cas d’antécédents familiaux de cancer de prostate – devraient bénéficier d’un dépistage systématique annuel, associant un toucher rectal et un dosage de PSA.
Le toucher rectal est rapide, facile à pratiquer et quasiment indolore. Il permet parfois de palper un nodule suspect au sein de la prostate.
Le dosage du PSA renseigne sur les risques de cancer de prostate.
En cas de problème prostatique, des examens complémentaires pourront être prescrits : échographie de la prostate, biopsies de prostate en cas de suspicion de cancer.
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