Question

A 60-year-old male patient has a condition called "prostatic hypertrophy."

• Why does this cause problem, both with starting a stream of urine, as well as with ejaculation?
• Identify the anatomical location as to why the doctor performed a "digital exam" to identify this prostatic hypertrophy?

Explain the anatomical location where a vasectomy would be performed. Why is this the logical location for it to be the best place for this surgical procedure? Use correct anatomical terms and references to other regional structures.

Answer 1

The condition prostrate hypertrophy is enlargement of the prostrate gland. Hence when there is increase in the size of the gland it causes pressure over urethra and thus have a problem with urination.

The patient might be unable to empty the bladder completely and there might also be blockage during the flow with stream of urine.

The increase in size of prostrate also results in some sexual dysfunctions like erectile dysfunction or problem with the ejaculation.

Anatomically when seen, the ejaculatory duct pass downwards and open into prostatic urethra. Hence when prostrate is enlarged, the prostatic urethra will be narrowed thus can cause problem with ejaculation.

The other factor is the medications used in the treatment of prostrate hypertrophy like alpha blockers which cause difficulty in ejacation.

To identify this condition, a digital rectal examination should be done. The digital examination helps in assessing the size of prostrate and also to detect certain areas which can be suggestive of malignancy.

Vasectomy is performed at the level of vas deferens (or) ductus deferens which transmits the sperms from epididymis to the ejaculatory duct.

As the lumen of vas deferens is narrow and is of approximately 45 cms in length and its anatomical course and positioning makes it suitable to perform the procedure.