Preliminary
The prostate is a major accessory sex glands of a man. Have prostate exocrine function, but until now have not endokrinnya function can be found. Secretion contributed 15% of the total fluid released during ejaculation. Results secretion of fluid from the prostate adds fluid as space motion of sperm, but until now the reproductive function of this fluid can not be identified. These glands become the subject of much research because the prostate can menjasi where infection and benign or malignant tumors. Prostate have a very close relationship with the bladder neck and urethra, so that interference with micturition disorders manifest prostate (lower urinary tract symptoms).
Anatomy
The prostate is a gland that is a combination tubuloalveolar. The prostate is located just distal to the bladder neck and posterior urethra joined to form the prostatic urethra all of which are attached to the distal urogenitalis diaphragm. Adult prostate gland has a shape such as almonds, and has a weight of 18-20 grams. This gland has a size of 4.4 cm at its base, 4.3 cm in length and 2.6 cm in anteroposterior diameter. urethra into the prostate near the center of the prostate base and out on the anterior surface of the apex of the prostate, forming part known as the prostatic urethra. Ejaculatory ducts which is a channel which channels the fluid ejaculation prostate ending at the posterior part near verumontnum.
Prostate cancer incidence is very high on the male population in North America (119.9), Australia and New Zealand (79.9), country of Scandinavia (61.9) per 100 000 inhabitants, but for the race asia, especially in southeast asia protat cancer incidence of only about 7 100 000 inhabitants, but with a level high enough terblang mortatilas which is 4.5 per 100,000 population. In Indonesia the rate is not much different. In a period of 20 years, prostate cancer is increasing, and the mortality rate also rose, It is because 70% of prostate cancer patients seeking treatment in Indonesia came in a state of advanced stage.
Role in prostate cancer early detection is crucial to reduce mortality, considering that prostate cancer grows very slowly and can be treated properly when the patient arrived at an early stage and the cancer is still localized within the prostate tissue.
Triassic digital rectal examination, PSA, and biopsy with ultrasound guidance transrektal used for early detection of prostate Ca. Combination digital rectal and PSA is the first-line test for assessing individual risk prostate Ca. Then, is not recommended because it has a low predictive value for detection of prostate Ca and high cost.
Digital rectal
Jewett (1956) report, the findings are suspected of digital rectal examination, 50% was observed after the biopsy of prostate Ca. Positive predictive value of digital rectal dependent of age, race, and PSA levels.
In population screening tests carried out (screening) with PSA <4 ng / ml and the suspicion of the inspection plug anus, Carvalhal et al found a higher detection rate in older age and black race.
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