Prostatic secretions

OTR is also expressed in male reproductive tissues, like testis, epididymis and in the prostate. OT increases the resting tone of prostatic tissue from guinea pig, rat, dog and human. The activation of these receptors could lead to the contraction of the prostate and the resulting expulsion of prostatic secretions during ejaculation. 

Prostate An organ in the urogenital tract that surrounds the urethra at the base of the urinary bladder. Prostatic secretions are secreted into the urethra and become part of the ejaculate in males. 

Lavallee and Rosenkrantz (54) studied the purification of dog prostatic acid phosphatase from prostatic secretion obtained from pilocarpine-stimulated dogs with cystopreputiostomy prostatic fistulas. A 45-... 

In man and in other mammalian species, the major mass of the prostate, usually consisting of the right and left lateral and the middle lobes, is composed of alveoli lined with columnar epithelium embedded in a thick fibromuscular stroma. These alveoli constantly secrete a fluid which is drained off by a system of branching ducts that empty into the floor and lateral surfaces of the posterior urethra. The normal secretion is dependent upon the degree of androgenic stimulation and amounts to about 0.5-2 ml per day. The prostatic secretion, which is characterized by very high acid phosphatase activity, is a milky fluid which contains citric acid, choline, cephalin, cholesterol, proteins, and electrolytes similar to those found in the plasma. 

Clark and Treichler (04) have studied the psychic factors involved in prostatic secretion, and it is possible that physiological or psychological stimuli might have played a role in yielding high values for prostatic acid phosphatase activity on the first visit. These patients were followed for a period of 6 months to a year and no evidence arose which indicated that these elevations had any pathological significance (D6). 

Available studies suggest that penetration of the newer quinolones into all extravascular sites (large-volume spaces i.e., ascites, pleural fluid, etc.), secretory fluids (urine, prostatic secretions, sputum, etc.), barrier fluids (CSFL), and whole tissues is high relative to the penetration reported for most other categories of antimicrobial agents, particularly, the penicillins, cephalosporins, and aminoglycosides... 

Scott, W. W., and Huggins, C., The acid phosphatase activity of human urine, an index of prostatic secretion. Endocrinology 30, 107-120 (1942). 

Acute bacterial prostatitis can be managed with many agents that have activity against the causative organism. Chronic prostatitis requires an agent that is not only active against the causative organism but also concentrates in the prostatic secretions. Therapy with trimethoprim-sulfamethoxazole or a fluoroquinolone is preferred for 4 to 6 weeks. 

The pH of prostatic secretions in patients with prostatitis also has been reported to be altered. Normal prostatic secretions have a pH in the range of 6.6 to 7.6. With increasing age, the pH tends to become more alkaline. In patients with inflammation of the prostate, prostatic secretions may have an alkahne pH in the range of 7 to 9. These changes suggest a generalized secretory dysfunction of the prostate that not only can affect the pathogenesis of prostatitis but also can influence the mode of therapy. 

Fig. 114—3). The method compares the bacterial growth in sequential urine and prostatic fluid cultures obtained during micturition. The first 10 mL of voided urine is collected (voiding bladder 1, or VBl) and constitutes urethral urine. After approximately 200 mL of urine has been voided, a 10-mL midstream sample is collected (VB2). This specimen represents bladder urine. After the patient voids, the prostate is massaged, and expressed prostatic secretions (EPS) are collected. After prostatic massage, the patient voids again, and 10 mL of urine is collected (VB3). 

Several factors that determine antibiotic diffusion into prostatic secretions were delineated from the canine model. Lipid solubility is a major determinant in the ability of drugs to diffuse from plasma across epithelial membranes. The degree of ionization in plasma also affects the diffusion of drugs. Only un-ionized molecules can cross the lipid barrier of prostatic cells, and the drug s pKa directly determines the fraction of unchanged drug. 

The pH gradient across the membrane has an influence on tissue penetration as well. A pH gradient of at least 1 pH unit between separate compartments allows for ion trapping. As the un-ionized drug crosses the epithelial barrier into prostatic fluid, it becomes ionized, allowing less drug to diffuse back across the lipid barrier. In early studies with the canine model, the prostatic pH was reported to be acidic (6.4). More recent studies in humans, however, have reported that the pH of prostatic secretions from an inflamed prostate is actually basic (8.1 to 8.3). ... 

ACB antibody-coated bacteria EPS expressed prostatic secretions LE leukocyte esterase PAF prostatic antibacterial factor PMN polymorphonuclear leukocyte UTI urinary tract infection WBC white blood cell... 

Treatment of uncomplicated lower urinary tract infections with trimethoprim—sulfamethoxazole often is highly effective for sensitive bacteria, usually for a minimum of 3 days. The combination is especially useful in chronic and recurrent infections of the urinary tract. Trimethoprim also is found in therapeutic concentrations in prostatic secretions, and trimethoprim—sulfamethoxazole is often effective for bacterial prostatitis. 

Huggins C, Clark PJ. Quantitative studies of prostatic secretions. II. The effect of castration and of estrogen injection on the normal and on the hyperplastic prostate glands of dogs. J Exp Med 1940 72 747-762. 

Provenge (sipuleucel T) is a prostate cancer vaccine made from antigen-presenting cells from the patient s own immune system, which are fused to a protein (prostate-secreted acid phosphatase) made from prostate cells. It is currently being evaluated in phase III trials. 

The secretions of the seminal vesicles vary greatly between species in their normal volumes and chemical compositions, and in the extent to which they contribute to the total seminal plasma. In comparison with prostatic secretions, vesicular fluids tend to be more alkaline, higher in dry weight, and richer in bicarbonate, potassium, acid-soluble phosphate compounds, and especially proteins and polypeptides. In several species seminal vesicle secretions contain well over 200 mg/ml of total protein which in good measure accounts for the high viscosity and stickiness of these fluids. 

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