Prostate: Blood Supply, Lymph Drainage, And Applied Anatomy

Question 1

Arterial supply

Answer 1

1. Inferior vesical artery
2. Middle rectal artery
3. Internal pudendal artery

Question 2

Venous drainage

Answer 2

Prostatic venous plexus

Question 3

Prostatic venous plexus

Answer 3

1. Lies around prostate anterolateral aspects between true and false capsules
2. Receives deep dorsal vein of penis in front and communicates with vesical venous plexus above
3. Drains into vesical and internal iliac veins

Question 4

Valveless vertebral veins of Bateson

Answer 4

1. Connect prostatic venous plexus with plexus of veins in front of vertebral bodies and within neural canal
2. This explains prostate cancer spread to vertebrae

Question 5

Lymph drainage

Answer 5

1. Drain to internal iliac, sacral, and obturator lymph nodes
2. Lymph vessels from posterior surface accompany vesical vessels to external iliac lymph nodes

Question 6

Applied anatomy: bladder uvula

Answer 6

1. In adult male, prostate median lobe causes small elevation behind bladder internal urethral meatus (bladder uvula)
2. In senile prostatic hypertrophy, bladder uvula enlarges and leads to difficulty in micturation

Question 7

Clinical subdivision

Answer 7

Prostate has 4 distinct glandular regions:
1. Peripheral zone
2. Central zone
3. Transition zone
4. Anterior fibromuscular zone (Stroma)

Question 8

Peripheral zone

Answer 8

1. Sub-capsular portion of prostate posterior aspect which surrounds distal urethra
2. Main site of prostatic cancer

Question 9

Central zone

Answer 9

1. Surrounds ejaculatory ducts
2. Rare site of cancer prostate

Question 10

Transition zone

Answer 10

1. Surrounds proximal urethra
2. Less common site of cancer prostate

Question 11

Anterior fibromuscular zone

Answer 11

Usually devoid of glandular components and composed only of muscle and fibrous tissue