This gland is subject to several painful and annoying diseases,
controlling, as it does, the flow of urine and exerting such a
profound influence over the sexual functions. The nerves to the
prostate pass between the gland and the levator ani muscle, and the
secretory branches are from the sacral nerves, while Quain gives the
sensory as from the tenth, eleventh (twelfth) dorsal, first, second
and third sacral and fifth lumbar. Lesions affecting the prostate are
occasionally found at the tenth and eleventh dorsal and fifth lumbar,
while the innominate lesions are common causes of trouble. These should
be corrected, if present, and local treatment given to the gland.
“Massage of the prostate,” says Lydston,[47] “properly performed, is
one of the most valuable advances in genito-urinary therapeutics that
has been developed in many years.” Osteopathic technique is to place
the patient on the side, knees flexed, and standing in front insert
the index finger. Care must be used not to bruise the gland and it
must be touched lightly when sensitive. Relax tissue about the gland,
and, then, from the median line with an outward movement, massage the
surface of each lobe. This influences the blood and nerve supply, while
the pressure will tend to relieve congestion. Length of treatment, as
well as frequency, depends entirely upon conditions. Do not make the
mistake of treating the perineum instead of the gland and do not gouge
it with the finger. Remember it is sensitive tissue.
=Hypertrophy= is most commonly met with in practice, as twenty per cent
of men past middle life are said to be afflicted. It is probably not a
sequence of old age, but due to chronic, congestive and inflammatory
conditions. Anything which would produce these conditions—spinal
lesions, excessive venery, masturbation, or other more innocent
causes—would in time bring about enlargement. As the length of catheter
life is estimated at six years it is of great importance that the
condition be early recognized, for in advanced stages surgery is the
last resort. In early stages the prognosis is good, either for a
cure or to stop further enlargement, while many enlarged ones at the
catheter stage have been greatly benefited or cured. Treatment of the
gland once per week is usually enough, but in older cases can be given
semi-weekly. Look well to nerve and blood supply.
=Acute Prostatitis= is a serious and painful inflammation, causing
urinary retention usually. It results from trauma, horseback riding,
over exertion, gonorrhea and its maltreatment, etc. Lower dorsal and
lumbar lesions are frequent. This condition must be closely watched.
Inhibition of the sacral nerves will help control pain and stop any
spasm of the sphincter. Cold applications to the gland externally at
the perineum will aid in reducing inflammation. Local treatment should
at first be given to the adjacent tissues as the gland will be very
sensitive. Later direct massage will be of great benefit.
=Chronic Prostatitis= may follow an acute attack or it may originate
as a chronic or subacute affection. Frequent micturition and dull
pain, referred to the perineum and rectum, with the local examination,
make diagnosis sure. The spinal lesions should be corrected and the
gland massaged. This will induce absorption, by squeezing out the
inflammatory products and do much toward preventing future hypertrophy.
“Massage is done by the finger. The patient is placed in the knee-elbow
position and massage employed for four minutes daily. The value of
massage in chronic prostatitis is very great, but should be employed
with much caution and never in cases of suppuration.”[48]
=Prostatorrhea= is often taken for spermatorrhea and any irritation
of anterior sacral nerves would cause undue activity to the secretory
nerves to the gland. This is easily determined.
=The Seminal Vesicles= can be reached just above the prostate, and if
inflamed and tender or if engorged by inspissated seminal fluid, local
treatment will be of benefit. Frequent massage, daily in some cases, to
the gland and treatment to the sympathetic nerves above the trigone of
the bladder, to the nerve fibres passing along the spermatic cord, and
to the arteries directly, will be of the greatest aid in impotency.
In =Chronic Gonorrhea=, where the gonococcus has found lodgement in and
about the gland, it can be more readily dislodged by massage than by
any other form of treatment.
=Retention of urine= from nervous excitement or other minor causes, can
often be overcome by local massage of the prostate.
=Spastic stricture= can usually be cured by work about the prostate and
its innervation.