Shafik A
Urology. 1981 Aug;18(2):155-60. doi: 10.1016/0090-4295(81)90427-1.
A new syndrome in which 7 cases share common clinical features of urethral discharge only at defecation, constipation, and hemorrhoids is reported. The discharge occurred only with constipation. The relationship between urethral discharge, constipation, and hemorrhoids is discussed. The concept that hemorrhoids lead to prostatic venous congestion is put forward. The urethral discharge at defecation seems to be the result of "milking" of the congested prostate by the hard stools. The mechanism of fecal and urinary "milking" of the prostate is discussed. The role of the congested prostate in infertilogenesis is presented. It seems that metabolic accumulation in the prostatic, vesicular, and ampullary secretions affected the spermatogenic activity as it similarly does in varicocele. Permanent disappearance of urethral discharge and improvement of semen quality were achieved on anoprostatic decongestion by medical treatment, hemorrhoid injection, or hemorrhoidectomy. The syndrome of prostatorrhea, constipation, and hemorrhoids should be considered in patients with idiopathic urethral discharge and in infertile patients.
报告了一种新综合征，7例患者具有仅在排便、便秘和患痔疮时出现尿道分泌物的共同临床特征。分泌物仅在便秘时出现。讨论了尿道分泌物、便秘和痔疮之间的关系。提出了痔疮导致前列腺静脉充血的概念。排便时的尿道分泌物似乎是硬便对充血前列腺“挤压”的结果。讨论了前列腺的粪便和尿液“挤压”机制。介绍了充血前列腺在不育发生中的作用。似乎前列腺、精囊和壶腹分泌物中的代谢积累影响了生精活性，就像在精索静脉曲张中一样。通过药物治疗、痔注射或痔切除术使肛门前列腺充血消退后，尿道分泌物永久消失，精液质量得到改善。特发性尿道分泌物患者和不育患者应考虑前列腺溢液、便秘和痔疮综合征。
