Prostatorrhea

PROSTATORRHEA, the discharge from the urethra during urination or defecation of normal or altered secretion of the prostate gland without any admixture of spermatozoa. The discharge of semen from the seminal vesicles under the same conditions is called spermatorrhea (see), with which it is usually confused by patients. Fürbringer combines both conditions, calling prostatorrhea "azoospermatorrhea." The differential diagnosis is made on the basis of microscopic examination of the discharge. Pure forms of prostatorrhea are rare; usually, the constituent elements of both secretions are found under the microscope. In some cases, prostatorrhea is not a pathological symptom, can exist for a number of years without any harmful consequences for the organism, and is explained by the mechanical squeezing of the secretion from the prostate during the passage of hard stool or during the contraction of muscle bundles which, being connected with the prostate, surround the neck of the urinary bladder. In other cases, prostatorrhea is caused by paresis of the excretory ducts of the prostate. This latter form of prostatorrhea is usually observed in atony of the prostate gland (see), very often in people who have never had gonorrhea. According to Fronstein, prostatorrhea is observed as a result of prostatitis and impaired tone of the excretory ducts of the prostate. Since the condition of the prostate plays a major role in the origin of prostatorrhea, in all cases of prostatorrhea it is necessary to examine it via the rectum. Analysis of the secretion expressed by massage allows for the determination of both the presence of inflammatory products (pus, microbes) and the presence of formed elements characteristic of the normal prostate gland (lecithin granules, etc.). Prostatorrhea often accompanies so-called sexual neurasthenia, by no means causing it, but being only one of the symptoms of the latter, or a symptom of a prostate lesion, in which functional disorders of the nervous system are often observed. In the latter case, the prognosis of the disease depends on the prognosis of prostatitis and is most often doubtful. Treatment, after clarifying the causal factors, consists (in the presence of prostate changes) in strengthening the organism, regulating bowel movements, eliminating atony or inflammation of the prostate by local massage, electrization, regulating sexual function, etc. Prevention should be directed toward preventing the development of atony and inflammatory diseases of the prostate (primarily gonorrhea).