Chronic Vesiculoprostatitis—a Reorientation

The term vesiculoprostatostasis is suggested for a complex of symptoms and findings occurring in many men and is believed to constitute a definite clinical entity. Probably more than 35% of all men over the age of 35 years have this condition. It consists of a variety of disturbances of urinary, sexual, and psychic functions; alterations in the size, shape, and consistency of the prostate and seminal vesicles; and the inconstant and quantitatively variable finding of pus in the secretions expressed from these structures. The finding of pus cells in the absence of recognizable pathogenic organisms justifies neither the diagnosis of infection nor the term prostatitis, which implies a bacterial cause. Anti-infective drugs in the uncomplicated case are useless. The primary cause of vesiculoprostatostasis is repeated sexual excitation without physiological discharge of secretions. Local treatment aims at decongestion of the seminal vesicles and prostate by periodic vesiculoprostatic massage. Relief of symptoms follows in a high percentage of patients. Cure is possible, however, only insofar as causes can be eliminated. Since the most common cause is marital sexual maladjustment, the cure may be relatively simple in some cases; in others the problem may be so deep-seated and complex as to lie in the sphere of the psychiatrist.