Hemorrhoids-prostatic hypertrophy-impotence syndrome, the human anorectal system and genitourinary system are organically connected. Hemorrhoid prostate hypertrophy and impoten syndrome (hemorrhoid prostate hypertrophy and impoten syndrome) refers to a triad of hemorrhoids, prostatic hypertrophy and impoten syndrome in men over 40 years old. Hemorrhoids in patients with this syndrome are usually three-stage hemorrhoids. Prostatic hypertrophy is a benign hyperplasia, so it is called BPH (benign prostatic hyperplasia), and impotence is organic in nature.
The exact cause is unknown, but it may be related to human degeneration. Thomson et al. once proposed that hemorrhoids are a specific manifestation of human degenerative changes in the anorectum. Glenn et al. believed that the pubertal development of prostate acinar and prostatic fibromuscular matrix depends on gonadotropins and testicular stromal cells. The secretion of androgens stimulates. After the age of 40, male androgen production decreases, acinar hypertrophy and prostate hyperplasia can occur, and it increases with age. As the prostate continues to enlarge, the glands protrude backwards, compressing the anterior wall of the rectum, sometimes resulting in constipation, aggravating the expansion of the anorectal venous plexus and forming hemorrhoids. In addition, patients with enlarged prostate often have to increase abdominal pressure due to difficulty in urinating, which intensifies the development of hemorrhoids.
Wespes et al. believe that the dynamic basis of penile erection is the result of increased arterial blood flow, relaxation of sinusoid smooth muscle and decreased venous return. Any changes in these vascular mechanisms can lead to impotence, but recent experimental studies have shown that changes in smooth muscle components play an important role in impotence. Computer imaging technology shows that the reduction or dysfunction of spongy smooth muscle fibers can cause impotence.
Clinically, prostatitis and transperineal prostatectomy are one of the important causes of organic impotence. Prostatic hypertrophy, as a benign hyperplasia, is always infiltrated by chronic inflammation, which not only causes the expansion of the prostate venous plexus and blood stasis, but also can cause the penile veins to dilate and cause impotence. Krupp believes that the incidence of impotence after prostate surgery is as high as 40% to 50%.
In terms of vascular anatomy, the anorectal venous plexus flows back to the internal iliac vein and inferior mesenteric vein; the bladder-prostatic venous plexus also flows back into the internal iliac vein; and the pudendal plexus, which collects blood from the dorsal penile vein, communicates with the bladder-prostatic plexus and passes through the bladder. The vein is eventually injected into the internal iliac vein. The same reflux route can make these venous plexus common stasis expansion under the condition of slow venous reflux, which forms the mutual influence and crossover of diseases between hemorrhoids, prostate and penis.