The entire urethra is often in a state of hyperaesthesia and paraesthesia, and the prostatic portion shows congestion and not seldom an inflammation of the mucous membrane. Especially the colliculus is often in a severe inflammatory condition. There is thickening sponginess or puffiness of the parts immediately involving the ejaculatory ducts. The urethra manifests great sensibility. The introduction of a bougie produces unbearable pains. The withdrawal of the sound is often followed by several drops of blood. This hypertrophy and inflammation of the colliculus seminalis is the cause of the ejaculatio praecox in the beginning of the disease. Later on the condition provokes weak erections and finally ejaculation with flaccid member before entrance into the vagina.
The irritation of the urethra causes hypersecretion of the glands of Littré and Cowper which is manifested by the so-called urethrorrhoea. In urethrorrhoea the secretion is thin, transparent, perfectly clear and sticky. The secretion has no spermatic odor and does not stain the linen, but stiffens it. It is seen as a drop in the morning at awakening with an erection. The drop is sticky and tenacious. The meatus urethrae sticks together. The drop is not rarely found in healthy men after violent and continuous erections. The secretions show under the microscope nothing beyond free mucous and columnar and pavement epithelia.
Besides the hypersecretion of the urethral glands, there is also a hypersecretion of the prostate, especially in patients who have indulged in excesses in masturbation and in onanism (coitus interruptus). Masturbation as well as onanism do not give the same satisfaction as normal coition, hence constant hankering for more and overindulgence. Prostatorrhoea is often found after gonorrhoea, when the yellowish drop gradually becomes whitish, flocculent, and finally a colorless watery drop of clear, slightly viscid fluid. It is best seen when the lips of the meatus are held apart.
In prostatorrhoea the discharge is never milky, white or purulent as in pure prostatitis. Microscopically the slowly dried slide shows the characteristic crystals of sodium chloride, but no spermatozoa. In prostatorrhoea the orifice of the urethra shows constant moisture. The copious evacuations occur while straining in the water-closet. The patients are, as a rule, constipated. The discharge is attended with peculiar sensations, sometimes of a pleasurable nature, sometimes of a dropping sensation, weight in the region of the prostate, anus and rectum. Examination per rectum often shows hard points and nodules in the prostatic gland.
The most frequent anomaly caused by venereal excesses is spermatorrhoea and nocturnal pollutions. The excesses provoke a chronic hypertrophy of the prostatic gland, and this hypertrophy renders the ejaculatory ducts insufficient.
In spermatorrhoea there is an oozing of semen from the urethra without erection or pleasurable sensations. The rhythmic muscular contractions, found in normal ejaculations, are missing here. The failure of the normal contractions is due to a paresis of the muscular fibres of the ejaculatory ducts.
Spermatorrhoea usually takes place after micturition or during defecation. Sometimes spermatorrhoea is caused by the slightest excitement. The sight of a woman’s bust or of her leg, the touch of her hand, the smell of her perfume, the glance at a lascivious painting, or a voluptuous thought may cause a precipitate discharge, without an erection or with an imperfect erection. The discharge taking place at a complete relaxation of the ejaculatory ducts, the voluptuous sensations are, as a rule, entirely absent.
Spermatic discharges sometimes occur in affections of the central nervous system, where the usual inhibitions through consciousness are ineffectual.
Microscopically the discharge in spermatorrhoea shows amyloid bodies, lecithin and prostatic epithelia. The fluid has the seminal odor which is peculiar to the spermin reaction; the amount of spermatozoa is somewhat diminished.
The testicles and the skin of patients, suffering from spermatorrhoea, are less sensitive to electrical stimulation, while the urethra is hypersensitive.