Role of hemorrhoids in the pathogenesis of recurrent bacteriuria with a new approach for treatment.

A new approach for the pathogenesis and treatment of recurrent bacteriuria is presented. Ten patients with recurrent bacteriuria were studied. Episodes started 3-8 years prior to presentation. Different antimicrobial therapy and surgical procedures had no influence on the recurrence of infection. Urinary tract investigations were normal except for bladder neck and urethral congestion in all patients. Urine cultures identified Escherichia coli in all episodes of each individual and were identical to those of anal flora. All patients had hemorrhoids and 3 had chronic cervicitis. An etiological concept for recurrent bacteriuria is put forward. Hemorrhoids are considered to be the source of recurrent infection, the E. coli being transmitted to the genitourinary organs through the rectogenital veins. Treatment of hemorrhoids and rectogenital vein obliteration resulted in the disappearance of bacteriuric episodes during a follow up period of 1.5-6 years. Urine cultures remained free. Chronic cervicitis is cured.