Discomfort and induration at the base of the penis: men should be wary.
Western medicine can also be used as an adjunct treatment: For acute superficial balanitis and circinate erosive balanitis, oral antibiotics such as erythromycin and tetracycline can be administered. For trichomonal infections, antitrichomonal drugs such as nitromethorphan can be given. For candidal infections, topical antifungal medications such as miconazole can be applied, or oral antifungal medications such as sporanox and fluconazole can be taken.
It is important to note that steroid ointments should never be used for this condition, as they can worsen the inflammation and enlarge the ulcers. The cause of this disease is sometimes difficult to determine, but it can often be identified through sexual partners. This disease is contagious, so sexual partners must be treated simultaneously.
Penile discomfort can also cause erectile dysfunction and flaccidity.
A phoenix-shaped hairpin adorned with gold and mud, a jade comb with dragon patterns. She comes to the window, laughing and supporting me, saying, "The depth of my eyebrow makeup, is it right now?" She leans against me for a long time, wielding a brush, trying her hand at drawing flowers. Casually interrupting my embroidery, she asks with a smile, "How do you write the characters for 'double mandarin ducks'?"
This poem, "Nan Ge Zi," was written by the famous writer Ouyang Xiu. The poem is very vivid and delicate. The poet portrays the intimate and passionate life of newlyweds in great detail, which is very lifelike. The content is simple and the style is flamboyant.
Sex has always been an enduring and indispensable theme in literature and art. Various art forms in ancient China, such as music, fine arts, and literature, all include a certain number of works containing sexual content. Even some orthodox works occasionally use natural phenomena to subtly express sexual and erotic themes; this poem is one such example. Furthermore, the intense, passionate union of lovers during sex perfectly aligns with the concept of "clouds and rain." Especially when sex reaches its climax, it feels like soaring through the clouds and roaming the heavens. Therefore, modern people often use phrases like "turning clouds and rain" and "going to Wushan together" to describe sexual intercourse.
But if a man's "vital organ" is sick, how can he lead his woman to passionate lovemaking?
"Recently, a patient has been experiencing discomfort at the base of his penis during two consecutive erections. The discomfort subsides after a good night's sleep, but recurs after two consecutive sexual encounters, or after a period of rest. However, after several days of continuous sexual activity, the discomfort returns..."
Xiao Wei's discomfort at the base of his penis is one of the main clinical symptoms of chronic prostatitis, often accompanied by frequent urination, painful urination, and various types of sexual dysfunction. Although this disease can be secondary to acute prostatitis, most patients do not experience an acute inflammatory process. This is a common disease among young adults and middle-aged and elderly men.
Traditional Chinese medicine believes that this disease is mostly caused by the accumulation of stagnant and foul-smelling semen, which obstructs the seminal vesicle; the downward flow of damp-heat toxins disturbs the seminal vesicle, causing qi and blood disorders; the key pathogenesis is the accumulation of stagnant and foul-smelling semen and the obstruction of damp-heat toxins; the location of the disease is in the seminal vesicle, which is related to blood stasis.
Diagnosis and differential diagnosis are essential: one is caused by chronic prostatitis, accompanied by frequent urination, incomplete emptying of the bladder, no white blood cells in the urine, but white blood cells in the prostatic fluid may be >10/HP, and the urethral opening is not red; the other is caused by chronic urethritis, often accompanied by burning urination, or white blood cells in the urine, a recent history of urethral infection, and improper use of antibiotics, or no treatment.
Western medicine diagnoses the disease, while traditional Chinese medicine differentiates the syndrome and then treats it accordingly.
1. Damp-Heat Accumulation Type. Symptoms include discomfort at the base of the penis, scanty and dark urine, dribbling urination, or incomplete bowel movements, bitter taste in the mouth, and irritability. There may be a recent history of urinary tract infection with white blood cells in the urine, or treatment with improper antibiotics or no treatment at all. The tongue is red with a yellow, greasy coating, and the pulse is slippery and rapid. Treatment should focus on clearing heat, detoxifying, and resolving turbidity. Formulas such as Gentian Root Decoction for Draining Liver Fire and Eight-Ingredient Powder for Clearing Heat are recommended, with modifications. Basic herbs include: Gentian root, Gardenia fruit, Pyrrosia lingua, Smilax glabra, Taraxacum mongolicum, Paeonia lactiflora, Peach kernel, Atractylodes macrocephala, and Coix seed.
For this symptom, a sufficient dose of macrolide or quinolone antibiotics should be added for treatment for 7 to 14 days. The medication should not be discontinued after a few days of no clinical manifestations.
2. Qi stagnation and blood stasis type. Discomfort at the base of the penis, or occasional distending pain or stabbing pain; dark purple tongue or petechiae; thready and hesitant pulse. Treatment should focus on promoting blood circulation, removing blood stasis, regulating qi, and relieving pain. Formulas include Shaofu Zhuyu Decoction, Fuyuan Huoxue Decoction, and Juhe Pill, with modifications. Basic herbs include: scorpion, chuanxiong rhizome, peach kernel, soap thorn, centipede, lindera root, angelica root, and turmeric.
3. Spleen and Kidney Deficiency Type. Discomfort at the base of the penis fluctuates in severity, persisting for a long time, accompanied by fatigue, weakness, lower back and knee pain, frequent urination with clear urine, loose stools, and possibly impotence and premature ejaculation. The tongue is pale, and the pulse is deep, thready, and weak. Treatment should focus on strengthening the spleen and replenishing qi, warming yang and tonifying the kidneys, while also promoting blood circulation and removing blood stasis. Formulas include Buzhong Yiqi Tang, Jin Kui Shen Qi Wan, and You Gui Yin, with modifications. Basic herbs include: Astragalus membranaceus, Cinnamomum cassia, Cervi cornu powder, Ligusticum chuanxiong, Prunus persica, Aconitum carmichaelii, and Tetrapanax papyriferus.
4. Blood Stasis with Damp-Heat Type. Symptoms include discomfort at the base of the penis, frequent and urgent urination, dribbling after urination, and sometimes lower abdominal and perineal distension, with a yellow tongue coating. Treatment should focus on removing blood stasis, promoting urination, and clearing heat. The recommended treatment is Qianlietongyu Capsules. Basic ingredients include: Red Peony Root, Peach Kernel, Chuanxiong Rhizome, Pyrrosia lingua Rhizome, Tetrapanax Papyriferus Pith, Astragalus Root, Polygonum Cuspidatum, and Angelica Root.
The key to this disease lies in the presence of damp-heat toxins or qi deficiency leading to impaired blood circulation. Therefore, the treatment should be guided by the principles of strengthening the body's resistance, clearing heat and dampness, and promoting blood circulation and removing blood stasis; the prescription should be adjusted according to the different accompanying symptoms.
Besides discomfort at the base of the penis, there is another condition called Peyronie's disease, similar to "penile nodules" in traditional Chinese medicine. It is a condition characterized by fibrous nodules on the corpora cavernosa of the penis. It is characterized by cord-like or plaque-like nodules on the dorsal side of the penis. The Ming Dynasty medical record *Surgical Principles* by Wang Ji mentions a case of scrotal abscesses: "A weak man had a nodule at the base of his penis the size of a soybean; it swelled and became painful with exertion..." which is similar to this condition.
Traditional Chinese medicine believes that "the anterior genitals are where the tendons of the penis converge, and where the Taiyin and Yangming meridians meet. When the spleen and stomach fail to function properly, phlegm is generated internally, descending to the tendons of the penis and congealing. In cases of liver and kidney yin deficiency with excessive fire, phlegm easily transforms into heat, resulting in phlegm-fire symptoms." The pathogenesis of this condition is closely related to the liver, spleen, and kidneys. The liver meridian encircles the genitals, and the liver governs the free flow of qi. If emotions are not properly managed, or anger injures the liver, liver qi stagnation occurs, leading to poor blood circulation and blood stasis in the penile meridians, which can cause this disease. The kidneys govern the anterior genitals. Liver and kidney deficiency, combined with exposure to cold and dampness, can invade the Jueyin meridian; or spleen and kidney yang deficiency can lead to dampness accumulation and phlegm production, which congeals and flows into the meridians, causing the disease. Furthermore, penile injury and unclean sexual intercourse can also cause blood stasis, with phlegm and dampness stagnating in the meridians, resulting in this disease.
Western medicine has not yet clarified the etiology of this disease; it may be a systemic collagen disease or a localized lesion. Clinical statistics suggest that its etiology may be related to a variety of factors, including atherosclerosis, hypertension, traumatic diseases, vitamin E deficiency, sclerosing inflammation, degenerative changes, genetic factors, alcoholism, and diabetes. The pathological changes are mainly manifested as the formation of band-like hard nodules of varying sizes and numbers between the tunica albuginea and penile fascia of the corpora cavernosa.
Diagnostic points:
1. If a hard lump is found on the penis, the penis may be curved or painful during erection. In severe cases, erectile dysfunction or impotence may occur, or there may be mild pain or difficulty urinating, as well as perineal discomfort and a feeling of heaviness in the anus.
2. Hard nodules can be felt on both sides of the dorsal side of the penis. They are 0.2 to 0.5 cm in size, with a texture like cartilage. They are oval, cord-like, or sheet-like, and can be single or multiple. They are arranged longitudinally, with no or slight tenderness. The nodules are immobile and are mostly located on the dorsal side of the penis, rarely on the ventral side.
3. There is no laboratory test to diagnose it. Occasionally, calcification or ossification shadows can be seen on X-ray. Generally, penile cavernosography can show the extent of the lesion.
Traditional Chinese medicine believes this disease is due to phlegm stagnation and blood stasis, and the accumulation of masses. Treatment should focus on promoting blood circulation, removing blood stasis, softening masses, and dispersing nodules. Long-term use of Danshen tablets, rhubarb and cockroach tablets, Panax notoginseng tablets, and Panax notoginseng total glycosides tablets is recommended. Water decoctions are often difficult to adhere to; if there is concurrent yin deficiency, add Liuwei Dihuang pills; if there is concurrent damp-heat, add Qianlietongyu capsules; if there is concurrent kidney essence deficiency, add Guilu Bushen pills.