Orchitis and hemospermia: Anti-inflammatory and blood-activating treatments to protect the sperm ducts.
In traditional Chinese medicine, orchitis falls under the category of "Ziyong," which refers to an acute suppurative infection of the testis and epididymis, a common infectious disease of the male external genitalia. Orchitis is an inflammatory lesion of the testis caused by various pathogenic factors. It can be divided into acute nonspecific orchitis and specific orchitis. Common symptoms include testicular swelling and tenderness, and significant pain in the affected scrotum.
Traditional Chinese medicine believes that "the liver meridian runs through the perineum and connects to the genitals," and the testicles are associated with the kidneys; therefore, uterine abscess is related to the liver and kidneys. There are three reasons for this:
The first cause is unclean sexual intercourse, where pathogenic toxins enter the testicles through the seminal duct. The toxins clash with the body's vital energy, causing imbalances in qi and blood, leading to heat and tissue decay. Alternatively, incomplete treatment of the pathogenic toxins, coupled with excessive alcohol consumption or overexertion, can force the toxins into the testicles through the seminal duct. The second cause is damp-heat descending downwards, causing stagnation of qi and blood, and obstruction of the meridians. If the damp-heat accumulates and fails to resolve, the heat will prevail, causing the decayed tissue to rot and form pus, resulting in an abscess. The third cause is falls and injuries, leading to damage to the testicular vessels and blood stasis.
Its onset is mainly related to external exposure to dampness and cold, the generation of damp heat, improper diet, emotional depression, internal generation of damp heat, unclean sexual environment, and retention of pathogenic toxins.
Western medicine considers acute nonspecific orchitis to occur frequently in patients with acute purulent urethritis, cystitis, prostatitis, after prostatectomy for benign prostatic hyperplasia, and in patients with long-term indwelling catheters. It can also be caused by inflammation in other parts of the body, leading to hematogenous infection of the testes. Pathogens infect the epididymis and testes via the bloodstream and lymphatic system, or spread retrogradely through the vas deferens to the epididymis, causing epididymo-orchitis, or spread from infections of adjacent organs. Common pathogens include Escherichia coli, Proteus, Staphylococcus, Enterococcus, and Pseudomonas aeruginosa. Acute specific orchitis can be caused by mumps orchitis due to the mumps virus and syphilitic orchitis due to spirochetes.
Orchitis is generally best treated with a combination of traditional Chinese and Western medicine. In the acute phase, antibiotics combined with the traditional Chinese medicine Xin Huang Pian (新癙片) often relieve pain within 2-3 days. However, thorough treatment for 2 weeks is necessary. Testicular atrophy caused by orchitis is often irreversible. Orchitis can easily lead to immune infertility. Chronic orchitis develops from prolonged acute orchitis. In this case, antibiotics combined with Qianlietongyu capsules (前列通瘀胶囊) can be used, with a course of treatment of about one month (antibiotics only need to be used for one week).
Hematospermia can be treated by promoting blood circulation and clearing the meridians to reduce inflammation.
Red, delicate hands, yellow wine, spring colors fill the city, willows line the palace walls. The east wind is cruel, joy is fleeting. A heart full of sorrow, years of separation. Wrong! Wrong! Wrong! Spring remains the same, but I am thin and frail, tears staining my red handkerchief. Peach blossoms fall, the pavilion by the idle pond stands. Our vows remain, but letters cannot be sent. No! No! No!
This poem, "The Phoenix Hairpin," was written by Lu You, a poet of the Southern Song Dynasty. It expresses the tragic love story between the poet and his ex-wife, Tang Wan.
In ancient times, of the three unfilial acts, the greatest was having no offspring. Lu You and Tang Wan had been married for three years, spending their days in blissful intimacy, yet they had no children. Therefore, Lu's mother threatened him with her life: "Quickly write a letter of divorce, abandoning Tang Wan, or I will die with her." This was a devastating blow to Lu You. His heart ached terribly. Always filial, he could do nothing but grieve in silence in the face of his resolute mother. Forced by his mother's command, Lu You had no choice but to agree to send Tang Wan back to her parents' home. Thus, under the constraints of societal norms, a deeply loving couple was forcibly separated.
Throughout history, countless lovers have been torn apart because of the lack of offspring. These legends have faded into sighs in the long river of history; some loves are simply beyond saving. Yet, different stories, the same ending continues to unfold. What will happen when a man suffers from seminal vesiculitis? Perhaps unbearable pain, or perhaps the inability to have an heir!
Seminal vesiculitis can cause male infertility, and this is not an exaggeration. Xiao Chen has been married for three years and he and his wife have always wanted a baby, but haven't been able to conceive. Recently, under the guidance of a doctor, Xiao Chen underwent a test and received the diagnosis of "azoospermia." It turns out that Xiao Chen's infertility was caused by seminal vesiculitis. Seminal vesiculitis is a disease caused by Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, and Pseudomonas aeruginosa, among others. When nearby organs such as the prostate, posterior urethra, and colon are infected, or when the prostate and seminal vesicles become congested under any circumstances, harmful bacteria can take advantage of the situation, invading the seminal vesicles and inducing seminal vesiculitis.
Generally speaking, seminal vesiculitis is more common in young and middle-aged men. Acute seminal vesiculitis presents with systemic symptoms such as general pain, chills and fever, and even shivering, high fever, nausea, and vomiting. Chronic seminal vesiculitis often results from more severe acute seminal vesiculitis or incomplete treatment. It is caused by frequent arousal or excessive masturbation, which leads to congestion of the seminal vesicles and prostate, resulting in secondary infection.
The seminal vesicle is a coiled, spindle-shaped sac, about 5 cm long. It occurs in pairs, located at the base of the bladder, outside the peritoneum, just lateral to the ampulla of the vas deferens. The excretory ducts of the seminal vesicles merge with the ampulla of the vas deferens to form the ejaculatory ducts. The ejaculatory ducts pass through the prostate gland and open into the prostatic urethra. This gland is where sperm is stored, hence the name seminal vesicle. It is now generally called the seminal vesicle, and is a secretory organ. The secretion of the seminal vesicle is a viscous, alkaline, pale yellow liquid, often containing a small number of sperm. Seminal vesicle fluid accounts for 46%–80% of semen, with an average content of 2.5 ml. The seminal vesicle secretion dilutes semen and neutralizes the acidity of the vagina and uterus, maintaining sperm motility within these environments. Some believe that the intensity of libido may be related to the expansion of the seminal vesicles.
The secretions of the seminal vesicles should not be ignored:
1. Prostaglandins (PGs), with PGE and PGF2α having significant effects on the male reproductive system. The former can enhance sperm motility, while the latter can inhibit sperm activity. In addition, PPGs in semen not only stimulate the contraction of smooth muscle in the female reproductive tract to facilitate sperm transport, but also have a contractile effect on the corpus cavernosum muscle of the penis, increasing the intensity and frequency of its contractions, and have a vasodilatory effect.
2. Fructose, a characteristic product secreted by the seminal vesicles, is the primary energy source for sperm motility and directly participates in sperm capacitation and fertilization. The fructose secreted by the seminal vesicles is converted from glucose in the blood. When the seminal vesicles are inflamed, the fructose content in seminal plasma may decrease. If prostatitis is also present, the reduced secretions and seminal plasma volume can result in a relatively normal fructose content. Measuring seminal fructose is also a primary method for identifying azoospermia. If azoospermia is caused by congenital absence of the vas deferens or seminal vesicles, the fructose content will be extremely low. However, if it is caused by primary testicular spermatogenesis dysfunction, the seminal fructose content will remain normal.
3. Flavin, which fluoresces under ultraviolet light, is often used in forensic medicine to confirm whether it is semen.
4. Protein enzymes can cause freshly ejaculated semen to be in a semi-coagulated state. If the semen is thin and does not coagulate when ejaculated, and has a low fructose content, it may indicate bilateral vas deferens and seminal vesicle hypoplasia.
5. Deenergizing factor, which can coat the sperm head and inhibit acrosomal protease activity.
6. Phosphates, carbonates, potassium, citric acid, vitamin C, etc.
The seminal vesicles are crucial for sperm to achieve normal motility. The maintenance of normal seminal vesicle function is highly dependent on androgens. Traditional Chinese medicine believes that the causes of seminal vesiculitis include the following:
1. Yin deficiency with exuberant fire: This condition arises from inherent yin deficiency, excessive sexual activity leading to kidney essence depletion, or damage to yin from febrile diseases or excessive consumption of warming and drying yang-tonifying substances, resulting in excessive heat damaging yin, yin deficiency with exuberant fire, heat disturbing the seminal chamber, scorching blood vessels, and causing hematospermia. It is commonly seen in chronic seminal vesiculitis.
2. Damp-heat in the lower burner: Excessive consumption of alcohol or spicy foods damages the spleen and stomach, leading to impaired digestion and the accumulation of damp-heat. Alternatively, damp-heat may stagnate in the lower burner, ascending along the meridians to disturb the seminal vesicles. The damp-heat may also injure the blood vessels, causing blood to flow erratically and resulting in hematospermia. Alternatively, heat toxins may accumulate in the lower burner, scorching the blood vessels and causing this condition.
3. Deficiency of both heart and spleen: The spleen governs the control of blood, and the heart governs the storage of blood. When the spleen is deficient, the blood loses its control.
4. Genital injury: When the blood vessels are broken and bleeding occurs, or due to prolonged illness, the blood stasis obstructs the flow of new blood, resulting in blood in the semen, which does not heal over time.
Western medicine believes that seminal vesiculitis commonly occurs in young and middle-aged men. Simple seminal vesiculitis is relatively rare, and prostatitis and seminal vesiculitis often coexist. Bacterial infection is the most common cause, with E. coli being the most prevalent. This condition often has a history of urinary tract infection, and patients experience abnormal sensations or pain at the base of the penis during ejaculation or urination. In some patients, sudden intercourse after a long period of abstinence can cause bleeding due to the compression and rupture of capillaries in the seminal vesicles. This bleeding is occasional, non-persistent, and disappears after recovery. Seminal vesicle tuberculosis can also cause seminal vesicle inflammation, often concurrently with prostatic tuberculosis, and in rare cases, it is caused by tumors of the seminal vesicles and prostate.
If the semen is mixed with blood during ejaculation, the semen may appear pink, coffee-colored, red, or contain blood clots. It may be accompanied by frequent and urgent urination, dribbling after ejaculation, discomfort at the base of the penis, or painful ejaculation, which is most pronounced at the moment of ejaculation and can last for a longer period in chronic seminal vesiculitis; while acute seminal vesiculitis, if accompanied by infection of adjacent organs, can cause abdominal pain. In cases of nonspecific infection, the prostate is tender, and the prostatic fluid contains a large amount of blood and red blood cells. In cases of seminal vesicle tuberculosis, the prostate may be uneven or thin. A family history of tuberculosis is possible.