Continued discussion of TCM etiology: pathogenic factors, predisposition, seven emotions, and trauma and infection in Western medicine etiology.

② Invasion of pathogenic toxins

The liver meridian encircles the genitals, and the kidneys open into the two lower orifices (urethra and anus). If a man engages in unclean sexual intercourse, pathogenic toxins can enter the body due to the deficiency of the liver and kidneys. For example, syphilis is caused by exposure to the toxins from fungal infections.

Unprotected sex can lead to infections caused by damp-heat toxins, insect toxins, etc., such as genital warts and genital herpes.

③ Drug damage

Medications can correct imbalances and harmonize Yin and Yang, but improper use can lead to an imbalance, causing physical decline, affecting sexual function, or impairing testicular sperm production, resulting in andrological diseases. For example, the misuse of kidney-tonifying and aphrodisiac drugs to treat impotence not only fails to improve sexual function but also often leads to serious consequences. Mistakenly taking strong laxatives or prolonged excessive use of bitter and cold herbs can cause spleen and stomach weakness, Qi and Yin deficiency, physical weakness, and symptoms such as low libido and impotence.

(2) Internal causes within the human body

① Insufficient endowment

Due to factors such as parents being frail and sickly, consanguineous marriage, or having a child late in life, the fetus may be born with insufficient endowment, resulting in incomplete development of reproductive function, testes, penis, etc.

② Internal injuries caused by the seven emotions

The seven emotions-joy, anger, worry, pensiveness, grief, fear, and fright-are seven states of mental activity triggered by different reactions to objective things. Human emotional activity is closely related to the internal organs. Normal emotional changes do not cause illness, but sudden, intense, or prolonged emotional stimulation, exceeding the normal physiological range, can lead to disordered Qi flow, imbalance of Qi, blood, Yin, and Yang in the internal organs, resulting in disease, known as "internal injury from the seven emotions."

③ Excessive sexual activity

Excessive sexual activity refers to the depletion of kidney essence due to immoderate sexual activity. Kidney essence should not be excessively depleted. Frequent sexual activity depletes kidney essence, and prolonged indulgence leads to deficiency of all five internal organs, resulting in organ dysfunction and increased susceptibility to pathogenic factors. This can lead to various urological diseases.

④ Balance work and rest

Labor, also known as overwork, includes mental and physical exhaustion; leisure refers to excessive comfort. Normal mental and physical labor and exercise help improve blood circulation, strengthen the body, and enhance its resistance. Adequate rest can eliminate fatigue and restore mental and physical energy. Excessive mental or physical exertion, or excessive comfort, can all lead to urological diseases.

⑤ Injury caused by diet

Human growth, development, and the maintenance of normal physiological functions all depend on the nutrition provided by diet. However, improper diet can lead to illness. Excessive consumption of tobacco, alcohol, spicy and dry foods, excessive consumption of cold and raw foods, irregular eating habits, overeating or binge drinking, or unclean food can all cause urological diseases.

⑥ Natural decline and other

Traditional Chinese medicine attributes the natural decline of a person's lifespan-from birth to growth, maturity, and aging-to "kidney deficiency." While aging is an inevitable natural law, some individuals, due to their strong constitution and skillful health maintenance, can defy aging and maintain their physical form.

It is normal for boys around 16 years old to experience seminal emission, which is a normal physiological phenomenon. However, excessive masturbation, or unhealthy psychological states such as anxiety, guilt, or self-blame after masturbation, can affect sexual function.

In addition, men who abstain from sex or have been deprived of sex for a long time, or who have too few sexual intercourse sessions, may also develop urological diseases.

(3) External injury

Male external genital injuries include open injuries (cuts, punctures, transections, etc.) and closed injuries (kicks, straddle injuries, crush injuries, etc.).

Western medicine believes that the causes of male diseases

Western medicine considers the causes of male diseases to be complex. In addition to general causes, these include psychological factors, organic causes, and other factors such as environment and diet. These pathogenic factors often interact and work together to lead to male diseases.

(1) General reasons

① Trauma

Male genital trauma most commonly involves testicular rupture. Due to localized external force, such as crushing, compression, or straddling injuries, a large hematoma develops in the scrotum and perineum, causing testicular swelling and severe pain. After the hematoma is absorbed, testicular atrophy and loss of function gradually occur. Urethral rupture is also common, resulting from trauma, bleeding, and inflammation, leading to urethral stricture, affecting normal urination and ejaculation, or allowing infection to spread. Penile fracture is relatively rare, caused by rupture of the tunica albuginea, forming a large hematoma in the corpora cavernosa. In later stages, extensive fibrosis of the corpora cavernosa affects penile congestion and swelling, potentially causing erectile dysfunction.

②Infection

Besides the proliferation of pathogens and the effects of toxins, infections are often associated with trauma, obstruction, and malformations. Infections frequently spread between the upper and lower urinary tracts, and between the reproductive and urinary systems. Infections damage normal tissue, leading to fibrous tissue hyperplasia, scarring, narrowing, and decreased physiological function, making recurrence highly likely. Based on the type of pathogen, infections can generally be classified into nonspecific and specific types.

Nonspecific infections: Chronic infections are more common and have a high incidence rate. Common pathogens include Staphylococcus, Streptococcus, Escherichia coli, and Proteus, which enter the relevant organs through the blood, urethra, and reproductive tract, causing prostatitis, seminal vesiculitis, epididymitis, and spermatic cord inflammation. Scrotal infections are often caused by bacterial invasion after scratching due to dermatitis or tinea pedis, or by the spread of inflammation from the testes or epididymis. In the early stages, the infection usually affects one organ. In the acute phase, there is congestion, edema, granulocyte infiltration, and a large amount of exudate containing bacteria and necrotic tissue. The scrotum is enlarged and often tender to the touch. In the chronic phase, the scrotum shrinks, the tissue hardens, and it often presents as a solid lesion. If there is infiltration of plasma cells and lymphocytes, fibrous tissue hyperplasia, or poor drainage of glandular secretions, recurrence is likely, or the infection may spread to adjacent organs or lead to sexual dysfunction.

Specific infections: Common examples include Mycobacterium tuberculosis, filariasis, amoebae, viruses, Neisseria gonorrhoeae, Treponema pallidum (syphilis), and HIV. Each infection has its own unique transmission methods, routes of infection, affected organs, and pathological changes. For instance, genital tuberculosis is often hematogenous or secondary to urinary tract tuberculosis, frequently affecting the tail of the epididymis, and involving the vas deferens, prostate, and seminal vesicles, leading to obstruction of the vas deferens, thin semen, and infertility. Mumps in adults is often complicated by orchitis. Gonococci and HIV are primarily transmitted through sexual contact.

(2) Psychological reasons