Diagnosis and treatment of retrograde ejaculation and dietary therapy for hematospermia
Inside the prostate, there are special Y-shaped "three-way tubes". After the ejaculatory ducts merge with the urethra, the upward passage is the bladder, and the downward passage is the penile urethral opening. There are two sphincter muscles in the "three-way tubes": the upward-facing bladder neck sphincter and the downward-facing membranous urethral sphincter. After ejaculation, these two sphincter muscles each perform their duties and work closely together.
Most men have experienced this during sexual intercourse: when in a state of extreme sexual arousal, even if they intentionally make the urination motion, urine will not easily flow out. This is because the bladder neck sphincter contracts and closes under the control of the sympathetic nervous system, while the membranous urethral sphincter relaxes under the control of the parasympathetic nervous system, making it easy for the accumulated semen to be ejaculated directly out of the body.
The causes of bladder neck sphincter dysfunction are multifaceted. Common causes include chronic inflammation of the bladder, urethra, and seminal colliculus, which can cause adverse stimulation; congenital urethral stricture, which can increase ejaculatory resistance; and the use of unhealthy methods such as squeezing the base of the penis during ejaculation to prevent ejaculation. These can all lead to bladder sphincter dysfunction. In addition, prostate, bladder, and rectal surgeries can also cause local nerve dysfunction; retrograde ejaculation may also occur in diabetic patients or those taking antihypertensive drugs such as guanethidine and reserpine long-term.
**VII. Diagnosis of Retrograde Ejaculation**
Retrograde ejaculation or other conditions may occur if a man experiences normal orgasm and ejaculation during normal sexual intercourse or under similar sexual stimulation, but there is little or no semen ejaculation, or if the wife has not conceived for an extended period after marriage. Further diagnosis is straightforward: simply examine the urine after ejaculation. The presence of a large amount of sperm and fructose in the urine confirms the diagnosis.
Examinations such as ultrasound, CT scans, and X-rays can further clarify the nature of the disease. A urinalysis or urine culture can also reveal whether there is an infection in the bladder or urethra, which is particularly important for individuals with a history of ejaculation. These diagnostic methods guide the understanding of prognosis and the appropriate treatment.
**8. Treatment of Retrograde Ejaculation**
Treatment for retrograde ejaculation falls into two main categories: surgical treatment and drug treatment.
Surgical treatment is indicated for patients with a history of bladder neck surgery. Bladder neck YV plasty can be performed, which should be done after the disease is diagnosed. Generally, hospitals at the county level or above can perform this procedure.
The main indication for drug treatment is for patients with sympathetic nerve dysfunction. Adrenergic drugs can be used for treatment, and anticholinergic drugs can also be used depending on the specific situation. All of these drugs should be taken under the guidance of a specialist to avoid adverse reactions.
Retrograde ejaculation caused by chronic infection can be treated with antibiotics such as norfloxacin and metronidazole. When Western medicine is ineffective, traditional Chinese medicine can be selected based on syndrome differentiation. The advantage of traditional Chinese medicine lies in its holistic treatment and treatment based on syndrome differentiation, which has a positive effect on improving symptoms and alleviating the condition.
For diabetic patients, the primary disease should be actively treated; retrograde ejaculation will naturally improve after recovery. For patients with hypertension, alternative medications or therapies can be used to lower blood pressure, and medications with adverse effects should be avoided as much as possible. Those suffering from chronic cystitis, chronic urethritis, or chronic seminal vesiculitis should avoid excessive consumption of spicy foods and alcohol, and should cultivate good personal hygiene and drink plenty of water. For couples eager to conceive, artificial insemination can be performed provided the husband's semen does not have any substantial pathological changes.
**Nine** Can intentionally holding back ejaculation during intercourse preserve "vital energy"?
Sexual activity is a human instinct and the foundation of human reproduction. For men, reaching orgasm and ejaculation is the main stage of sexual activity. If intercourse is stopped before reaching orgasm and ejaculation, it is called "incomplete intercourse." This not only prevents both partners from achieving full physical and emotional satisfaction, but also prevents the congestion of the reproductive system from dissipating quickly. The cerebral cortex and spinal cord remain in a state of excitement for an extended period, and accessory glands such as the seminal vesicles are not fully emptied. This results in the man being in a prolonged state of excitement without rest, leading to fatigue. Over time, this can cause chronic nonbacterial prostatitis and seminal vesiculitis in men.
It is a normal physiological phenomenon for healthy men to experience nocturnal emissions 1-2 times per month. Married men who have not had sexual intercourse for a long time may also experience nocturnal emissions. Therefore, even if one intentionally does not ejaculate during intercourse, it does not guarantee that semen will not be leaked. In fact, of the 2-5 ml of semen ejaculated during each sexual intercourse, 95% is seminal plasma (the main component of seminal plasma is water, accounting for about 90%), and sperm accounts for only about 1%. The rest consists of small amounts of proteins, fats, and other substances. Even if sperm is not ejaculated, it will age, die, and eventually be digested by enzymes. The British Medical Journal once pointed out that "frequent sexual intercourse can satisfactorily maintain a long life and is beneficial and enjoyable for both partners." Therefore, the theory of "not ejaculating during intercourse" and "cherishing semen" to preserve "vital energy" and prolong life is unfounded.
**Dietary Therapy for Hematospermia**
Hematospermia, as the name suggests, is the presence of blood in the semen. The milky white semen turns pink or red, or contains blood streaks. Under a microscope, a large number of red blood cells can be seen. It may be accompanied by mild perineal, rectal, and lower abdominal pain, or signs of urinary tract infection such as painful urination.
Inflammation in organs adjacent to the seminal vesicles, such as the prostate, urinary tract, and rectum, can easily spread to the seminal vesicles, causing inflammation, swelling, congestion, and bleeding. The most common cause of hematospermia is seminal vesiculitis. Treatment for hematospermia includes: abstaining from sexual activity; treating the inflammation; and massaging the seminal vesicles and prostate to drain the bacteria-containing fluid and promote recovery.
In treating hematospermia, in addition to treating the underlying cause of seminal vesicle inflammation, dietary therapy often yields good results. One can regularly consume foods that nourish yin, clear heat, promote diuresis, and cool the blood to stop bleeding, such as duck meat, red beans, water chestnuts, winter melon, fresh lotus root, shepherd's purse, lotus seeds, jujubes, Job's tears, rehmannia root, poria cocos, yam, fresh fish, and fresh imperata root. The following medicinal diets can also be used for conditioning.
**Carp Soup**
[Ingredients] 1 carp (about 500g), pepper, fennel seeds, scallions, and ginger as needed.
[Preparation] Remove the scales and entrails from the fish, wash it thoroughly, and boil it in an appropriate amount of water to make soup. Add seasonings after it is cooked. Regular consumption is effective.
[Efficacy] Clears heat and dampness. Suitable for hematospermia caused by damp-heat accumulation.
**Pork** **Neck** **Job** **Porridge**
[Ingredients] 2 pig bladders, 100g of Job's tears.
[Dosage] Rinse the pig's neck thoroughly with warm water, cut it into strips, stir-fry it in oil in a pan, add appropriate amounts of Job's tears, scallions, ginger, and sugar, add water and simmer over low heat to make porridge. The above is a one-day dose, taken on an empty stomach, 1-2 times. Half a month is one course of treatment.
[Efficacy] Clears heat and promotes diuresis. Suitable for hematospermia caused by damp-heat accumulation.
**Pork** **Kidney** **Boiled** **Black** **Beans**
[Ingredients] 1 pair of pork kidneys, 500g of black beans.
[Preparation] Cut open the pig kidney, remove the fascia and glands, wash it clean, and cook it together with black beans in water. Do not add too much water. Cook until the black beans are cooked but not mushy. Remove the black beans, dry them in the sun, and stir-fry them over high heat until cooked. Eat the pig kidney and chew the black beans. Take 30-60g daily for half a month as one course of treatment.
[Efficacy] Tonifies the kidneys and replenishes essence. Suitable for hematospermia caused by kidney deficiency and instability.
**Yam and Mutton Porridge**
[Ingredients] 500g mutton, 500g yam, 250g rice.
[Preparation] Boil the mutton until tender and make it into a soup. Grind the yam into a paste, add rice to the broth, and cook together into a porridge. Continue for several days.
[Efficacy] Tonifies the kidneys and strengthens yang. Suitable for hematospermia caused by kidney yang deficiency.