Patient's question:
Patient has nocturnal emissions without sperm, obtained a small amount of sperm through aspiration from the testicles. Before the age of 18, after experiencing nocturnal emissions, there was a relatively large amount of semen discharge from the penis, which was not easy to stop, and it might be normal. Mainly after the age of 20, especially after marriage at the age of 27, the patient checked his testicles and found that the left and right epididymis were about half the thickness of a finger and relatively hard. Sexual life is relatively poor.Doctor's answer:
Epididymal obstruction is not an independent disease but rather a symptom caused by various conditions. Treatment should first address the underlying cause, such as anti-inflammatory, anti-tuberculous, or anti-tumor therapies. In some cases, the blocked section can be excised and the ends reanastomosed, or sperm may be directly aspirated from the epididymis for artificial insemination. Traditional Chinese Medicine (TCM) that epididymal obstruction is due to blood stasis obstructing the spermatic channel, which blocks the downward flow of kidney essence and prevents ejaculation and conception. It is classified into two types: cold stasis and damp-heat stasis. Treatment involves promoting blood circulation, resolving stasis, and generating new blood to restore the blocked spermatic channel.1. Damp-heat stasis type: Fatigue, soreness in the lower back and knees, aching pain in the testicles and perineum, frequent urination with yellowish and turbid urine, yellow greasy tongue, and slippery wiry pulse. Treatment should focus on clearing heat, draining dampness, anding the spermatic channel.
2. Cold stasis type: Cool and painful sensation in the perineum and testicles, worsening with cold, cloudy urine, pale tongue with white coating, and deep wiry pulse. Treatment should involve promoting blood circulation, resolving stasis, and warming the meridians.