Article 15: Physiological Functions of the Epididymis, Etiology of Epididymitis, and Analysis of Hematospermia

What are the physiological functions of the epididymis?

The epididymis not only functions to expel a small amount of fluid containing sperm, but also to store sperm and promote sperm production.

A mature environment. Its main physiological functions are as follows:

(1) Absorption function: The Sertoli cells of the testis can produce a large amount of reticulum testis fluid every day, of which 99% is absorbed by the surrounding tissues.

The testicular epithelium is reabsorbed back into the body.

(2) Secreting nutrients to promote sperm maturation: The epididymis secretes glycerophosphate choline and botulinum toxin.

Alkali, glycoproteins, and various enzymes are closely related to sperm metabolism, maturation, and normal physiological functions.

(3) Sperm storage: Sperm must remain in the epididymis for 19-25 days before reaching the tail of the epididymis.

If discharged promptly, it will be stored in the tail.

(4) Secretory function: The epididymal epithelium itself secretes a small amount of sex hormones.

(5) Immune barrier function: Due to its barrier function, it can prevent sperm from entering its epithelium.

To avoid triggering an autoimmune response.

(6) Contractile function: The efferent ductules of the testis and the epididymal duct have the function of spontaneous rhythmic contraction, which can

The sperm is transported into the vas deferens.

(7) Degradation and absorption of unejaculated sperm: The epididymis contains phagocytes that can degrade and absorb unejaculated sperm.

Sperm gradually breaks down and is absorbed.

What are the common causes of epididymitis?

Epididymitis in middle-aged men often occurs after physical labor (such as lifting heavy objects), but can also occur during periods of intense physical activity.

Epididymitis can occur after intense sexual arousal, and it can also be a complication after prostatectomy.

There are three common causes of epididymitis:

(1) Secondary to prostatitis or urinary tract infection.

(2) During prostatectomy, bacteria may be present in the urine after surgery, causing urine to reflux during urination.

Infection can enter the vas deferens and cause retrograde infection, leading to epididymitis. Infection can also invade the epididymis via surrounding lymphatic vessels.

(3) Sterile urine reflux into the ejaculatory duct leads to chemical epididymitis.

What causes blood in semen?

Semen changes from its normal milky white color to blood red, reddish-brown, or mixed with blood streaks; this indicates contamination.

Blood is produced, but where does this blood come from? Blood in the semen of middle-aged men is simply due to blood in the sperm's pathway.

A lesion has occurred in a certain part of the body, such as bleeding, inflammation, or even a tumor. Since semen mainly comes from...

First, the seminal vesicles; second, the prostate gland. The seminal vesicles, prostate gland, and posterior urethra are interconnected; inflammation...

The condition can easily spread. Furthermore, the seminal vesicle wall is very thin, and after becoming congested with blood, the wall is prone to bleeding. Therefore...

Therefore, the most common cause of hematospermia is seminal vesiculitis, followed by prostatitis and posterior urethritis, or posterior urethral congestion.

Hemorrhage can also be caused by the spread of inflammation from other organs, leading to inflammation, swelling, congestion, and bleeding of the seminal vesicle wall.

If it occurs only occasionally and without any specific changes, it may be due to certain tissues undergoing rapid changes during sexual intercourse.

It is caused by congestion and mechanical impact leading to the rupture of tiny blood vessels.

Why do middle-aged men experience premature ejaculation?

Premature ejaculation refers to the condition where a person is not ready for sexual intercourse (including psychological preparation) or can only ejaculate within a few seconds of penile penetration.

However, premature ejaculation without reaching orgasm is a pathological condition that is often accompanied by erectile dysfunction.

The causes of premature ejaculation in some middle-aged men can be summarized as follows:

(1) Excessive ministerial fire: This is often caused by unfulfilled desires or frequent masturbation, where the yin essence cannot restrain the ministerial fire, plus

Excessive desires can ignite the fire in the heart, leading to an excessive interaction between the two fires, resulting in an overactive fire and excessive sexual desire, which in turn causes premature ejaculation.

(2) Kidney Yin Deficiency: Frequent masturbation or early marriage and childbirth during adolescence, excessive sexual activity or lack of moderation in sexual activity.

As essence is depleted, kidney yin deficiency occurs, which in turn leads to the need to store essence for preservation. This yin deficiency and yang excess result in premature ejaculation.

(3) Kidney Qi deficiency: due to congenital weakness, old age-related kidney decline, or excessive sexual activity, kidney Qi deficiency.

Weakness, with depleted kidney yang, leads to the kidney's inability to store essence, resulting in premature ejaculation.

Why are men more prone to arterial erectile dysfunction?

Arterial erectile dysfunction is a common cause of secondary erectile dysfunction in men over 40 years of age.

One cause is obliterative vascular disease. This occurs if the internal pudendal artery and its branches are blocked or underdeveloped.

If there is an abnormality, it will hinder blood flow to the penis, thus leading to erectile dysfunction.

Generally, obstructive vascular diseases occur in the abdominal aorta, iliac artery, pudendal artery, and their surrounding areas.

In addition to causing erectile dysfunction, it often leads to intermittent claudication and difficulty walking in various parts of the penis.

Frequent, unpleasant, and painful erections in patients with vascular lesions, such as soreness in the calves or lower limbs, are common clinical symptoms.

The incidence of erectile dysfunction can reach 70% to 80%, and erectile dysfunction can be the primary cause of vascular occlusion.

Symptoms: After lower limb ischemia is corrected, erectile dysfunction will also be corrected accordingly.

Vascular obstructive lesions can be diagnosed by bilateral iliac artery angiography or lower extremity blood flow Doppler ultrasound.

A diagnosis is made. Some people have symptoms of vascular occlusive disease, along with erectile dysfunction.

Currently, during foreplay, the penis can achieve a fully erect erection, but during insertion into the vagina...

It weakens quickly afterward. However, it may last longer in a supine or lateral position, due to...

Normally, the pelvic muscles have sufficient collateral circulation to compensate for the blockage of a particular artery, but once the main artery begins to swell...

The patient's body experiences increased blood supply due to the sudden increase in muscle movement caused by the twitching of the pelvic muscles.

The need to reduce or interrupt blood supply to the penis can lead to a rapid decline in ejaculation.

When in a supine or lateral position, the reduced muscle activity decreases, thereby reducing blood supply to the muscles and ensuring...

This ensured the blood supply to the penis.

Through dilators, thrombolysis, or surgical treatment (such as artificial artery implantation), patients can regain access to [the treatment/career].

The ability to maintain an erection during sexual intercourse.