Dietary therapy for benign prostatic hyperplasia, seminal vesicle diseases, and male infertility

[Ingredients] 1 turtle, 200g pork spinal cord, appropriate amount of ginger, scallions, and pepper powder.

[Preparation] Scald the turtle with boiling water to kill it, remove the shell, internal organs, head and claws, put it in an aluminum pot, add ginger, scallions and pepper powder, bring to a boil over high heat, then simmer over low heat until the turtle meat is cooked; then add the cleaned pork spinal cord, cook until done, and add MSG to taste.

[Ingredients] 250g clam meat, 30g achyranthes bidentata, 30g plantain seeds, 20g cowherb seeds.

[Administration] Wash the clam meat and set aside. Place the achyranthes bidentata, plantain seeds, and cowherb seeds into a gauze bag, then put them into a clay pot with the clam meat. Add an appropriate amount of water and simmer over low heat until the meat is cooked. Remove the gauze bag. Add a small amount of seasonings. Eat the meat and drink the soup, once a day, divided into 3 servings; continue for several days.

[Efficacy] Nourishes Yin and clears heat, softens hard masses and promotes urination. Suitable for benign prostatic hyperplasia, dysuria, and five-center heat caused by kidney Yin deficiency and internal damp-heat.

[Ingredients] 1 pig bladder, 30g of Cistanche deserticola, 15g of Epimedium, 15g of scallion whites.

[Preparation] Wash and chop the pig bladder. Wrap the Cistanche deserticola and Epimedium in gauze, put them together in a clay pot, add an appropriate amount of water, and simmer over low heat until almost cooked. Add scallions and a small amount of salt. Drink the soup regularly.

[Efficacy] Warms the kidneys, replenishes deficiency, and promotes urination. Suitable for benign prostatic hyperplasia due to kidney deficiency, difficulty urinating, and weak urination.

[Ingredients] 500g dog meat, appropriate amounts of chili peppers, ginger, orange peel, Sichuan peppercorns, and salt.

[Preparation] Wash the dog meat and cut it into pieces. Put it in a pot, add an appropriate amount of water, then add chili peppers, ginger, orange peel, and Sichuan peppercorns. Simmer over low heat until tender, then add salt to taste.

[Ingredients] 1 green-headed duck, 30g of Codonopsis pilosula, 30g of Astragalus membranaceus, 15g of Cimicifuga foetida, and 15g of Bupleurum chinense.

[Preparation] Slaughter the duck, remove the feathers and internal organs, and wash it clean. Crush the Codonopsis pilosula, Astragalus membranaceus, Cimicifuga foetida, and Bupleurum chinense, wrap them in gauze, and stuff them into the duck's abdomen. Put the duck in a pot, add an appropriate amount of water, and cook until the duck meat is thoroughly cooked. Season with salt.

[Ingredients] 500g mutton, 1 sheep lung, 1 sheep stomach, 250g mushrooms, 5 cardamom pods, 6g galangal, 15g pepper powder, 500g wheat flour, 500g mallow, appropriate amounts of scallions, salt, and vinegar.

[Preparation] First, simmer mutton, cardamom, and galangal to make a soup. Then, finely chop the separately stewed mutton tripe, mutton lungs, and mushrooms and add them to the soup. Finally, add pepper, sunflower seeds, scallions, salt, and vinegar to make a thick soup. Separately, make thin noodles from wheat flour, cook them, and mix them with this soup before eating.

[Ingredients] 10 sparrows, 50g Shaoxing wine, ginger juice, soy sauce, scallion whites, and salt to taste.

[Preparation] Slaughter the sparrow, remove its feathers and internal organs, marinate it with ginger juice and soy sauce for 10 minutes, then stir-fry it in a wok with oil heated to 60% of its maximum temperature. Add 50g of Shaoxing wine, salt, water and crushed scallion segments, simmer over low heat for 40-60 minutes. Before serving, add a little sugar and MSG, and reduce the sauce until thickened.

[Ingredients] 250g pork leg meat, 15g goji berries, 50g tomato sauce, cooking wine, salt, starch, sugar, and vinegar as needed.

[Preparation] Wash the pork leg meat and cut it into small cubes. Pound it with the back of a knife to tenderize it. Add wine, salt, and wet starch, mix well, and marinate for 15 minutes. Then roll it in dry starch. Fry it once in hot oil until it is crispy. Remove and place on a plate. Grind the goji berries into a paste, mix with tomato sauce, sugar, and white vinegar to make a sweet and sour sauce. Pour the sauce into the remaining oil and stir-fry until thickened. Add the pork cubes and mix well before serving.

[Ingredients] 60g raw astragalus root, 1 live carp.

[Preparation] Kill the live carp, remove the scales, gills and internal organs, cut into pieces, and cook with astragalus until done.

[Ingredients] 12g white fungus, 1500ml chicken broth, salt, cooking wine, and pepper to taste.

[Preparation] Soak the white fungus in warm water until softened. Pour chicken broth into a clean, oil-free pot, add salt, cooking wine, and pepper, and bring to a boil. Then add the white fungus and steam over high heat until the white fungus is soft and flavorful. Remove from the steamer and add MSG to taste.

[Ingredients] 250g Codonopsis pilosula, 250g Astragalus membranaceus, 500g white sugar.

[Administration] Soak Codonopsis pilosula and Astragalus membranaceus thoroughly and decoct them. Take the decoction once every 30 minutes, and decoct for a total of 3 times. Combine the decoctions and simmer over low heat until thick and sticky. After cooling, add white sugar and stir well. Dry in the sun, crush, and store in a porcelain jar for later use.

[Ingredients] 500g black sesame seeds, appropriate amount of honey.

[Preparation] Clean the black sesame seeds, stir-fry them until fragrant, let them cool, crush them, and store them in a porcelain jar for later use.

[Ingredients] 30g walnut kernels, 100g yam, 15g plantain seeds.

[Preparation] Crush the walnut kernels and grind the yam into a fine powder. Add water to the two powders and mix them into a thin paste. Add the plantain seeds and cook until done.

[Ingredients] 500g walnuts, 500g white sugar.

[Preparation] Place white sugar in a pot, add a little water, and simmer over low heat until it forms threads that can be lifted with a spatula without sticking to your hands. Turn off the heat, add the fried walnuts in sesame oil while it is still hot, mix well, pour into a plate, and let it cool slightly before flattening and cutting into pieces.

[Ingredients] 20g minced scallion whites, 50g orange peel powder, 500g stir-fried sunflower seeds, 500g white sugar.

[Preparation] Place white sugar in a pot, add a little water, and simmer over low heat until it becomes quite thick. Add mallow seeds, orange peel powder, and scallion paste, and mix well. Continue simmering until the sugar forms threads when lifted with a spatula but is not sticky. Remove from heat and pour into a porcelain plate while hot. Let it cool, press flat, and cut into pieces. Alternatively, it can be steamed with glutinous rice flour to make a cake.

[Ingredients] 5g cinnamon powder, 60g white rice.

[Preparation] Cook white rice into porridge, and when it is half-cooked, add cinnamon powder and simmer until done.

[Ingredients] 10g peach kernels, 10g apricot kernels, 15g Sichuan achyranthes root, 100g japonica rice.

[Preparation] Boil the above 3 ingredients in water, remove the dregs, add japonica rice and cook together until the porridge is done.

[Ingredients] 20g Poria cocos, 100g chestnuts, 15g Cuscuta chinensis, 15g lotus seeds.

[Preparation] Grind Poria cocos into a fine powder and cook it with the other three ingredients into porridge.

[Ingredients] 5g fennel seeds, 4 scallions (white part only).

[Administration] Crush together, decoct in water, and remove the dregs.

It is widely accepted that men with benign prostatic hyperplasia (BPH) should not sit for long periods; however, the importance of proper sitting posture for BPH patients is often overlooked. When a person sits upright, their center of gravity naturally falls on the prostate. Over time, the enlarged prostate inevitably bears the pressure of body weight, which can cause it to expand into the urethra, compressing it and potentially leading to difficulty urinating or even urinary retention. If BPH patients consciously shift their weight to their left or right hip (alternating between the two hips), they can avoid direct pressure on the enlarged prostate, thus preventing or reducing pressure on the urethra. Long-term adherence to this method can undoubtedly provide unexpected protection for the enlarged prostate.

The seminal vesicle is an organ composed of numerous mucosal folds and tortuous ducts, located above the prostate gland, between the base of the bladder and the rectum, adjacent to the ureters, vas deferens, prostate gland, and rectum. Its excretory duct merges with the vas deferens to form the ejaculatory duct, which passes through the prostate gland and opens into the posterior urethra. The most common pathology is seminal vesicle inflammation; other conditions such as seminal vesicle stones, seminal vesicle cysts, and tumors are relatively rare.

Due to its anatomical location and physiological structure, the seminal vesicle is relatively prone to infectious diseases, and often coexists with prostatitis or posterior urethritis.

1. The routes of bacterial infection for acute seminal vesiculitis include: ① ascending infection from the urethra; ② lymphatic infection; ③ hematogenous infection. Common pathogens include Staphylococcus, Streptococcus, Escherichia coli, and Corynebacterium diphtheriae.

The main symptom is hemospermia. Common symptoms of acute inflammation include lower abdominal pain radiating to the perineum and both groins. Systemic symptoms such as chills, fever, and shivering may also occur. Because seminal vesiculitis often coexists with prostatitis and posterior urethritis, symptoms may include urinary frequency, urgency, hematuria, painful urination, difficulty urinating, and bloody urethral discharge. Diagnosis is not difficult; in addition to the above clinical manifestations and physical examination, ultrasound and seminal vesiculography can be performed.

Treatment: Anti-inflammatory drugs such as penicillin, streptomycin, erythromycin, and chloramphenicol are used; if systemic symptoms are present, intravenous administration is more effective. Local physical therapy and sitz baths can also be given as adjunctive treatments.

2. Chronic seminal vesiculitis: After acute seminal vesiculitis, poor drainage of secretions makes it difficult to completely control the inflammation, which often turns into chronic inflammation.

Symptoms: Similar to chronic prostatitis, including urinary discomfort, burning sensation, urinary frequency, urgency, perineal discomfort, and dull pain in the suprapubic region, as well as hematospermia. Diagnosis can be made by examining prostatic fluid and semen, which may show increased red and white blood cells and pus cells. Ultrasound and seminal vesiculography can also be performed, showing enlarged seminal vesicles and signs of chronic inflammation.

Treatment: A comprehensive approach should be taken, including the use of Chinese and Western anti-inflammatory drugs, local iontophoresis, regular prostate and seminal vesicle massage, and hot sitz baths every night.

In cases of chronic inflammation of the seminal vesicle, the mucosa of the duct may become rough, leading to the crystallization and deposition of inorganic salts such as calcium phosphate and calcium carbonate, forming small stones known as seminal vesicle stones.

Symptoms include lower abdominal and groin pain, which is more pronounced during sexual arousal and ejaculation and may radiate to the perineum and testicles; hematospermia is common. A digital rectal examination may occasionally reveal a calculus with a rubbing sensation in the upper outer part of the prostate. Plain X-ray may show a shadow of the calculus.

The main treatment is conservative symptomatic treatment, including anti-inflammatory, antispasmodic, and analgesic drugs and hot sitz baths; in some cases, surgical lithotomy may be performed.

Clinical symptoms are rare. When the cyst grows larger, lower abdominal or lumbar pain may occur; other symptoms include hematospermia or bloody discharge from the urethra, and sometimes urinary obstruction. A cyst may be palpable on one side of the seminal vesicle during a digital rectal examination or bimanual abdominal examination. Ultrasound, CT scan, and seminal vesiculography can determine the size and location of the cyst. Treatment depends on the size of the cyst and the symptoms. Small cysts are treated conservatively with close observation; larger cysts may be removed via the lower abdomen or perineum, or drained via a sac-like procedure through the bladder or suprapubic region.

Seminal vesicle tumors are classified into primary and secondary types. Primary tumors are mostly epithelial papillomas and seminal vesicle carcinomas, but stromal sarcomas are also possible. Secondary seminal vesicle tumors can originate directly from prostate cancer, rectal cancer, and bladder cancer, or they can be metastasized from tumors in other organs to the seminal vesicles.

The main clinical symptom is hematospermia, along with urinary frequency, urgency, and hematuria. Urinary obstruction and pain in the lower abdomen, groin, or testicles may also occur. Late-stage symptoms include anemia, fatigue, and weight loss. If the tumor compresses the rectum, it can deform stools and cause difficulty in defecation. If a seminal vesicle tumor is definitively diagnosed, a wide resection including the prostate and bladder should be performed. If tumors are present in both the prostate and seminal vesicle, bilateral orchiectomy and estrogen therapy should be considered. The prognosis for seminal vesicle tumors is generally poor.

Male infertility refers to the inability of a wife to conceive after three years of unprotected cohabitation due to male factors. The basic conditions for male fertility are normal sexual function and the availability of sperm capable of fertilizing an egg. These depend on the normal anatomy and physiology of the reproductive organs, as well as the balanced coordination of the hypothalamus, pituitary gland, and testes. Both anatomical and functional defects of the reproductive organs and disorders of the hypothalamic-pituitary-gonadal axis lead to male infertility. The average time for a normal couple to conceive after marriage is 5.3 months, with 80% conceiving within one year. Statistics show that 10%–15% of couples of reproductive age are infertile, with male factors accounting for 35%–50% of these cases. Recent medical surveys confirm that the health status of men in my country is concerning, with an increasing number of infertile patients, and the incidence is higher in urban areas than in rural areas. Rural patients account for 4%–5% of the total adult male population, while urban men account for about 7%, and in industrially developed cities, the figure reaches 10%.

1. Environmental Factors: Humans live in an environment filled with various types of pollutants. The toxic effects of these pollutants on the reproductive system, especially the male reproductive system, are increasingly attracting attention. This is because, in addition to directly affecting the male gonads and causing oligospermia and azoospermia leading to infertility, these pollutants can also induce sperm chromosome aberrations, increasing the number of abnormal sperm. This is a major issue related to human health. Besides tangible pollutants such as various toxic compounds and certain metallic elements, there is also an intangible form of pollution-electromagnetic radiation pollution-which is becoming one of the public health hazards.

2. Lifestyle factors

(1) Wearing tight jeans: Andrologists and urologists believe that tight jeans not only compress male reproductive organs and affect the normal development of the testes, but also hinder sperm survival because they are not breathable and do not dissipate heat. Under normal circumstances, the temperature of the testes is 3-4°C lower than the body temperature.

(2) Excessively high bath temperature: Sperm can only develop normally in an environment of 34-35℃. Excessively high bath water temperature often poses a hidden danger. For example, the room temperature in a sauna can reach 70-80℃, more than twice the normal bathroom temperature, which is very detrimental to sperm growth or can cause excessive "dead sperm" leading to infertility. Some infertile men have testicular temperatures 2-3℃ higher than normal, preventing sperm from surviving. Therefore, young men should be cautious about taking saunas, and the water temperature for regular baths should ideally be around 34℃.

(3) Zinc- and selenium-deficient diet: The trace element zinc can promote sperm motility, prevent premature sperm disintegration, and facilitate fertilization. Therefore, zinc has a significant impact on fertility. Selenium is also an essential trace element for the human body, almost entirely obtained from food. Japanese medical researchers observed 1000 cases of male infertility and found that 37 men had insufficient selenium levels in their semen. Therefore, men should pay attention to eating more foods rich in zinc and selenium, such as fish, oysters, liver, soybeans, and brown rice.

(4) Inhaling kitchen fumes: There are 74 kinds of chemicals in kitchen fumes that can cause cell mutations, leading to infertility, becoming a new "evidence" of "family killer".

(5) Chronic exposure to heavy metals such as lead, cadmium, and mercury, or pesticides, herbicides, and substances containing carbonates and sulfides; long-term heavy smoking and drinking; and prolonged exposure to high temperatures, such as long-distance driving, can all affect testicular spermatogenesis, leading to decreased semen quality and reduced fertility. Smoking marijuana and heroin can also affect male fertility.

3. Physiological and pathological factors: Taking internal medicine diseases as an example, diabetes and some neurological diseases can cause impotence and reduce sperm count; epididymitis and prostatitis caused by tuberculosis can both cause problems with sperm transport; chronic sinusitis, chronic bronchitis, or bronchiectasis are sometimes associated with asthenospermia or cystic fibrosis (causing bilateral vas deferens defects); viral mumps after puberty can sometimes cause orchitis, causing the testes to lose their ability to produce sperm; if the fever exceeds 38.5℃, it can inhibit sperm production for up to 6 months.

Certain medications can cause a temporary or permanent reduction in sperm count. These include hormonal preparations such as androgens, estrogens, and steroids; medications for gout such as colchicine; and medications for ulcerative colitis. Some chemotherapy drugs used to treat cancer can also affect fertility; radiation therapy can cause irreversible damage to reproductive function. Additionally, undergoing general anesthesia or testicular biopsy within the past six months can temporarily suppress testicular spermatogenesis.

Patients who have undergone prostatectomy or bladder neck dilation may experience retrograde ejaculation leading to azoospermia; hypospadias or epispadias may cause ejaculation difficulties after reconstruction surgery, and urethral stricture caused by trauma can also prevent ejaculation; hernia surgery can sometimes cause vas deferens obstruction; vasectomy or ligation of the vas deferens can lead to the production of antisperm antibodies, significantly reducing the effectiveness of vas deferens reconnection surgery. If semen quality does not improve after successful varicocele surgery, other causes of infertility should be identified.

Testicular injury can occasionally cause infertility, primarily due to testicular hematoma or atrophy caused by trauma. Unilateral testicular injury can lead to the production of antisperm antibodies, affecting the sperm production function of the other testicle. Experiences of scrotal swelling and severe pain before or during puberty may indicate testicular torsion. Testicular torsion lasting more than 6 hours without emergency surgery can lead to decreased fertility. Cryptorchidism is also related to the severity of infertility.

Repeated urinary tract infections, such as prostate infections, can damage reproductive organs and affect semen quality; sexually transmitted infections such as syphilis, gonorrhea, herpes simplex virus, and human papillomavirus (HPV) can cause male infertility; herpes simplex virus and HPV can reduce sperm motility.

Through detailed medical history taking and comprehensive physical examination, the cause of infertility is generally not difficult to determine; however, some cases require a series of specialized examinations to achieve the purpose of diagnosing the cause.

1. The medical history inquiry mainly includes the following:

(1) Sexual history, whether there is any sexual dysfunction. Marital history, whether it is consanguineous marriage, whether there is any family hereditary disease. If they are not the original couple, they should also ask about the previous reproductive history in order to understand whether it is male infertility and whether it is primary or secondary infertility.

(2) Whether there are systemic and urogenital diseases that affect fertility. The presence or history of urinary frequency, urgency, dysuria, white mucus discharge from the urethra, purulent discharge, and hemospermia clearly indicate inflammation of the urogenital organs that affects fertility; those with enuresis, especially those with persistent enuresis in late adolescence, may have abnormal nerve supply to the bladder and prostate, and may have the possibility of retrograde ejaculation.

(3) History of trauma or surgery that may affect fertility. External force may directly injure the testicles; hernia repair, high ligation of varicocele, eversion of the tunica vaginalis and other surgeries in the groin or scrotum may damage the testicles or testicular blood supply; lumbar sympathectomy and bladder neck repair may cause retrograde ejaculation.

(4) Whether you have been exposed to radioactive substances or drugs and narcotics that can affect sperm production or fertility.

(5) Personal lifestyle habits, hobbies, and work and living environment. Excessive smoking and alcohol poisoning, and nicotine poisoning can affect sexual function and sperm production. Occupational stress, fear of one's parents, marital discord, and other mental disorders not only cause sexual dysfunction but also harm sperm survival. Male infertility patients from cotton-producing areas should be asked whether they frequently consume crude cottonseed oil. Tight underwear that causes the testicles to be close to the abdomen, frequent hot sitz baths, and high-temperature working environments can all interfere with scrotal heat regulation and affect spermatogenesis.

2. The physical examination includes a systematic physical examination and an examination of the reproductive organs.

(1) Systematic physical examination: Pay attention to body shape, nutritional status, whether the person is particularly thin or obese, and whether there are signs of hypertension or endocrine abnormalities. Pay attention to secondary sexual characteristics such as tone of voice, Adam's apple, beard and hairline type (a slightly rounded hairline may indicate insufficient testosterone secretion), breast development, and the distribution of axillary and pubic hair.

(2) Examination of reproductive organs

① Penile development: whether there is severe phimosis or urethral stricture, whether there is epispadias or hypospadias, and whether there is penile cavernous fibrosis.

②Scrotum (and groin area): Are there any surgical scars? Are there any sinus tracts, whether they have healed or not? Is the scrotal skin thickened? Is there a large hydrocele or hernia? An empty scrotum indicates cryptorchidism or anorchidism. Is varicocele present?

③ Testes: Are the size, location, and texture normal? Are there any nodules? The normal testicular volume in most adult males is >15ml; if it is <11ml, it suggests poor testicular function.

④ The relationship between the epididymis and the testis, and whether there are nodules or fibrosis in the epididymis.

⑤ Vas deferens: whether it exists, whether it is smooth and round, whether it is thickened, and whether there are beaded nodules.

⑥ Prostate and seminal vesicles: their size, texture, presence of nodules and tenderness (can be determined through digital rectal examination).

3. Semen Analysis: Semen analysis includes physical and biochemical characterization and is the most basic laboratory diagnostic procedure for male infertility. The submitted semen sample should be the complete semen from a single ejaculation five days after the subject has abstained from sexual intercourse. At least three semen analyses should be performed, as parameters may vary significantly between each sample; therefore, multiple analyses provide a more objective result.

4. The purpose of testicular biopsy is to assess testicular spermatogenesis in men with azoospermia or severe oligospermia. In patients with azoospermia, testicular biopsy can differentiate between obstructive and non-obstructive azoospermia (i.e., azoospermia due to loss of testicular spermatogenesis), and determine the type and extent of non-obstructive dysfunction. In men with severe oligospermia, testicular biopsy can identify the type of testicular lesion.

5. Examination of the seminal ducts: The patency of the seminal ducts directly affects ejaculation and fertility. Radiological examinations are a direct and reliable means of examining seminal duct lesions and patency, including vas deferens angiography, urethrography, and urethroscopy. Vas deferens angiography carries the risk of scarring and stenosis at the puncture site; therefore, case selection should be cautious.

6. Laboratory tests in cytogenetics include sex chromatin and karyotype identification, the indications of which are:

(1) Infertile men with abnormal development of secondary sexual characteristics or signs of intersex malformation.

(2) Functional azoospermia, severe oligospermia or azoospermia.

(3) Infertile men have abnormal sperm density and a low ratio of normal sperm morphology.

(4) The spouse has a history of habitual miscarriage or the baby has birth defects.

7. Endocrine examinations, including serum FSH, LH, and testosterone measurements, as well as hormone kinetic tests, can estimate the function of the hypothalamus, pituitary gland, and testes, and differentiate whether gonadal insufficiency is due to primary testicular causes or secondary to hypogonadotropic hypofunction.

8. Immunological Examination: If a couple is infertile and postcoital tests are unsatisfactory, but the male has normal sperm count and quality, it indicates the presence of antisperm antibodies, which often occur in the male. Immunological testing should be performed. Semen and sperm themselves contain antigenic substances. Under normal circumstances, the blood-testis barrier prevents these antigenic substances from entering the bloodstream, and immune cells are separated from the normal seminal duct, so no immune response occurs. However, inflammation, trauma, or surgery of the seminal duct can disrupt the blood-testis barrier, potentially leading to an immune response and the production of antisperm antibodies. In women, antisperm antibodies are generally caused by an immune response resulting from contact between sperm antigens and the vagina and uterus during intercourse. The antisperm antibodies primarily affecting fertility are those present in semen or cervical mucus, causing sperm agglutination or immobilization.