Seminal colliculitis and its impact on sexual function and proper management of hematospermia

How should seminal colliculitis be treated?

**Dr. Cao:**

I went to the hospital because of painful ejaculation and erectile dysfunction. The doctor said I had seminal vesicle inflammation. I had never heard of this disease before. How does seminal vesicle inflammation affect sexual function?

Shu XX

Mr. Shu:

In recent years, the incidence of seminal colliculitis has increased due to improved understanding and diagnostic techniques. The seminal colliculum is located within the prostate gland, below which lies the opening of the ejaculatory ducts. Sperm transported from the vas deferens converges here with prostatic fluid and seminal vesicle fluid to form semen, which is expelled from the body along the urethra during ejaculation. The seminal colliculum is richly innervated, controlling the ejaculatory action during intercourse and causing the ejaculatory duct openings to contract, increasing the speed and force of semen ejaculation. Due to its important anatomical location and physiological significance, the seminal colliculum plays a crucial role in male sexual function. Furthermore, retrograde infection of the reproductive system can cause inflammation of the seminal colliculum, in addition to inflammation of the urethra and bladder. Inflammation of the prostate and seminal vesicles can also affect the seminal colliculum; infection of the seminal colliculum often indicates infection of the prostate and seminal vesicles.

The pathogens that cause seminal colliculitis include Escherichia coli, Proteus, Mycobacterium tuberculosis, Neisseria gonorrhoeae, and Chlamydia trachomatis virus. Clinical manifestations generally include varying degrees of urethral irritation symptoms; if bladder symptoms are present, prostatitis or cystitis may be present. Mild seminal colliculitis typically presents with urethritis symptoms; some individuals may experience premature ejaculation or erectile dysfunction during sexual intercourse. Painful ejaculation is a prominent symptom of seminal colliculitis. During ejaculation, the seminal colliculum and the opening of the ejaculatory ducts rhythmically contract. Inflammation and swelling of the seminal colliculum impair its function, resulting in intermittent pain during ejaculation. Some individuals fear intercourse due to painful ejaculation, while others experience aversion to intercourse due to impaired sexual pleasure, leading to decreased libido or erectile dysfunction.

Long-term, recurrent seminal colliculitis can lead to fibrous tissue hyperplasia and scar formation. When scarring occurs in the seminal colliculum, it can obstruct the ejaculatory duct opening and cause infertility. Patients with similar symptoms to seminal colliculitis should seek medical attention promptly for early diagnosis and treatment to avoid affecting sexual function.

Patients with seminal colliculitis should drink plenty of water to increase urine output, which helps flush the tissue around the colliculum and aids in reducing inflammation. To avoid aggravating local congestion in the colliculum, sexual activity can be abstained from for a period of time, resuming only after the inflammation subsides. Maintaining good hygiene during sexual activity is crucial; both partners should wash their external genitalia before intercourse. Unhealthy habits such as masturbation and frequent interruptions in intercourse can also cause congestion, swelling, and inflammation of the colliculum; these factors should be eliminated, and healthy lifestyle habits should be cultivated. Seminal colliculitis is curable with active treatment, and along with the cure, any accompanying sexual dysfunction will also disappear.

**Cao Kaiyong**

**Don't panic if you experience blood in your semen.**

**Dr. Cao:**

Last week, during intercourse with my wife, I suddenly noticed that the semen inside the condom was bright red, which startled me. I've heard this is called hematospermia (blood in semen). What causes hematospermia? How is it treated?

Yue××

Mr. Yue:

Hematospermia refers to the presence of blood in semen. Normal semen is milky white, but some men may suddenly find their semen turns pink or even bright red; this condition is hematospermia. An examination of the semen will reveal a large number of red blood cells under a microscope. Patients may also experience mild perineal, rectal, and lower abdominal pain, or symptoms of a urinary tract infection such as painful urination.

Traditional Chinese medicine believes that hematospermia is mainly caused by "excessive strain damaging kidney qi." Modern medicine identifies the following causes of hematospermia: ① seminal vesicle and prostate cancer, benign prostatic hyperplasia; ② inflammation of the seminal vesicles and prostate; ③ excessive sexual activity or prolonged intercourse, leading to long-term congestion of the seminal vesicles and venous dilation, causing bleeding; or the accumulation of seminal vesicle secretions during sexual stimulation, followed by a sudden and rapid emptying, causing a sharp drop in pressure and resulting in the rupture of capillaries in the sac wall.

Hematospermia is not a serious illness. If you discover hematospermia, don't panic; try to stay calm. First, stop sexual activity. This allows the seminal vesicles to rest and restore normal sexual function, and also prevents bacteria-laden semen from entering the woman's reproductive tract. Second, consult a doctor for diagnosis and medication. Third, maintain a light diet, avoiding spicy, fatty, and greasy foods that promote dampness and heat. Also, pay attention to balancing work and rest, and avoid overwork.

**Cao Kaiyong**