External treatments for male infertility include: fumigation, sitz baths, rectal irrigation, oral medication, topical application, and umbilical therapy.

What are some external treatment methods for male infertility?

(1) Vulvar fumigation

The fumigation and washing method involves decocting the medicinal herbs, filtering out the dregs, pouring the decoction into a clean basin, placing the affected area over the basin to fumigate, and then washing the affected area with the decoction. This method utilizes the medicinal properties and heat to achieve therapeutic effects. The heat helps the medicine penetrate. However, for inflammatory or allergic diseases, the water temperature should not be too high, and should be close to body temperature. For other diseases, the water temperature should be tolerable.

Fumigation and washing have a direct effect, often opening the pores, reducing swelling, and promoting blood circulation. The medications used vary depending on the specific urological condition. In this method, washing is primary, while fumigation is secondary.

In cases of balanitis, the medicated solution should be cooled slightly before fumigation. The solution should not be too hot, as this may worsen the inflammatory reaction. Commonly used herbs for fumigation include those that clear heat, detoxify, and dry dampness, such as Sophora flavescens, Scutellaria baicalensis, Coptis chinensis, Lonicera japonica, alum, borneol, Smilax glabra, and Gentiana scabra.

For dysphoric urethritis, use warming and qi-regulating herbs for fumigation and washing. The temperature of the herbal water should be high, but within a tolerable range. Herbs such as fennel, evodia, cinnamon, and mugwort are recommended.

For cases of yang deficiency, fumigation with heat-clearing and meridian-clearing drugs is often used.

For scrotal and penile elephantiasis, fumigation and washing with herbs that dispel dampness and unblock the meridians are often used. Herbs such as Clematis chinensis, Acanthopanax senticosus, and ginger peel are commonly used.

In summary, the choice of medication and water temperature for fumigation and washing should be based on the etiology and pathogenesis of various andrological diseases.

(2) Traditional Chinese medicine sitz bath

A sitz bath involves decocting the medicinal herbs in at least 1500ml of water, then using this decoction to soak the patient in a large basin for 20-30 minutes. Care should be taken to ensure the decoction is not too hot to avoid scalding the skin; the temperature should be tolerable.

The therapeutic mechanism of sitz baths is to achieve therapeutic effects through drug penetration. The selection of medications is based on the nature of the lesion and is determined through syndrome differentiation, but the dosage is larger than that used orally. This method is commonly used to treat impotence, benign prostatic hyperplasia, chronic prostatitis, scrotal eczema, hydrocele, and condyloma acuminata.

For example, Pang Baozhen randomly divided 155 patients with chronic prostatitis into a treatment group (79 cases) and a control group (76 cases) using a self-prepared Xianquan Dixie Decoction: Smilax glabra 30g, Gynostemma pentaphyllum 30g, Sophora flavescens 20g, Clematis chinensis 30g, Lycopodium clavatum 30g, Salvia miltiorrhiza 30g, Carthamus tinctorius 20g, Corydalis yanhusuo 20g, Ligusticum chuanxiong 20g, Citrus aurantium 20g, Cinnamomum cassia 20g, Zanthoxylum bungeanum 20g, Artemisia argyi 20g, the above herbs were decocted and used for sitz baths, 2-3 times/day, 20 minutes each time) and a control group (76 cases). The results showed that the treatment group had significantly better efficacy than the control group (p<0.01). Conclusion: Sitz bath with Xianquan Dixie Decoction is one of the ideal ways to treat chronic prostatitis.

(3) Rectal irrigation

Rectal irrigation involves injecting a medication solution into the rectum, where it is absorbed through the rectal mucosa to treat urological diseases. This method is commonly used to treat benign prostatic hyperplasia, chronic prostatitis, erectile dysfunction, low libido, priapism, and premature ejaculation.

For example, Pang Baozhen treated 168 cases of chronic prostatitis-related infertility with her self-formulated Wenwu Yulin Decoction (containing 12g of Achyranthes bidentata, 12g of Smilax glabra, 12g of Viola yedoensis, 10g of Achyranthes bidentata, 15g of Salvia miltiorrhiza, 10g of Vaccaria segetalis, 10g of Poria cocos, 10g of Alisma plantago-aquatica, 10g of Plantago asiatica [wrapped in cloth], 8g of Lindera strychnifolia, 10g of Acorus tatarinowii, 4g of Glycyrrhiza uralensis, 10g of Cuscuta chinensis, 10g of Dipsacus asper, 10g of Lycium barbarum, and 10g of Polygonum multiflorum, decocted to 200ml, poured into a sterilized liquid bottle, connected to a disposable infusion set (the scalp needle of the infusion set must be removed), connected to a 14-gauge urinary catheter inserted into the rectum, and slowly dripped in. The temperature of the medicine solution should be around 39℃, once a day). The results showed that 102 cases were cured, 51 cases improved, and 15 cases were ineffective, with a total effective rate of 91.1%.

(4) Rectal administration of medication

Rectal suppository therapy involves inserting medication, either in the form of a suppository or a paste, into the anus to achieve therapeutic effects. In andrology, this method is primarily used to treat chronic prostatitis, benign prostatic hyperplasia, and erectile dysfunction. Its mechanism of action involves the medication being absorbed through the rectal mucosa to treat diseases near the rectum. However, it is important to avoid using corrosive medications. For example, after defecation, a suitable amount of Ma Yinglong Musk Hemorrhoid Ointment can be squeezed into the anus once daily. This has the effect of cooling the blood and promoting blood circulation. It is suitable for prostatitis and other conditions caused by excessive heat and toxicity or internal blood stasis.

(5) Application method

This method involves applying medication directly to the skin to achieve therapeutic effects such as detoxification, swelling reduction, cold relief, pain relief, diuresis, or tissue regeneration.

Instructions for use: The herbs or herbal extracts can be made into ointments, powders, or pastes as needed, or fresh herbs can be mashed into a paste and applied to the skin. For urological diseases of the vulva, apply locally; for other urological diseases (such as benign prostatic hyperplasia, impotence, spermatorrhea, chronic prostatitis, etc.), apply to the perineum, navel, or Guanyuan point, or sometimes to the soles of the feet or palms.

For example, grind Epimedium into powder and store it in a bottle for later use. When needed, take 10g of the powder, mix it with warm water to form a paste, apply it to the Shenque (CV8) and Mingmen (GV4) acupoints, cover with gauze, and secure with adhesive tape. Change the dressing every 3 days. This has the effect of warming and tonifying kidney yang, and promoting sperm production. It is suitable for impotence, oligospermia, excessive azoospermia, and low sperm motility caused by kidney yang deficiency.

(6)Navel therapy

Umbilical therapy is a method of treating diseases by applying various medications or non-drug therapies (such as moxibustion) directly to the navel. The navel is an acupoint on the Ren meridian, connected to all the meridians of the body and the internal organs. Applying medication to this acupoint can stimulate the Qi of the meridians and exert significant pharmacological effects through local absorption. In andrology, umbilical therapy is mainly used for impotence, low libido, spermatorrhea, premature ejaculation, priapism, overexertion during sexual activity, chronic prostatitis, and benign prostatic hyperplasia.

For example, Pang Baozhen randomly divided 128 patients with chronic nonspecific prostatitis into two groups using a placebo-controlled study, and administered the medication in a double-blind manner. Results: 66 patients were treated with a self-prepared pure traditional Chinese medicine preparation, Xiajiao Zhuyu Dan (containing 30g of Wangbuliuxing, 30g of Sanleng, 30g of Ezhu, 15g of fried pangolin scales, 15g of Chuanniuxi, 15g of Chuanxiong, 15g of Cheqianzi, 15g of Longdancao, and 20g of Shichangpu, etc., all ground into a fine powder and bottled for later use. Before use, 10g of the powder was mixed with warm water to form a ball, applied to the Shenque acupoint, and secured with gauze and adhesive tape. The dressing was changed every 3 days). 44 patients achieved clinical cure. Compared with the 62 patients treated with the placebo (χ²=51.42, p<0.01), the efficacy of the two groups was significantly different. Conclusion: Xiajiao Zhuyu Dan has a good therapeutic effect on chronic prostatitis (nonspecific) of the qi stagnation and blood stasis type.

Male Infertility Plaster (Self-Formulated): Epimedium, Pinellia, Cyperus, and Leonurus japonicus are mixed with sesame oil and cinnabar in appropriate proportions to form a hard plaster. This plaster is spread on a cloth, each weighing 30g, and applied to the navel. It is changed every 7 days, with 28 days constituting one course of treatment. It is effective in treating male infertility caused by kidney yang deficiency, phlegm-dampness accumulation, and liver stagnation and blood stasis.