Manifestations and treatment of lichen sclerosus of the male genitalia, and early symptoms and misconceptions of sexually transmitted diseases.

This disease is most common in individuals aged 30-49 and 8-10 years. Clinical manifestations are variable; early stages may be asymptomatic. Initially, milky-white plaques appear on the inner foreskin and glans, with recurrent ulceration. The foreskin and glans skin and mucous membranes secrete copious purulent discharge, accompanied by itching, stinging, and burning sensations. Further progression leads to dryness and atrophy of the foreskin and glans skin and mucous membranes, reduced foreskin elasticity, and difficulty in retraction, severely impacting sexual life. In later stages, it can invade the urethral meatus, causing stenosis, and extend into the proximal urethra, causing extensive fibrosis and complex long-segment urethral stricture. However, proximal urethral involvement usually stops at the bulbous urethra, rarely affecting the membranous or prostatic urethra. In severe cases, increased residual urine in the bladder, hydronephrosis, and even kidney damage may gradually occur.

Drug treatment: Corticosteroids, such as 0.05% clobetasol propionate cream, are currently the first-line treatment in clinical practice, with an efficacy rate of 88%. For patients with a history of herpes simplex virus infection, prophylactic antiviral drugs such as acyclovir can be used. Calcineurin inhibitors: Tacrolimus or pimecrolimus, adalimumab, and retinoic acid can also be used; surgical treatment.

Non-surgical treatments include urethral dilation, cryotherapy, ultraviolet light therapy, carbon dioxide laser therapy, pulsed dye laser therapy, and subcutaneous injection of anhydrous alcohol. Circumcision is the basic treatment. Surgical treatments include urethral meatus incision or reconstruction, urethral plasty or reconstruction (oral mucosa, colonic mucosa, bladder mucosa, and decellularized matrix of the small intestine/bladder submucosa), and perineal stoma.

Swollen inguinal lymph nodes: soft and painful lymph nodes, hard and slightly painful lymph nodes may indicate lymphogranuloma venereum; hard and painless lymph nodes may indicate syphilis; persistent swelling of lymph nodes throughout the body may indicate chronic lymphadenopathy syndrome of AIDS; or lesions on the skin or mucous membranes. If symptoms such as erythema, papules, induration, vesicles, erosions, and ulcers appear on the external genitalia such as the foreskin, penis, glans, coronal sulcus, anus, hands, eyelids, lips, tongue, and throat, it may indicate a sexually transmitted disease (STI). Pain, inflammation, constipation, rectal discharge, tenesmus, and fever in the anus or rectum may indicate an STI or genital herpes. Urinary tract symptoms such as frequent urination, urgency, painful urination, difficulty urinating, urinary retention, and terminal hematuria may also indicate an STI. A large amount of thick, purulent discharge from the urethra may indicate gonorrhea; only thin, white mucus may indicate non-gonococcal urethritis; a small amount of discharge only in the morning or after urination, or even grayish-white or purulent discharge only when the urethra is squeezed, may indicate prostatitis.

Some people believe that if there are no symptoms, sexually transmitted diseases (STDs) do not need further treatment. However, STD treatment has a specific course, and medication should not be stopped just because there are no symptoms. This is to prevent recurrence or the development of drug-resistant strains.

Others claim that the blood from blood donation centers is absolutely safe and there's no need to worry about contracting sexually transmitted diseases. However, HIV has a window period, and currently there are no effective methods for testing it. Therefore, while the blood from blood donation centers undergoes screening for syphilis and HIV, its absolute safety cannot be guaranteed.

Some people believe that as long as they avoid illicit places, they won't contract sexually transmitted diseases (STIs). Herpes and genital warts can often be contracted without sexual activity. Sharing needles or syringes with STI carriers during blood transfusions can also lead to STI transmission, such as syphilis and HIV.

Furthermore, condoms are not absolutely safe. While condoms have a certain probability of preventing the transmission of sexually transmitted diseases, they are not 100% effective. Wearing a condom cannot completely prevent the transmission of sexually transmitted diseases.

Due to the influence of traditional Chinese beliefs, society harbors blind fear, discrimination, and rejection towards patients with sexually transmitted diseases. Furthermore, a lack of knowledge about sexually transmitted diseases, coupled with misdiagnosis and mistreatment by some hospitals and clinics, causes significant harm to patients' physical and mental well-being. This leads to difficulties and tension in interpersonal and family relationships, and patients may experience autonomic nervous system dysfunction, manifesting as sexually transmitted disease phobia, hyperreaction, hypochondria, and virtual illness. Especially when the disease requires long-term treatment and is prone to recurrence, patients may become negative, experiencing self-blame, regret, worry, and even abandoning treatment or seeking revenge against society. Therefore, society as a whole should care for these patients, with professionals providing psychological counseling, and when necessary, using suggestion therapy, systematic desensitization, and other psychological treatments, while also strengthening psychological support to enhance their confidence in overcoming the disease.

The ancients said, "Food and sex are human nature," and "Food and sex are the greatest desires of humankind," succinctly illustrating the two fundamental needs of human life: food and sex. Sex is the foundation of reproduction and the origin of human life. However, human sexual activity is not only a necessity for reproduction but also an important way for couples to communicate emotionally and is beneficial to individual physical and mental health. Yet, due to the influence of traditional concepts in my country, many people are ashamed to talk about sex. Because of some misconceptions and prejudices regarding sex, a significant number of people avoid seeking medical help when problems arise in their sex lives. Unharmonious sex lives have many harmful effects on individuals, marriages, families, and society. Therefore, we must correctly understand and address the issue of sex and actively supplement our knowledge about it. While procreating, we should fully enjoy the pleasures of sex. When problems arise in our sex lives, we should face them openly, seek medical attention promptly, and consult, examine, and treat at a reputable medical institution.

Male sexual physiology comprises five stages: sexual arousal, penile erection, orgasm, ejaculation, and erectile detumescence. Unlike the general physiological phenomena of other organs in the human body, sexual physiology is based on hormones, nerves, and the brain, and involves complex psychological activities. It is also intricately linked to the social environment and cultural traditions. Therefore, male sexual physiology is not a simple physiological phenomenon, but a comprehensive phenomenon based on physiology and closely related to psychology and society. Normal sexual physiological function requires healthy internal and external reproductive organs and the participation of sensory organs, the nervous system, the endocrine system, and the circulatory system to function properly.