Elsevier

European Urology

Volume 44, Issue 5, November 2003, Pages 546-548
European Urology

Impact of Prostatitis NIH IIIB (Prostatodynia) on Ejaculate Parameters

https://doi.org/10.1016/S0302-2838(03)00370-1Get rights and content

Abstract

Objectives: Prostatitis NIH IIIB is defined by chronic pelvic pain without evidence of inflammation in prostate secretions or ejaculate. The relations between chronic prostatitis and fertility are discussed controversially. In this context, we analysed fertility data of a well defined collective of patients with prostatitis NIH IIIB.

Methods: We analysed prospective fertility data of a group of 30 patients with chronic prostatitis NIH IIIB and compared these data with the duration of symptoms as well as with an age-matched control group.

Results: The prostatitis group and the control group differed significantly in terms of ejaculate volume, motility and fructose concentration. The remaining parameters did not differ significantly. An azoospermia was present in 3 patients of the prostatitis group versus none of the control group. The duration of symptoms did not correlate with the sperm parameters (sperm density, motility and morphology).

Conclusions: Patients with Prostatitis NIH IIIB have changes in their ejaculate with a reduction of motility and a reduced fructose concentration. This supports a somatic aetiology of the chronic pelvic pain syndrome.

Introduction

Prostatitis is the most common urologic diagnosis in men younger than 50 years and represents 8% of urology office visits [1]. Male infertility is also a common condition affecting 7.5% of men in North America, without identification of a correctable cause in close to 50% of these men [2]. The relations between fertility and prostatitis remain obscure. There are several studies on semen quality of men who presented with chronic prostatitis symptoms [3], [4], [5], [6], [7], [8], [9], but some of these lack exact classification criteria, control groups or have incomplete spermiogram data.

Section snippets

Material and methods

Consecutive prospective fertility data of 30 patients with prostatitis NIH IIIB were analysed. None of the subjects had been referred for infertility investigation. Diagnosis of chronic symptomatic prostatitis was accepted in case of a history of 3 months or more of pelvic or genital pain, or both, associated with voiding and/or sexual dysfunction and a painful digital rectal examination of the prostate. First voided volume, midstream urine, expressed prostatic secretions (EPS) and urine after

Results

The prostatitis and the age-matched asymptomatic control group (mean age 41 (range 22–66) versus 42 (range 22–66) years, p=0.74) differed significantly in terms of ejaculate volume, motility and fructose concentration. For the remaining parameters no statistically significant difference was found (Table 1). An azoospermia was present in 3 patients (10%) of the prostatitis group versus none of the control group. Duration of prostatitis symptoms did not correlate with sperm parameters (for sperm

Discussion

Aetiology, evaluation and therapy of chronic prostatitis remain clinical problems [12]. Patients are treated usually by costly and often unsuccessful antibiotic cycles which have attendant risks and side effects. These patients typically consult multiple urologists and often claim psychological problems including sexual dysfunction and impotence [13]. While recent studies showed significant immunological changes in the ejaculate of patients with abacterial, noninflammatory chronic prostatitis

Conclusions

Patients with a chronic non-bacterial, noninflammatory Prostatitis (NIH IIIB) have changes in their ejaculate with a reduction of motility and a reduced fructose concentration. This supports a somatic aetiology of the chronic pelvic pain syndrome.

Acknowledgements

Marika Borsos, technician, for her excellent support.

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