Seminal, clinical and colour‐Doppler ultrasound correlations of prostatitis‐like symptoms in males of infertile couples

Abstract

SUMMARY'Prostatitis-like symptoms' (PLS) are a cluster of bothersome conditions defined as 'perineal and/or ejaculatory pain or discomfort and National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) pain subdomain score ≥4' (Nickel's criteria). PLS may originate from the prostate or from other portions of the male genital tract. Although PLS could be associated with 'prostatitis', they should not be confused. The NIH-CPSI is considered the gold-standard for assessing PLS severity. Although previous studies investigated the impact of prostatitis, vesiculitis or epididymitis on semen parameters, correlations between their related symptoms and seminal or scrotal/transrectal colour-Doppler ultrasound (CDU) characteristics have not been carefully determined. And no previous study evaluated the CDU features of PLS in infertile men. This study was aimed at investigating possible associations among NIH-CPSI (total and subdomain) scores and PLS, with seminal, clinical and scrotal/transrectal CDU parameters in a cohort of males of infertile couples. PLS of 400 men (35.8 AE 7.2 years) with a suspected male factor were assessed by the NIH-CPSI. All patients underwent, during the same day, semen analysis, seminal plasma interleukin 8 (sIL-8, a marker of male genital tract inflammation), biochemical evaluation, urine/seminal cultures, scrotal/transrectal CDU. PLS was detected in 39 (9.8%) subjects. After adjusting for age, waist and total testosterone (TT), no association among NIH-CPSI (total or subdomain) scores or PLS and sperm parameters was observed. However, we found a positive association with current positive urine and/or seminal cultures, sIL-8 levels and CDU features suggestive of inflammation of the epididymis, seminal vesicles, prostate, but not of the testis. The aforementioned significant associations of PLS were further confirmed by comparing PLS patients with age-, waist-and TT-matched PLS-free patients (1 : 3 ratio). In conclusion, NIH-CPSI scores and PLS evaluated in males of infertile couples, are not related to sperm parameters, but mainly to clinical and CDU signs of infection/inflammation.

Chronic Prostatitis Affects Male Reproductive Health and Is Associated with Systemic and Local Epigenetic Inactivation of C-X-C Motif Chemokine 12 Receptor C-X-C Chemokine Receptor Type 4

“…In order to analyze, whether the detected impairment of standard semen parameters is in fact associated with CP/CPPS and not with elder age of the patient cohort, we performed age-matched comparative analyses. We considered only young CP/CPPS type IIIb patients (n = 32, median age 27 (range [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32]) and compared those to healthy controls. We still detected a significant association between CP/CPPS and reduced sperm motility (total and progressive, p < 0.001), increased aberrations in sperm morphology (head and tail defects, p < 0.001) and reduced seminal pH (p < 0.001).…”

“…Given the high prevalence of prostatitis-like symptoms in males in their reproductive age [17], the aim of the study was to identify if there is an adverse effect on the male genital compartment and if there are systemic and/ or compartment specific local signals for epigenetic dysregulation of inflammatory factors in CP/CPPS IIIb patients.…”

DNA fragmentation in two cytometric sperm populations: relationship with clinical and ultrasound characteristics of the male genital tract

“…The data reported in this study were collected during routine clinical procedures according to a “Day Service” standard protocol for males of infertile couples, encoded by PACC L-99 (D/903/110 Azienda Ospedaliera-Universitaria Careggi [AOUC], Florence, Italy) and approved by the Regional Health Care Service (§ DGRT n. 1045; § DGRT n. 722; § DGRT n. 867), as previously described 23. In line with the PACC L-99 protocol, all patients underwent, within the same day, the following routine procedures: (i) medical history assessment, including screening of prostatitis-like symptoms (see below); (ii) a complete andrological and physical examination, including measurement of blood pressure, height, weight and waist circumference; (iii) hormonal assessment; (iv) scrotal and transrectal CDUS evaluation performed before and after ejaculation; (v) semen analysis including evaluation of sDF.…”

“…Prostate and seminal vesicles were studied by scanning the organs at 5 mm intervals in various longitudinal, transverse and oblique scans, according to previous studies,23 using a transrectal biplanar probe (linear transducer U533L 7.5 MHz; convex transducer U533C 6.5 MHz), which is more sensitive in the detection of prostatic features, and an “end-fire” probe (V53W 6.5 MHz, field of view 50°–200°) to better investigate seminal vesicles 24. Prostate volume was measured using the planimetric method, as previously reported 23.…”

037 Semen Quality Impairment is Associated with Sexual Dysfunction According to its Severity

“…The data reported in this study for patients have been collected according to a 'Day Service' standard protocol for males of infertile couples, encoded by PACC L-99 (D/903/110 Azienda Ospedaliera-Universitaria Careggi [AOUC], Florence, Italy) and approved by the Regional Health Care Service ( §DGRT n.1045; n.722; n.867), as previously described (Lotti et al, 2014a). Data reported for the healthy, fertile subjects were collected according to the EAA study protocol, approved by the Florence Ethical Committee (6 June 2013; Prot.2013/0024124) and the AOUC (11 November 2013; Prot.37896/2013, Rubrica n.60/13).…”