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Transrectal ultrasonography in infertile patients with persistently elevated bacteriospermia.
Asian J Androl. 2008 Sep; 10(5):731-40.AJ

Abstract

AIM

To identify and define prostate and seminal vesicle abnormalities in patients with chronic male accessory gland infection (MAGI) who failed to respond to antibacterial treatment.

METHODS

We selected 67 consecutive patients with MAGI and persistently elevated bacteriospermia (=or>10(6) colony forming units [CFU]/mL) after three antibiotic courses. Fourteen infertile patients with initial chronic microbial (=or>10(6) CFU/mL) MAGI who responded to antibacterial treatment (<10(3) CFU/mL) served as a control group. All patients and controls underwent transrectal ultrasonography (TRUS) scans and semen analysis. Patients with low seminal plasma volume (<1.5 mL) underwent both pre-ejaculatory and post-ejaculatory TRUS examination.

RESULTS

TRUS revealed multiple abnormalities indicative of: (i) bilaterally extended prostato-vesiculitis (group A: 52 cases, 77.6%) (nine of these patients also had micro-emphysematous prostate abscess); and (ii) prostato-vesiculitis with unilateral or bilateral sub-obstruction of the ejaculatory ducts (group B: 15 cases, 22.4%). Mean sperm concentration, total sperm number, ejaculate volume and pH value were significantly higher in group A than in group B. In addition, sperm forward motility and the percentage of normal forms were significantly worse than in controls, whereas leukocyte concentration was significantly higher in group A. Group B patients had all sperm parameters, but their pH values, significantly different from those of controls.

CONCLUSION

Although antibiotic therapy is considered suitable when microbial MAGI is suspected, it is impossible to account for a poor response to antibiotics merely on the basis of conventional criteria (clinical history, physical and ejaculate signs). Thus, TRUS may be helpful in the follow-up of these patients.

Authors+Show Affiliations

Section of Endocrinology, Andrology and Internal Medicine, Department of Biomedical Sciences, University of Catania, Garibaldi Hospital, 95123 Catania, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18645676

Citation

La Vignera, Sandro, et al. "Transrectal Ultrasonography in Infertile Patients With Persistently Elevated Bacteriospermia." Asian Journal of Andrology, vol. 10, no. 5, 2008, pp. 731-40.
La Vignera S, Calogero AE, Arancio A, et al. Transrectal ultrasonography in infertile patients with persistently elevated bacteriospermia. Asian J Androl. 2008;10(5):731-40.
La Vignera, S., Calogero, A. E., Arancio, A., Castiglione, R., De Grande, G., & Vicari, E. (2008). Transrectal ultrasonography in infertile patients with persistently elevated bacteriospermia. Asian Journal of Andrology, 10(5), 731-40. https://doi.org/10.1111/j.1745-7262.2008.00425.x
La Vignera S, et al. Transrectal Ultrasonography in Infertile Patients With Persistently Elevated Bacteriospermia. Asian J Androl. 2008;10(5):731-40. PubMed PMID: 18645676.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Transrectal ultrasonography in infertile patients with persistently elevated bacteriospermia. AU - La Vignera,Sandro, AU - Calogero,Aldo E, AU - Arancio,Alessandro, AU - Castiglione,Roberto, AU - De Grande,Gaetano, AU - Vicari,Enzo, PY - 2008/7/23/pubmed PY - 2008/11/5/medline PY - 2008/7/23/entrez SP - 731 EP - 40 JF - Asian journal of andrology JO - Asian J Androl VL - 10 IS - 5 N2 - AIM: To identify and define prostate and seminal vesicle abnormalities in patients with chronic male accessory gland infection (MAGI) who failed to respond to antibacterial treatment. METHODS: We selected 67 consecutive patients with MAGI and persistently elevated bacteriospermia (=or>10(6) colony forming units [CFU]/mL) after three antibiotic courses. Fourteen infertile patients with initial chronic microbial (=or>10(6) CFU/mL) MAGI who responded to antibacterial treatment (<10(3) CFU/mL) served as a control group. All patients and controls underwent transrectal ultrasonography (TRUS) scans and semen analysis. Patients with low seminal plasma volume (<1.5 mL) underwent both pre-ejaculatory and post-ejaculatory TRUS examination. RESULTS: TRUS revealed multiple abnormalities indicative of: (i) bilaterally extended prostato-vesiculitis (group A: 52 cases, 77.6%) (nine of these patients also had micro-emphysematous prostate abscess); and (ii) prostato-vesiculitis with unilateral or bilateral sub-obstruction of the ejaculatory ducts (group B: 15 cases, 22.4%). Mean sperm concentration, total sperm number, ejaculate volume and pH value were significantly higher in group A than in group B. In addition, sperm forward motility and the percentage of normal forms were significantly worse than in controls, whereas leukocyte concentration was significantly higher in group A. Group B patients had all sperm parameters, but their pH values, significantly different from those of controls. CONCLUSION: Although antibiotic therapy is considered suitable when microbial MAGI is suspected, it is impossible to account for a poor response to antibiotics merely on the basis of conventional criteria (clinical history, physical and ejaculate signs). Thus, TRUS may be helpful in the follow-up of these patients. SN - 1008-682X UR - https://www.unboundmedicine.com/medline/citation/18645676/Transrectal_ultrasonography_in_infertile_patients_with_persistently_elevated_bacteriospermia_ DB - PRIME DP - Unbound Medicine ER -