Abstract Objective:The effect of chronic prostatitis (CP) on semen quality. METHODS: Semen analysis was performed in 220 patients to observe the changes of semen quality before and after treatment in patients with chronic prostatitis. Results: The number of forward-moving spermatozoa in the semen routine of the patients improved significantly after treatment, and the total effective rate reached 83.66%.
Conclusion: Chronic prostatitis affects the quality of semen in patients.
Keywords: Chronic prostatitis, semen quality
In men with infertility, the probability of genitourinary tract infections is significantly increased [1], but the relationship between CP and infertility has been the focus of many debates, and there is a lack of sufficient theoretical and clinical evidence whether prostatitis can cause infertility and affect semen quality. In order to study the relationship between this disease and infertility, the author did a clinical study through a large number of clinical data, which is reported as follows:
1. Clinical data.
1.1 General data
From June 2006 to May 2009, 220 patients who met the diagnostic criteria, all aged between 23 and 35 years old, were selected from the outpatient clinics for the control of semen quality before and after treatment.
1.2 Inclusion criteria The cases were determined according to the classification criteria of prostatitis in the American Institute of Health (NIH) prostatitis evaluation meeting in 1995.
1.3 Exclusion criteria (1) Prostatic hyperplasia and prostate tumors were excluded. (2) Combined with serious primary diseases such as heart, liver, kidney and hematopoietic system are excluded. (3) Those who have used drugs for prostatitis or other related drugs one month before treatment are excluded. (4) Low sperm motility, rule out caused by other causes.
1.4 Semen analysis The semen was collected by masturbation method after 3-7 days of abstinence, collected in a clean and dry container, kept warm for 30-60 minutes, and analyzed according to the experimental method recommended by WHO in 1999. All patients were excluded from other causes of infertility.
2. Methods
2.1 Treatment: treatment group: prostate ampoule, 1 capsule daily, inserted into the anus 3-5 cm after the evening stool; Zegui retention capsule, 2 capsules three times daily; control group: prazosin tablets, 2 mg twice daily, taken orally for one month. During the treatment period, the patients were dynamically observed to see whether they had discomfort and whether they followed the medical prescription.
2.1 Criteria for judging efficacy The National Institute of Health Chronic Prostatitis Symptom Score (NIHCPSI) [3] and the number of leukocytes and lecithin vesicles in the routine prostate fluid were used as indicators. Cured: prostatitis symptoms disappeared and prostatic fluid leukocytes decreased to normal range, lecithin vesicles were above 75%, A-grade sperm ≥ 25% or A+B ≥ 50%; Effective: NIHCPSI decreased ≥ 50% and prostatic fluid leukocytes decreased ≥ 50%, lecithin vesicles increased compared with before treatment, A and B grade sperm count increased 50-70%; Effective: NIHCPSI decreased ≥ 25 Effective: NIHCPSI decreased ≥25%～50%, and prostatic fluid white fine decreased ≥25%～50%, lecithin vesicles increased compared with before treatment, A and B sperm count increased 30～50%; Ineffective: NIHCPSI decreased ≤25%, and prostatic fluid white cell decreased ≤25%, lecithin vesicles decreased or no change compared with before treatment A and B sperm count improved insignificantly or no improvement. Total effective = cured + significant + effective.
2,3 Statistical treatment:
Statistical analysis The χ2 test was used for count data, ±s was used for measurement data, and P<0.05< span=""> was considered a statistically significant difference.
3. Results
3, 1 Evaluation of the therapeutic effect:
Table 1
Number of cases Cured Apparent effect Effective Ineffective Total effective rate (%)
Treatment group 196 43 68 53 32 83.66
Control group 30 3 10 8 9 71.32
3.3 Comparison of WBC changes in EPS before and after treatment:(±s)
Table 1
Before treatment After treatment P
18.82±6.48 15.94±6.50 P<0.05
From the above table, it can be seen that the difference between the patients themselves before and after treatment is significant (P<0.05)
3.4 Comparison of the percentage change of forward motion of sperm in semen routine of patients: (±s)
Table 2
Before treatment After treatment P
15.83±6.12 24.94±5.92 P<0.05
From the above table, it can be seen that the difference between the patients themselves before and after treatment was significant (P<0.05)
4. Discussion
Whether chronic prostatitis (CP) causes infertility or not has been debated. In the past, it was thought that although CP affects sperm quality to some extent, it does not necessarily cause infertility, but currently most people believe that CP often causes infertility [2]. Xu Fusong [3] counted 403 cases of male infertility, 73 cases (18%) were clearly caused by CP, and Bai Wenjun et al [4] concluded that male reproductive tract infections endanger men’s health, 15% of male infertility is related to it, and prostate infection accounts for the majority.
Prostate fluid is an important component of semen and is the main source of energy for sperm activity. Although CBP does not generally affect spermatogenesis in the testis and sperm maturation in the epididymis, CBP can affect fertility by altering semen composition, sperm density and semen quality, so prostate disease can undoubtedly have an impact on fertility [5]. It was found [5] that sperm density, sperm motility, especially class A sperm, and sperm motility parameters VCL, VAP, VSL, LIN, and LTR were significantly decreased in CBP infertile men. This suggests that sperm motility is reduced due to prostate inflammation, which may affect fertility [6]. It has also been shown that CP can alter semen quality, pH and biochemical components, and can affect the viscosity and liquefaction process of semen, thus affecting fertility [7].
Currently, the occurrence of CBP in male infertility is not well understood [8], and it is necessary to clarify the relationship between the occurrence of prostate disease and infertility from a clinical perspective. In this study, we fully understand that eliminating or relieving inflammatory cells in the prostate has significantly improved sperm motility and the percentage of forward motion of sperm, which is consistent with many scientific findings.