LONG-TERM RESULTS OF TREATMENT OF PATIENTS WITH CHRONIC NONBACTERIAL PROSTATITIS AND INCREASED LEVEL OF SPERM DNA FRAGMENTATION WITH THE PROSTATILEN® AC DRUG

Abstract

The study objectiveis to evaluate the results of treatment of patients with chronic nonbacterial prostatitis, increased level of sperm DNA fragmentation, and concomitant reproductive function disorders with the Prostatilen® AC drug 1, 2, and 3 months after the end of therapy.Materials and methods. Thirty five men aged 21–46 years (mean age 31.3 ± 4.3 years) with a verified diagnosis of “chronic nonbacterial prostatitis, associated reproductive function disorders, history of early-stage missed miscarriage in a wife/sex partner” were examined. All patients received Prostatilen® AC as rectal suppositories daily for 10 days with a repeat course 20 days later. Before and after the treatment, as well as after 1, 2, and 3 months after its end, the fraction of spermatozoa with fragmented DNA was measured in all patients using sperm chromatin structure assay with flow cytofluorometry. The risk of decreased fertility was considered low if the number of spermatozoa with fragmented DNA was 15 % or lower (this value is considered the norm). If DNA fragmentation was 16 % or higher, it was considered increased.Results. The fraction of spermatozoa with fragmented DNA significantly decreased during the treatment, and 1 month after the end of the therapy it was 7.5 ± 4.2 % (prior to treatment it was 17.8 ± 6.7 %) (p <0.005). Prior to Prostatilen® AC treatment, enhanced DNA fragmentation was observed in 18 (51 %) patients, 1 month after treatment – only in 6 (17 %); the difference is statistically significant (p <0.001). Two months after the end of treatment, increased level of DNA fragmentation was detected in 7 (20 %) patients, 3 months after – in 15 (42 %) patients. Aside from that, if the fraction of spermatozoa with fragmented DNA was more than 30 % before treatment, then a decrease in this value during treatment wasn’t statistically significant.Conclusion. Prostatilen® AC promotes a reduction in the level of sperm DNA fragmentation in patients with chronic nonbacterial prostatitis. A steady positive effect persists for 2 months with a tendency to weaken at the end of month 3 which indicates advisability of repeated courses of Prostatilen® AC treatment 2 months after the end of therapy.