Abstract
BackgroundChronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is one of the risk factors of impaired male fertility potential. Studies have investigated the effect of CP/CPPS on several semen parameters but have shown inconsistent results. Hence, we performed a systematic literature review and meta-analysis to assess the association between CP/CPPS and basic semen parameters in adult men.MethodsSystematic literature searches were conducted with PubMed, EMBASE and the Cochrane Library up to August 2013 for case-control studies that involved the impact of CP/CPSS on semen parameters. Meta-analysis was performed with Review Manager and Stata software. Standard mean differences (SMD) of semen parameters were identified with 95% confidence intervals (95% CI) in a random effects model.ResultsTwelve studies were identified, including 999 cases of CP/CPPS and 455 controls. Our results illustrated that the sperm concentration and the percentage of progressively motile sperm and morphologically normal sperm from patients with CP/CPPS were significantly lower than controls (SMD (95% CI) −14.12 (−21.69, −6.63), −5.94 (−8.63, −3.25) and −8.26 (−11.83, −4.66), respectively). However, semen volume in the CP/CPPS group was higher than in the control group (SMD (95% CI) 0.50 (0.11, 0.89)). There was no significant effect of CP/CPPS on the total sperm count, sperm total motility, and sperm vitality.ConclusionsThe present study illustrates that there was a significant negative effect of CP/CPPS on sperm concentration, sperm progressive motility, and normal sperm morphology. Further studies with larger sample sizes are needed to better illuminate the negative impact of CP/CPPS on semen parameters.
Highlights
Prostatitis is a common male urogenital disease with prevalence ranging from 2.2% to 9.7% worldwide, with an overall rate of 8.2% [1]
To improve its clinical diagnosis, the National Institutes of Health (NIH) classifies prostatitis into four categories, namely, I: acute bacterial prostatitis, II: chronic bacterial prostatitis, NIH III subgroup (III): chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), and IV: asymptomatic inflammatory prostatitis [4]
The results suggested that sperm concentration and the percentage of progressively motile sperm and morphologically normal sperm from patients with CP/CPPS were significantly lower than controls
Summary
Prostatitis is a common male urogenital disease with prevalence ranging from 2.2% to 9.7% worldwide, with an overall rate of 8.2% [1]. CP/CPPS accounts for more than 90% of all symptomatic prostatitis cases in urology outpatient clinics [4] It is characterized by chronic pelvic pain symptoms, which lasted at least 3 months during the previous 6 months, in the absence of a urinary tract bacterial infection but in the presence of urinary symptoms and sexual dysfunction [4,5]. Based on the presence or absence of leukocytes in prostatic secretions (EPS), postprostatic massage urine (VB3), or semen, CP/CPPS is further subdivided into two subtypes: NIH IIIA (inflammatory) and NIH IIIB (noninflammatory) [4,8]. We performed a systematic literature review and meta-analysis to assess the association between CP/CPPS and basic semen parameters in adult men
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