Male Accessory Gland Infection Research Articles

Relationship between male aging and semen quality: a retrospective study on over 2500 men

PurposeWe aimed to evaluate whether and to what extent an association exists between male aging and worsening of semen parameters and to determine whether a threshold age can be identified above which the decline in semen quality becomes statistically significant.Methods2612 men (age: 16–56 years) attending an andrology outpatient clinic for semen analysis and clinical evaluation were studied. Semen analyses were performed according to the ongoing WHO-recommended procedures. Total motile count (TMC) and total progressive motile count (TPMC) were calculated by multiplying total sperm number by total motility and progressive motility, respectively.ResultsSignificant negative correlations were found between age and total motility (r = − 0.131, p < 0.0001), progressive motility (r = − 0.112, p < 0.0001), TPMC (r = − 0.042, p = 0.037), and normal sperm morphology (r = − 0.053, p = 0.007). All these associations persisted in multivariate regression models adjusted for abstinence time, smoking, history of male accessory gland infections, varicocele and the year in which semen analysis was performed. When comparisons were performed among quartiles of increasing age, the fourth quartile, corresponding to the age group > 40 years, was associated with a significant decrease in total and progressive motility. An earlier decline in the TPMC and percentage of normal forms was also observed.ConclusionAdvancing male age exhibits an independent association with a decrease in the percentage of motile and morphologically normal spermatozoa, with greater evidence from the age of > 40 years. Further studies are warranted to elucidate the mechanisms and clinical reflections of these associations.

HYPERSPERMIA, THE OFTEN-NEGLECTED SEMEN ABNORMALITY AFFECTING FECUNDABILITY

Highlights Hyperspermia is often ignored, but it can affect fecundability by diluting sperm and reducing sperm concentration. Hyperspermia might be associated with genetic causes and male accessory gland infections, but no specific treatment is mentioned to treat this condition. Abstract Background: Hyperspermia is defined as a seminal volume greater than 6.3 ml. This definition is often ignored by physicians, while it may affect fecundability. Objective: To report a case of an adult with hyperspermia that affects his fecundability and to discuss it with the scoping review’s result. Case: A 30-year-old man came desiring to have a child. He had regular sexual intercourse with his wife for the last 3 months, after living in different cities before. Based on the semen analysis, it was found that he had hyperspermia (volume 8.2 ml) and oligozoospermia (sperm concentration 4.25 million/ml). After taking antioxidants, the seminal volume was lowered, and the couple got pregnant. Method: A scoping review was conducted by using guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR). After a comprehensive search based on the inclusion and exclusion criteria, only 3 original research were retrieved due to the rarity of articles regarding this topic. Discussion: According to previous studies, hyperspermia can affect fecund-ability by diluting the sperm, causing sperm concentration to be decreased as in this case. Genetic mutation and male accessory gland infection may be contributing factors to hyperspermia. No consensus and studies about the treatment are available. Conclusion: Hyperspermia is a semen parameter alteration that needs to be taken care of to increase fecundability.

Antioxidants for male infertility: therapeutic scheme and indications. A retrospective single-center real-life study.

This single-center real-life study was conducted to evaluate the most effective combination of nutraceuticals and the most appropriate indications for the treatment of male infertile patients. Infertile patients aged 20-55 years were treated with a combination of antioxidants (Androlen®; Enfarma, Misterbianco, Catania, Italy) (group A), with Androlen® (Enfarma) and a mixture of fibrinolytic molecules (Lenidase®, Enfarma) (group B), or Androlen® (Enfarma) and other molecules different from those used for the patients of the group B (group C). Patients were also subdivided according to the presence of varicocele, mild testicular hypotrophy, idiopathic infertility, and chronic male accessory gland infection. Forty-three patients were enrolled. In the overall analysis, only progressive motility significantly improved after therapy. Subgroup analysis showed a significant increase in progressive motility, total motile sperm count (TMSC), and in the percentage of alive spermatozoa after treatment in the group A. Progressive motility improved significantly in patients with varicocele, while the TMSC in patients with varicocele and those with idiopathic infertility. The percentage of alive spermatozoa increased in patients with testicular hypotrophy. Treatment with antioxidants increased progressive sperm motility, especially in patients with varicocele or idiopathic infertility.

Productivity Index in Clinical Andrology: Research Directions on High-Impact Topics and in Particular on Male Infertility.

Andrological diseases have an important social and economic impact as they cause a serious impairment of the quality of life of the affected patient. Epidemiologically, the impact of these disorders is progressively increasing, as demonstrated by the ever-growing prevalence of male infertility. This evidence justifies the rapid development of research in andrology that the scientific community has undertaken in recent decades. This study aims to evaluate the productivity index of the main andrological topics studied and reported in the literature. The total number of published articles was extracted from the Scopus database by entering the following keywords and mesh terms: "Male Infertility", "Erectile Dysfunction", "Premature Ejaculation", "Male Hypogonadism", "Testicular Tumors", "Prostate Cancer", "Prostatic hyperplasia", "Prostate hyperplasia", "Prostatitis", "Prostate inflammation", and "Male Accessory Gland Infections". Furthermore, a list of the top 50 researchers sorted by productivity was created for each topic. For male infertility, a further search was performed by combining the search term "male infertility" with the above-mentioned terms. Thus, a list of the top 30 authors in order of productivity was also extracted. The graphs were created using Excel. As could be expected, we observed that prostate cancer and male infertility were the two most investigated topics, followed by benign prostatic hyperplasia and erectile dysfunction, whose prevalence is set to increase given the progressive aging of the population. Less investigated is the inflammation of the accessory sexual glands. In conclusion, this study provides a ranking of the main andrological topics investigated in the literature, also presenting the top list of the most productive authors for each one.

Polyphenolic and Flavonoids Contents and Antibacterial Activity of Hydro-Ethanolic and Aqueous Extract of Fresh Leaves of Gardenia Aqualla Staph and Hutch (Rubiaceae)

Erectile dysfunction has become for two decades, a real public health problem. Its prevalence is estimated at 322 million in 2025. Its management is based on the administration of phosphodiesterase inhibitors alone or in combination. Infections have been rarely mentioned although <i>E coli</i>, <i>Staphylococcus aureus</i>, <i>Klebsiella pneumoniae </i>or <i>Serratia marcescens</i> are recognized as factors of erectile dysfunction. The purpose of this study was to evaluate the phytochemical profile of the aqueous (AE) and hydroethanolic (HE) extracts of the fresh leaves of <i>Gardenia aqualla</i> and to determine their antibacterial potential on bacteria involved in male accessory gland infections. The aim of this study was to evaluate phytochemical profile of aqueous (AE) and hydroethanolic (HE) extracts of fresh leaves of <i>Gardenia aqualla</i> and to determine their antibacterial potential on bacteria involved in male accessory gland infections. Phytochemical profile highlighted the presence of alkaloids, polyphenols with concentrations of 434.5 ± 14.5 mgEq Tannic acid/g of dried extract greater than 249.5±18.3 mgEq Tannic acid/g of dried extract found in AE including flavonoids whose concentrations is 184.9 ± 6.3 μgEqRutin/g of dry extract in HE against 183.0±9.1 μgEqRutin/g of dried extract in AE. Antibacterial tests showed equivalence of activity on <i>E coli</i> and S aureus strains with MICs of 100 mg/mL and 50mg/mL respectively and only HE showed activity on <i>Klebsiella pneumoniae</i> and<i> Serratia marcescens</i> which had the lowest MIC 6.25 mg/mL.

INFORMATIVENESS OF COMBINED HUMAN SEMEN ANALYSIS ON THE WAY TO CLARIFY THE CAUSES OF REPRODUCTIVE DYSFUNCTION: BASIC SEMEN EXAMINATION AND SPERM SEDIMENT CYTOLOGY (SSC)

Aim. To analyze the informativeness of combined human semen analysis using a basic semen examination &amp; SSC on the way to clarify the causes of reproductive dysfunction. Materials and methods. We examined 529 samples of semen sediment from men aged 18 – 59 years with infertility and male accessory gland infection (MAGI) between 2019 and 2022. Study was conducted in combination of two laboratory methods like ROSE (rapid onesite examination) which one of them is 1 – 'basic semen examination' and second one is 2 – 'SSC' (‘Basic semen examination+SSC’-ROSE). Results. 15.13 % of all of patients presented normozoospermia, 1.25 % of them have SSC-markers like bacteriospermia (SSC-mB «+»). Outcomes of SSC-reports clarify that 84.69 % of all men have the diagnostic significant SSC-findingsand different combination of it; 69.75 % of them were SSC-mB «+». ‘Normozoospermia’ and ‘SSC-mB’ are associated, thus, the frequency of SSC-mB in the presence of normozoospermia is recorded as follows. Conclusion. The combined approach ‘Basic semen examination+SSC’-ROSE, allows the doctors to exclude a missing in the laboratory algorithm for check-up in male with impaired reproductive function and identifying the causes of idiopathic infertility, the causes of which were mainly positioned as unspecified.

THE BENEFITS FROM UPDATE LABORATORY PREANALYTICAL STAGE IN PCR ON THE WAY TO IDENTIFY OCCULT UROLOGICAL INFECTIONS IN MALE

Aim of the study. Assess the diagnostic capabilities of detecting microorganisms in the wild ejaculate and sediment ejaculate. Materials and methods. 42 male volunteers were examined, aged 28 to 69, who were married and had children. Men applied for a preventive examination and to exclude asymptomatic male accessory gland infections. All patients had no active complaints characteristic of inflammatory diseases of the genitourinary tract. The study of the wild ejaculate and sediment ejaculate was performed by PCR real-time on DT-96 amplifiers (NPO DNA-Technology LLC, Russia) using the Androflor? test. Results. The value of the total bacterial mass in the sediment of the ejaculate is not statistically significantly higher compared to the wild ejaculate (p &gt; 0.05). Candida spp. was statistically significantly more common in semen sediment (p &lt; 0.05). In the sediment of the ejaculate were more often identified Enterobacteriaceae spp. / Enterococcus spp., Haemophilus spp., Staphylococcus spp., Streptococcus spp., Bacteroides spp. / Porphyromonas spp. / Prevotella spp. and Anaerococcus spp. (p &gt; 0.05). In 11.9 % of observations, in the absence of bacteria in the wild ejaculate, microorganisms in low titers were identified in sediment ejaculate. Conclusion. According to the data obtained, the performance of the biological sample of the ejaculate sediment is higher compared to the sample of the wild ejaculate. The proposed modification of the preanalytical laboratory stage of the PCR technique, namely the diagnosis of ejaculate sediment using PCR real-time with the Androflor® test, makes it possible to more accurately determine pathogens, including those persisting in the form of biofilms in male accessory gland, even at low concentrations.

Association of Probiotic Treatment With Antibiotics in Male Accessory Gland Infections.

Male accessory gland infection (MAGI) represents a frequent disease, commonly treated with antibiotics alone. However, in approximately 40% to 50% of patients, persistent infection is detected. Intestinal dysbiosis is involved in the pathogenesis of prostatitis. We aimed to evaluate the efficacy of antibiotic treatment in association with a specific probiotic supplementation. A total of 104 infertile patients, with microbiological analysis on semen and/or prostatic secretions positive for Gram-negative bacteria, have been enrolled. All patients received antibiotic treatment with fluoroquinolones. In total, 84 patients received a commercial association of Enterococcus faecium and Saccharomyces boulardii during antibiotic treatment, followed by treatment with Lactobacilli. After the treatment, a complete microbiological analysis was repeated. Polymicrobial infections have been observed in 11% of patients, while infections due to a single germ were reported in 89% of the patients. After the treatment was performed, a complete eradication with negative semen culture and microbiological analysis on prostatic secretion was observed in 64 of 84 patients (76.2%), while only 10 of 20 patients receiving antibiotics alone (50%; p < .05) reported negative microbiological analysis. Persistent infections have been observed only in patients with infections due to Enterococcus faecalis and Escherichia coli. This study represents the first approach demonstrating the efficacy of a specific probiotic treatment in reducing the rate of persistent infections in patients with MAGI.

P–082 Effect of semen hyper viscosity (SHV) on blastocyst formation rate and implantation rate

Abstract Study question Does semen hyper viscosity effects blastocyst formation rate Summary answer Hyper viscosity of semen sample later results in poor blastocyst formation rate and lower implantation rate. What is known already Normal range of semen hyper viscosity ranges between 12–29%.Highly viscous semen samples impairs the physical and chemical characteristics of seminal fluid and due to which seminal oxidative damage increases which further increases the ROS and reduces the sperm motility there are some factors that can affect the seminal viscosity out of which one is Male accessory gland infection, Hypo function of prostate seminal vesicles and varicoceles. SHV create hindrance in semen preparation. Study design, size, duration Retrospective study was conducted from June 2019 to Oct 2020 at IVF unit IKDRC hospital. Participants/materials, setting, methods 142 patients were enrolled from June 2019 to Oct 2020 in IVF unit IKDRC hospital and divided into two groups. Group A (n = 83) patients with hyper semen viscosity and Group B (n = 69) patients with normal semen viscosity, inclusion and exclusion criteria’s were same for both the groups, only patient with normozoospermia were taken. Semen analysis was done by using WHO manual 2010. Main results and the role of chance In group A with hyper semen viscosity fertilization rate was (49.2% vs. 70% p = &amp;lt;0.001) vs in group B with normal semen viscosity which is significantly higher in group B, Blastocyst formation rate ( 18.4% vs 35% p = &amp;lt;0.01) and implantation rate (9.4% vs 20% p = &amp;lt;0.005) both are significantly higher in group B . Which implies fertilization rate , blastocyst formation rate and implantation rate is significantly lower in patients with semen hyper viscosity. Limitations, reasons for caution Larger randomized control studies are needed to strengthen these results. Wider implications of the findings: Our study demonstrates that patients having higher semen viscosity have poor blastocyst formation rate and implantation rate due to oxidative stress. Trial registration number Not applicable

Male accessory gland inflammation (MAGI): an evolving entity

Male accessory gland infection (MAGI) is a generic acronym indicating inflammatory conditions affecting the prostate gland, seminal vesicles, the ductus deferens and the epididymis. It is a frequent disease, mostly with a chronic course. Majority of the MAGIs remain asymptomatic, thereby leading to a debate whether to treat these patients or not. The primary criterion for MAGI was suggested by Comhaire and colleagues in 1980. The role of MAGI in causing infertility and sexual dysfunctions has long been a matter of debate. The most recent studies show that MAGI could alter, with various mechanisms, both conventional and biofunctional sperm parameters, and determine worst reproductive outcome. This article provides an overview of up-to-date research findings about MAGI with special focus on data published on its impact on fertility; and diagnostic criteria including cellular and seminal biomarkers along with the promising results of emerging proteomic platforms for the identification of MAGI.

An update on clinical and surgical interventions to reduce sperm DNA fragmentation in infertile men

Sperm chromatin integrity is essential for normal embryo development and pregnancy outcome. Sperm DNA fragmentation (SDF) testing constitutes a diagnostic tool to measure the proportion of spermatozoa with damaged chromatin in the ejaculate. SDF is associated with potentially treatable conditions, including varicocele, male accessory gland infections, inadequate lifestyle, and gonadotoxin exposure, thus prompting their treatment as a means of improving sperm DNA quality and the reproductive outcomes. To provide an up-to-date review of the role of clinical and surgical interventions on SDF values in subfertile men. An extensive search of studies examining the relationship between male infertility conditions associated with SDF was performed using PubMed and MEDLINE, with a focus on interventional therapy. The start date for the search was not defined, whereas the end date was March 2019. Randomized and non-randomized controlled trials, observational studies, systematic and narrative reviews, and case series were evaluated. Treating the underlying male infertility factor seems a promising way to alleviate SDF and to increase the likelihood of achieving natural and assisted conception, but data remain limited. The best evidence relates to varicocele repair and hormonal therapy with the follicle-stimulating hormone. Antioxidant therapy and lifestyle changes might alleviate oxidative sperm markers and decrease SDF but their effects on pregnancy outcomes are still unclear. Among men with high SDF undergoing assisted reproductive technology, the use of testicular spermatozoa in preference over ejaculated spermatozoa for intracytoplasmic sperm injection (ICSI) has been shown to improve pregnancy rates possibly owing to the better sperm chromatin quality in testicular spermatozoa than in ejaculated spermatozoa. Current evidence supports interventional therapy as a means to alleviate sperm DNA damage. Identification of the conditions associated with SDF remains important to enable treatment to potentially improve pregnancy outcomes but given the limited data further research is needed to determine the exact role of specific interventional therapy for subfertile men with impaired sperm chromatin.

Monocyte-derived extracellular trap (MET) formation induces aggregation and affects motility of human spermatozoa in vitro

ABSTRACTThe presence of bacteria and/or leukocytes can alter semen quality resulting in low sperm quality and infertility. Inflammation or infection increases the numbers of PMN or macrophages/monocytes in male genital tract. Release of extracellular traps (ETs) by leukocytes has been recognized as a novel mechanism of early host innate immunity, in response to invasive pathogens. This is the first work that evaluated the mechanism of triggered ETs in monocytes co-incubated with spermatozoa or bacteria and the effect on sperm function. Selected spermatozoa and human monocytes isolated from peripheral blood were obtained by healthy donors. Two experimental models were developed, one aseptic (non-infectious) incubating spermatozoa and monocytes, and septic models (infectious) incubating spermatozoa with monocytes and uropathogenic Escherichia coli (E. coli). ETs of monocytes (METs) (DNA, global histone and citrullinated histones) were visualized by scanning electron microscopy (SEM) and immunofluorescence analyses. Progressive motility was performed at 0, 10, 30, 60, and 180 min after co-incubation with CASA system. SEM- and immunofluorescence-analyses revealed human spermatozoa alone or in the presence of E. coli as strong inducers METs. In aseptic model, the motility decreased to 65.2 ± 3.5% at 10 min of incubation and 29.3 ± 3.3% at 30 min (p < 0.001). In septic model, motility decreased to 44.5 ± 5.9% (10 min) and 12.7 ± 2.2% (30 min) (p < 0.001). MET-derived small spermatozoa aggregations were observed in both models. METs might physically block spermatozoa and decrease motility after a brief contact. This may impair male fertility, especially in patients with genital tract infections or chronic inflammation.Abbreviations: PMN: polymorphonuclear; ETs: extracellular traps; E. coli: Escherichia coli; METs: ETs of monocytes; SEM: scanning electron microscopy; NE: neutrophil elastase; MPO: myeloperoxidase; MAGI: male accessory gland infection; PBMC: peripheral blood mononuclear cells; RT: room temperature; CFU: colony forming units; CASA: computer-aided sperm analysis; H4Cit3: histone H4 citrullinated 3

High rate of detection of ultrasound signs of prostatitis in patients with HPV-DNA persistence on semen: role of ultrasound in HPV-related male accessory gland infection.

Papillomavirus (HPV) often occurs in the semen of patients with male accessory gland infection (MAGI). Ultrasound (US) evaluation has been suggested as a promising diagnostic tool for patients with HPV-related MAGI. No data on the spontaneous clearance of HPV-DNA have been reported so far in HPV-related MAGI. The primary aim of the study was to assess the percentage of early HPV-DNA spontaneous clearance in patients with prostatitis. The secondary aim was to evaluate the frequency of spontaneous clearance of HPV-DNA among patients with prostatitis associated with the presence or absence of US abnormalities. Patients with inflammatory MAGI and at least one suspicious criterion for HPV infection underwent semen HPV-DNA detection and prostate US. The presence of HPV-DNA was further investigated after a 6-month-long follow-up. Eighty patients satisfied the inclusion criteria and were recruited in the study. 69% of patients (55/80) showed HPV-DNA persistence in the semen. Among them, 82% (45/55) was positive for US signs of prostatitis, while they occurred only in 12% (3/25) of those patients with no sign of HPV-DNA persistence (p < 0.001). All patients with persistent high-risk HPV genotype (n = 30) showed at least two US signs of prostatitis. In 73% of patients (22/30), E6 and E7 mRNAs were detected. US signs of prostatitis more frequently occurred in patients with evidence of HPV-DNA persistence on semen, especially in those with high-risk genotypes. This highlights the importance of US in the framework of HPV-related MAGI.

Therapeutic options in male genital tract inflammation.

Chronic inflammatory conditions of the genital tract are still unsatisfactorily recognised in the workup of male infertility due to inappropriate definitions and inconsistent diagnostic criteria. The most popular term used for description of both, infections and inflammation in the genital tract is MAGI (male accessory gland infection). In asymptomatic patients, the diagnosis is primarily based on leucocytospermia (i.e., more than 1 million peroxidase-positive leucocytes per ml ejaculate), although ongoing infections should be identified and distinguished from post-infectious or non-infectious inflammatory disease. In addition to alterations of the basic semen parameters, sperm functions -and DNA integrity may be affected by chronic inflammation of the male genital tract. Despite considerable diagnostic drawbacks and a rather limited database concerning evidence-based therapy, adequate management of affected patients appears mandatory. Antibiotic treatment aims at the eradication or reduction of pathogenic bacteria in the ejaculate. Available studies suggest, that NSAID are effective in chronic inflammatory conditions. Moreover, low-dose corticosteroids, mast cell blockers, and other immune-modulatory compounds as well as a sequential adjuvant treatment with antioxidants can be considered as therapeutic options.

The advantages of proteomic investigation in the management of male accessory gland infection: A response to Grande et al

The advantages of proteomic investigation in the management of male accessory gland infection: A response to Grande et al

Cytokines and male infertility.

Many male infertility cases have no apparent cause, being characterized as idiopathic. Both inflammation and obesity have long been associated with infertility. On one hand, inflammation, such as orchitis and male accessory gland infections (MAGIs), are regulated by inflammatory cytokines. The latter are also produced in the testis by Leydig and Sertoli cells, being associated with gap junctional communication at the blood-testis barrier. Furthermore, they regulate spermatogenesis through cell interaction, Toll-like receptors and production of reactive oxygen species. Additionally, they affect testosterone production, acting at many levels of the pituitary - gonadal axis. Any imbalance in their production may result in infertility. On the other hand, obesity has also been associated with infertility. Adipokines, cytokines produced by white adipose tissue, regulate the lipid and glucose metabolism and the inflammatory system. Recent data on leptin show that it regulates reproduction by adjusting hypothalamus - pituitary - gonadal axis at both the central and peripheral levels. In this regard, resistin, visfatin and the GH secretagogue peptic hormone ghrelin affect spermatogenesis, whereas data on adiponectin are rather scarce. In conclusion, inflammatory cytokines and adipokines seem to have a pivotal role in the regulation of spermatogenesis; any imbalance in this stable environment may lead to infertility. Nevertheless, further studies are needed to clarify their exact role.

Association between male accesory gland infections and prostate cancer in Turkish men: A case-control study.

It is well known that chronic inflammation contributes to several forms of human cancer. Although several studies have investigated the association between prostatitis and prostate cancer, there is a lack of specifically designed study about male accessory gland infections (MAGI) and prostate cancer co-occurrence. We aimed to investigate this association with a case-control study in Turkish men. A total of 155 patients were enrolled to the study. After the pathological examination of the transrectal ultrasound-guided prostate biopsy specimens, patients were divided the two groups as control and prostate cancer and the presence of MAGI was determined. Of 155 patients, 145 met inclusion criteria. In the prostate cancer group, MAGI diagnose was determined in 18 of 31 patients (58.06%), while it was determined in 25 of 114 (21.93%) patients in the control group (p=.001). A significant correlation between MAGI and pathological Gleason score also revealed (p=.0001). We demonstrated that men with MAGI have increased risk for the development of prostate cancer. Moreover, in this population, most of the prostate cancers tend to be clinically significant or high grade.

Infertility in the Moroccan population: an etiological study in the reproductive health centre in Rabat.

The causes of infertility vary widely and differ between regions and within countries. There is no report on this subject in Morocco. Therefore, the aim of this study was to determine the causes of infertility in Moroccan infertile couples and to compare the findings with data from the various published studies. This retrospective study included 1265 infertile couples who attended the Assisted Reproductive Technology Unit of the Reproductive Health Centre of the University Hospital Ibn Sina in Rabat. All couples had been infertile for at least 1 year and both partners were fully investigated. The median duration of infertility was 5 ± 4 years. Couples had primary and secondary infertility in 77.2% and 22.8% of cases, respectively. Among the 1265 couples, 39.6% had a female factor, 28.2% had a male factor, 17% had both male and female factors and in 15.2% of couples, the cause of infertility was undetermined. The most common causes of male infertility were varicocele (14.3%), obstructive azoospermia (7%), Congenital anomalies (5.5%) and male accessory gland infection (4%). Results showed that 54.8% of men had a normal semen analysis. Among women, infertility factors were ovulatory disorders (27.5%), tubal factor (26.6%), uterine factor (12.6%), endometriosis (4.1%), and 43.4% of women were normal. The causes of infertility in this study are comparable with those reported by the World Health Organization and other studies. However, the substantial delay before attending an infertility clinic highlighted by the study needs additional consideration.

Hormonal treatment with transdermal testosterone in patients with male accessory gland inflammation (MAGI): Effects on sperm parameters.

Recently, it has been reported that treatment with testosterone (T) could have favourable effects on prostate inflammation; however, the data appear inconsistent. The main evidences concern experimental studies, and there is lower information obtainable from clinical studies. This study was conducted on patients with diagnosis of male accessory gland infection (MAGI) and a concomitant hormonal condition of acquired hypergonadotropic hypogonadism and has evaluated the effects on sperm parameters of the administration of a transdermal formulation of T gel for 3months. The treated patients showed a significantly increased percentage of spermatozoa with normal form and progressive motility (p<.05 vs baseline), a significant reduction of CD45pos leucocytes in the semen (p<.05 vs baseline) and finally a significant increase of the seminal concentrations of zinc, fructose and alpha-glucosidase (p<.05 vs baseline) identified as key parameters associated to secretory function of the male accessory glands. The results of this study suggest the use of transdermal T in hypogonadal patients with MAGI for favourable effects on sperm parameters.

Human Papilloma Virus Infection in Patients with Male Accessory Gland Infection: Usefulness of the Ultrasound Evaluation.

This study evaluated the ultrasound (US) features of 20 patients with MAGI and concomitant papilloma virus (HPV) infection compared to 20 patients with microbial (presence of Chlamydia trachomatis alone) MAGI and 20 patients with amicrobial (inflammatory) MAGI. Patients with HPV infection showed significantly (p < 0.05) higher total prostate, seminal vesicles, and epididymal US signs (18.0 ± 2.0) compared to the other 2 groups (12.0 ± 4.0 versus 10.0 ± 3.0, resp.). In addition, patients with MAGI and HPV had a higher prevalence of complicated forms of MAGI [prostatovesiculitis (PV) and prostate-vesiculo-epididymitis (PVE)] and a higher frequency of the fibrosclerotic variant compared to the other groups (70.0 ± 10.0% versus 48.0 ± 5.0% versus 15.0 ± 10.0%). Moreover, HPV infected patients had a higher number of US criteria suggestive for MAGI in the periurethral region of the prostate compared to the other groups. In particular, the patients showed a higher ratio between periurethral and lobar US criteria distribution (5.0 versus 0.5). Finally, the seminal fluid concentration of CD45pos leukocytes (2.0 ± 0.2 versus 1.3 ± 0.3 versus 1.0 ± 0.3 mil/mL) was significantly higher and sperm progressive motility was significantly lower in these patients compared to other groups.