Department of Urology, Pediatric Urology and Andrology, Justus Liebig University Giessen, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany.
World J Urol. 2013 Aug;31(4):717-23. doi: 10.1007/s00345-013-1082-7. Epub 2013 Jul 16.
Urogenital infections and inflammation may contribute significantly to ejaculate parameters essential for male infertility.
For this review, data were acquired by a systematic search of the medical literature of the last 5 years.
We address the andrological relevance of male urogenital infections and inflammation on ejaculate parameters. The different classification systems of the WHO and NIH are illustrated. In most cases, a separation of the different areas of the urogenital tract, for example, of the prostate, epididymis and testicles, is not possible. The significance of bacteriospermia with common bacteria is discussed. Furthermore, HIV, ascending chlamydial, mycoplasmal and gonococcal infections are relevant. Especially, the relevance of sexually transmitted microorganisms seems to be underestimated. Leukocytospermia is not well defined in its biological significance. Seminal plasma elastase and the cytokine expression reveal better insights into the inflammatory response of the seminal pathways. Sperm antibodies and reactive oxygen species are not usable as indicators for infection and inflammation. Different aspects for an impairment of ejaculate quality have been demonstrated although a direct ascension of microorganisms to the prostate has not been confirmed. Probably, lesions of the epididymis may sustain an ongoing disturbance of sperm parameters. A potential negative influence of urogenital infections and inflammation on sperm function is under discussion. However, the severity of impairment differs according to the underlying infections and the involved compartments.
Signs of infections and inflammation in the ejaculate of infertile men are common, and the relevance is often doubtful in spite of microbiological, spermatological and immunological facilities.
泌尿生殖系统感染和炎症可能对男性不育症中重要的精液参数有重大影响。
为了进行这项综述，我们对过去 5 年的医学文献进行了系统搜索，以获取数据。
我们探讨了男性泌尿生殖系统感染和炎症对精液参数的男科相关性。WHO 和 NIH 的不同分类系统都有说明。在大多数情况下，无法对泌尿生殖系统的不同区域（例如前列腺、附睾和睾丸）进行分离。常见细菌引起的菌精症的意义也有所讨论。此外，HIV、上行性衣原体、支原体和淋病感染也具有相关性。特别是，性传播微生物的相关性似乎被低估了。白细胞精子症在其生物学意义上尚未得到明确界定。精液弹性蛋白酶和细胞因子表达揭示了对精液途径炎症反应的更好理解。精子抗体和活性氧不能作为感染和炎症的指标。尽管尚未证实微生物直接上升到前列腺，但已经证明了不同方面对精液质量的损害。可能是附睾的病变持续导致精子参数的紊乱。泌尿生殖系统感染和炎症对精子功能的潜在负面影响正在讨论中。然而，根据潜在的感染和涉及的部位，损害的严重程度不同。
在不育男性的精液中，感染和炎症的迹象很常见，尽管有微生物学、精子学和免疫学的方法，但相关性往往值得怀疑。
