Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy.
Andrology. 2014 Jan;2(1):30-41. doi: 10.1111/j.2047-2927.2013.00156.x. Epub 2013 Nov 28.
'Prostatitis-like symptoms' (PLS) are a cluster of bothersome conditions defined as 'perineal and/or ejaculatory pain or discomfort and National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) pain subdomain score ≥4' (Nickel's criteria). PLS may originate from the prostate or from other portions of the male genital tract. Although PLS could be associated with 'prostatitis', they should not be confused. The NIH-CPSI is considered the gold-standard for assessing PLS severity. Although previous studies investigated the impact of prostatitis, vesiculitis or epididymitis on semen parameters, correlations between their related symptoms and seminal or scrotal/transrectal colour-Doppler ultrasound (CDU) characteristics have not been carefully determined. And no previous study evaluated the CDU features of PLS in infertile men. This study was aimed at investigating possible associations among NIH-CPSI (total and subdomain) scores and PLS, with seminal, clinical and scrotal/transrectal CDU parameters in a cohort of males of infertile couples. PLS of 400 men (35.8 ± 7.2 years) with a suspected male factor were assessed by the NIH-CPSI. All patients underwent, during the same day, semen analysis, seminal plasma interleukin 8 (sIL-8, a marker of male genital tract inflammation), biochemical evaluation, urine/seminal cultures, scrotal/transrectal CDU. PLS was detected in 39 (9.8%) subjects. After adjusting for age, waist and total testosterone (TT), no association among NIH-CPSI (total or subdomain) scores or PLS and sperm parameters was observed. However, we found a positive association with current positive urine and/or seminal cultures, sIL-8 levels and CDU features suggestive of inflammation of the epididymis, seminal vesicles, prostate, but not of the testis. The aforementioned significant associations of PLS were further confirmed by comparing PLS patients with age-, waist- and TT-matched PLS-free patients (1 : 3 ratio). In conclusion, NIH-CPSI scores and PLS evaluated in males of infertile couples, are not related to sperm parameters, but mainly to clinical and CDU signs of infection/inflammation.
“前列腺炎样症状”（PLS）是一组烦人的症状，定义为“会阴和/或射精疼痛或不适和美国国立卫生研究院-慢性前列腺炎症状指数（NIH-CPSI）疼痛子域评分≥4”（镍的标准）。PLS 可能源自前列腺或男性生殖系统的其他部位。虽然 PLS 可能与“前列腺炎”有关，但不应将它们混淆。NIH-CPSI 被认为是评估 PLS 严重程度的金标准。尽管先前的研究调查了前列腺炎、精囊炎或附睾炎对精液参数的影响，但它们相关症状与精液或阴囊/经直肠彩色多普勒超声（CDU）特征之间的相关性尚未得到仔细确定。并且以前没有研究评估过不育男性的 PLS 的 CDU 特征。本研究旨在调查 NIH-CPSI（总分和子域）评分与 PLS 之间与精液、临床和阴囊/经直肠 CDU 参数之间的可能关联在不育男性的队列中。通过 NIH-CPSI 评估了 400 名（35.8±7.2 岁）疑似男性因素的男性的 PLS。所有患者均在同一天进行精液分析、精液白细胞介素 8（sIL-8，男性生殖道炎症标志物）、生化评估、尿液/精液培养、阴囊/经直肠 CDU。在 39 名（9.8%）受试者中发现了 PLS。调整年龄、腰围和总睾酮（TT）后，NIH-CPSI（总分或子域）评分或 PLS 与精子参数之间没有关联。然而，我们发现与当前阳性尿液和/或精液培养、sIL-8 水平和提示附睾、精囊、前列腺炎症的 CDU 特征之间存在正相关，但与睾丸无关。通过比较年龄、腰围和 TT 匹配的 PLS 无患者（1:3 比例），进一步证实了 PLS 的上述显著相关性。总之，在不育男性中评估的 NIH-CPSI 评分和 PLS 与精子参数无关，但主要与感染/炎症的临床和 CDU 迹象有关。
