Fu Weihua, Zhou Zhansong, Liu Shijian, Li Qianwei, Yao Jiwei, Li Weibing, Yan Junan
Department of Urology, Southwest Hospital, Third Military Medical University, Chongqing, People's Republic of China.
Institute for Pediatric Translational Medicine, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
PLoS One. 2014 Apr 17;9(4):e94991. doi: 10.1371/journal.pone.0094991. eCollection 2014.
Chronic 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.
Systematic 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.
Twelve 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.
The 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.
慢性前列腺炎/慢性盆腔疼痛综合征（CP/CPPS）是男性生育潜能受损的风险因素之一。研究已调查CP/CPPS对多个精液参数的影响，但结果并不一致。因此，我们进行了一项系统文献综述和荟萃分析，以评估成年男性中CP/CPPS与基本精液参数之间的关联。
截至2013年8月，利用PubMed、EMBASE和Cochrane图书馆进行系统文献检索，查找涉及CP/CPSS对精液参数影响的病例对照研究。使用Review Manager和Stata软件进行荟萃分析。在随机效应模型中确定精液参数的标准平均差（SMD）及95%置信区间（95%CI）。
共纳入12项研究，包括999例CP/CPPS患者和455例对照。我们的结果表明，CP/CPPS患者的精子浓度、进行性运动精子百分比和形态正常精子百分比显著低于对照组（SMD（95%CI）分别为-14.12（-21.69，-6.63）、-5.94（-8.63，-3.25）和-8.26（-11.83，-4.66））。然而，CP/CPPS组的精液量高于对照组（SMD（95%CI）0.50（0.11，0.89））。CP/CPPS对精子总数、精子总活力和精子活力无显著影响。
本研究表明，CP/CPPS对精子浓度、精子进行性运动和正常精子形态有显著负面影响。需要进一步开展更大样本量的研究，以更好地阐明CP/CPPS对精液参数的负面影响。
