Graziani Andrea, Grande Giuseppe, Martin Michel, Ferraioli Giordana, Colonnello Elena, Iafrate Massimo, Dal Moro Fabrizio, Ferlin Alberto
Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, 35122 Padova, Italy.
Urology Clinic, Department of Surgery, Oncology and Gastroenterology, University of Padova, 35122 Padova, Italy.
Life (Basel). 2023 Aug 7;13(8):1700. doi: 10.3390/life13081700.
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is defined as urologic pain or discomfort in the pelvic region, associated with urinary symptoms and/or sexual dysfunction, lasting for at least 3 of the previous 6 months. The rate of symptoms related to prostatitis has a mean prevalence of 8-8.2%. CP/CPPS is most frequent in men younger than 50 years, among whom it is the most common urologic diagnosis. In the last decades, many studies have been published on CP/CPPS and its association with male infertility. The pathophysiologic relation between CP/CPPS and male infertility involves several aspects, which are not well studied yet. A reduction in semen parameters has been demonstrated in patients with CP/CPPS, and several mechanisms have been proposed to represent putative pathophysiological links between CP/CPPS and infertility, including male accessory gland inflammation, metabolic syndrome, inflammatory bowel disease, HPV co-infection and autoimmunity. In light of this evidence, a multidisciplinary approach is advocated for patients with known CP/CPPS, and particular attention is needed for male patients of infertile couples in order to evaluate male accessory glands correctly. In addition, it is advisable that future studies dealing with the treatment of CP/CPPS take into consideration all the different pathophysiological aspects implicated.
慢性前列腺炎/慢性盆腔疼痛综合征（CP/CPPS）定义为盆腔区域的泌尿系统疼痛或不适，伴有泌尿系统症状和/或性功能障碍，且在过去6个月中至少持续3个月。前列腺炎相关症状的发生率平均为8-8.2%。CP/CPPS在50岁以下男性中最为常见，是该年龄段最常见的泌尿系统诊断疾病。在过去几十年中，已经发表了许多关于CP/CPPS及其与男性不育症关系的研究。CP/CPPS与男性不育症之间的病理生理关系涉及多个方面，但尚未得到充分研究。CP/CPPS患者的精液参数已被证明有所降低，并且已经提出了几种机制来代表CP/CPPS与不育症之间可能的病理生理联系，包括男性附属腺炎症、代谢综合征、炎症性肠病、HPV合并感染和自身免疫。鉴于这些证据，对于已知患有CP/CPPS的患者，提倡采用多学科方法，对于不育夫妇中的男性患者，需要特别关注以正确评估男性附属腺。此外，未来关于CP/CPPS治疗的研究应考虑到所有涉及的不同病理生理方面，这是可取的。
