Magri Vittorio, Perletti Gianpaolo, Stamatiou Konstantinos, Trinchieri Alberto
Urology Clinic, ASST Fatebenefratelli Sacco Hospitals, 20026 Milan, Italy.
Department of Biotechnology and Life Sciences, Section of Medical and Surgical Sciences, University of Insubria, 21100 Varese, Italy.
Diagnostics (Basel). 2025 Apr 1;15(7):887. doi: 10.3390/diagnostics15070887.
: Patients with chronic bacterial prostatitis (CBP) often present symptoms of sexual dysfunction. We aimed to evaluate the impact of the infection location and etiology on sexual dysfunction in patients with CBP. : Male patients with CBP diagnosed by microbiological tests underwent a complete clinical assessment and were administered questionnaires for prostatitis (NIH-CPSI), voiding (IPSS), and sexual function (IIEF-15, PEDT). : Out of 614 patients, erectile dysfunction (ED) was present in 49.8%, and premature ejaculation (PE) in 40.7%. At least one sexual disorder was present in 86.3% when other disorders of ejaculation, orgasm, and sexual desire were considered. Patients with Gram-negative infections in expressed prostatic secretion (EPS) or voided urine after prostatic massage (VB3) had higher odds of moderate to severe erectile dysfunction compared to patients with infection by atypical pathogens (OR 3.31, CI 1.43-7.63, = 0.0039). Rates of orgasmic dysfunction were also higher in Gram-negative and Gram-positive with respect to atypicals (OR 3.2, CI 1.36-7.90, = 0.006 and OR 3.78, CI 1.64-8.71, = 0.001). Hemospermia was more frequent in patients with semen infection by Gram-positive than in patients with infection by atypical pathogens (OR 2.2984, CI 1.3239-3.9901, = 0.002). Prostatic calcifications at transrectal ultrasound were less frequent in patients with semen infection by Gram-negative compared to Gram-positive (OR 0.471, CI 0.3029-0.7322, = 0.000). The addition of an "S" (sexual) domain to the UPOINT classification achieves a more significant correlation between the number of positive domains in each patient and the NIH-CPSI score. : Infections by Gram-negative are associated with more sexual morbidity in patients with CBP. The use of a questionnaire investigating all the main domains of sexual dysfunction could be very useful for the phenotyping of patients with chronic prostatitis.
慢性细菌性前列腺炎（CBP）患者常出现性功能障碍症状。我们旨在评估感染部位和病因对CBP患者性功能障碍的影响。男性CBP患者经微生物检测确诊后接受全面临床评估，并填写前列腺炎问卷（NIH - CPSI）、排尿问卷（IPSS）和性功能问卷（IIEF - 15、PEDT）。在614例患者中，勃起功能障碍（ED）发生率为49.8%，早泄（PE）发生率为40.7%。若考虑射精、性高潮和性欲的其他障碍，86.3%的患者至少存在一种性功能障碍。与非典型病原体感染的患者相比，前列腺按摩后前列腺液（EPS）或尿液（VB3）中革兰氏阴性菌感染的患者出现中度至重度勃起功能障碍的几率更高（OR 3.31，CI 1.43 - 7.63，P = 0.0039）。与非典型病原体相比，革兰氏阴性菌和革兰氏阳性菌感染患者的性高潮功能障碍发生率也更高（OR 3.2，CI 1.36 - 7.90，P = 0.006和OR 3.78，CI 1.64 - 8.71，P = 0.001）。革兰氏阳性菌精液感染患者的血精症比非典型病原体感染患者更常见（OR 2.2984，CI 1.3239 - 3.9901，P = 0.002）。经直肠超声检查发现，革兰氏阴性菌精液感染患者的前列腺钙化发生率低于革兰氏阳性菌感染患者（OR 0.471，CI 0.3029 - 0.7322，P = 0.000）。在UPOINT分类中增加一个“S”（性）领域，可使每位患者的阳性领域数量与NIH - CPSI评分之间的相关性更显著。革兰氏阴性菌感染与CBP患者更多的性功能障碍相关。使用一份调查性功能障碍所有主要领域的问卷对慢性前列腺炎患者的表型分析可能非常有用。
