Infertility and chronic prostatitis.

Long term treatment of chronic prostatitis with antimicrobials and their influence on semen quality and infertility were studied in 30 men with mean age of 36.7 +/- 6 years. The infection was symptomatic only in 50% of the patients with abnormal prostatic physical findings in 66.7%. Cardinal findings in the spermatogram were leukocytosis in 100% and oligoasthenozoospermia in 66.5% of the patients. E. coli and Staphylococci presented the most commonly isolated bacteria in prostatic secretion cultures. Various treatment schedules, including mostly co-trimoxazole, doxycycline and erythromycin, were given alternatively for 6-8 months. Symptoms were cured or improved in 79.7%, with elimination or improvement of abnormal physical findings in 85%, while the isolated pathogens were eradicated in all. Spermatograms were normalized or improved in 70% of the patients, while among them 9 impregnated their wives and in 2 of them twice. It is concluded that male infertility in the presence of semen leukocytosis and oligoasthenozoospermia should be investigated for underlying chronic prostatitis, while whenever proved, long term treatment with the proper antimicrobials not only cures or improves chronic prostatitis, but subsequently cures or improves male infertility.