Krieger J N, Berger R E, Ross S O, Rothman I, Muller C H
Department of Urology, University of Washington School of Medicine, Seattle 98195, USA.
J Androl. 1996 May-Jun;17(3):310-8.
There is considerable confusion about the effects of prostatitis syndromes on male reproductive physiology. Therefore, we correlated findings on seminal fluid and expressed prostatic secretions from 100 men attending a special prostatitis clinic. These men had symptoms of prostatitis but no evidence of urethritis, acute or chronic bacterial prostatitis, or significant urological abnormalities. All subjects were evaluated following a standardized protocol, including lower urinary tract localization studies, expressed prostatic secretion analyses, and seminal fluid analyses with Bryan-Leishman staining. Seminal fluid findings were compared in men with inflammation (> or = 10(6) leukocytes/ml) in their expressed prostatic secretions, i.e., nonbacterial prostatitis, and men without inflammation in prostatic secretions, i.e., prostatodynia. Of 23 men with inflammation (> or = 10(6) leukocytes/ml) in their seminal fluid, 6 (26%) had nonbacterial prostatitis (mean leukocyte concentration 8.6 +/- 9.4 x 10(6)/ml of semen) and 17 (74%) had prostatodynia (mean leukocyte concentration 6.2 +/- 7.0 x 10(6)/ml, not significant). Of 77 men who did not have seminal inflammation, 15 (19%) had nonbacterial prostatitis (mean leukocyte concentration 0.1 +/- 0.2 x 10(6)/ml) and 62 (81%) had prostatodynia (mean leukocyte concentration 0.1 +/- 0.2 x 10(6)/ml, not significant). Men with nonbacterial prostatitis had lower values for several parameters associated with sperm motility, especially the proportion of motile sperm (45% compared with 60% for men with prostatodynia, P = 0.08) and sperm subjective speed score (median 3 compared to 4 for men with prostatodynia, P = 0.03). In summary, a minority of men had seminal inflammation, even among men with nonbacterial prostatitis. There was poor correlation between inflammation in the prostatic secretions and in the semen. Nonbacterial prostatitis, but not seminal inflammation, was associated with reduced sperm motility. Our findings highlight technical issues and the importance of investigating different sites and samples, including the urethra, expressed prostatic secretions, and seminal fluid.
前列腺炎综合征对男性生殖生理的影响存在相当大的混淆。因此，我们对100名前往一家特殊前列腺炎诊所就诊的男性的精液和前列腺按摩液检查结果进行了相关性分析。这些男性有前列腺炎症状，但无尿道炎、急慢性细菌性前列腺炎或明显泌尿系统异常的证据。所有受试者均按照标准化方案进行评估，包括下尿路定位研究、前列腺按摩液分析以及采用Bryan-Leishman染色法进行精液分析。对前列腺按摩液中有炎症（≥10⁶白细胞/毫升）即非细菌性前列腺炎的男性与前列腺按摩液中无炎症即前列腺痛的男性的精液检查结果进行了比较。在精液中有炎症（≥10⁶白细胞/毫升）的23名男性中，6名（26%）患有非细菌性前列腺炎（精液中白细胞平均浓度为8.6±9.4×10⁶/毫升），17名（74%）患有前列腺痛（精液中白细胞平均浓度为6.2±7.0×10⁶/毫升，无显著差异）。在精液无炎症的77名男性中，15名（19%）患有非细菌性前列腺炎（精液中白细胞平均浓度为0.1±0.2×10⁶/毫升），62名（81%）患有前列腺痛（精液中白细胞平均浓度为0.1±0.2×10⁶/毫升，无显著差异）。患有非细菌性前列腺炎的男性与精子活力相关的几个参数值较低，尤其是活动精子的比例（45%，而前列腺痛男性为60%，P = 0.08）和精子主观速度评分（中位数为3，而前列腺痛男性为4，P = 0.03）。总之，即使在非细菌性前列腺炎患者中，也只有少数男性精液中有炎症。前列腺按摩液中的炎症与精液中的炎症之间相关性较差。非细菌性前列腺炎而非精液炎症与精子活力降低有关。我们的研究结果突出了技术问题以及对包括尿道、前列腺按摩液和精液在内的不同部位和样本进行研究的重要性。
