Aim: To identify and define prostate and seminal vesicle abnormalities in patients with chronic male accessory glandinfection (MAGI) who failed to respond to antibacterial treatment. Methods: We selected 67 consecutive patientswith MAGI and persistently elevated bacteriospermia (≥ 106 colony forming units [CFU]/mL) after three antibioticcourses. Fourteen infertile patients with initial chronic microbial (≥ 106 CFU/mL) MAGI who responded to antibacterialtreatment (< 103 CFU/mL) served as a control group. All patients and controls underwent transrectal ultrasonography(TRUS) scans and semen analysis. Patients with low seminal plasma volume (< 1.5 mL) underwent both preejaculatoryand post-ejaculatory TRUS examination. Results: TRUS revealed multiple abnormalities indicative of: (i)bilaterally extended prostato-vesiculitis (group A: 52 cases, 77.6%) (nine of these patients also had micro-emphysematousprostate abscess); and (ii) prostato-vesiculitis with unilateral or bilateral sub-obstruction of the ejaculatoryducts (group B: 15 cases, 22.4%). Mean sperm concentration, total sperm number, ejaculate volume and pH valuewere significantly higher in group A than in group B. In addition, sperm forward motility and the percentage of normalforms were significantly worse than in controls, whereas leukocyte concentration was significantly higher in group A.Group B patients had all sperm parameters, but their pH values, significantly different from those of controls. Conclusion:Although antibiotic therapy is considered suitable when microbial MAGI is suspected, it is impossible to account for apoor response to antibiotics merely on the basis of conventional criteria (clinical history, physical and ejaculate signs).Thus, TRUS may be helpful in the follow-up of these patients. (Asian J Androl 2008 Sep; 10: 731–740)

Transrectal ultrasonography in infertile patients with persistently elevated bacteriospermia

LA VIGNERA, SANDRO SALVUCCIO MARIA;CALOGERO, Aldo Eugenio;VICARI, Enzo Saretto
2008-01-01

Abstract

Aim: To identify and define prostate and seminal vesicle abnormalities in patients with chronic male accessory glandinfection (MAGI) who failed to respond to antibacterial treatment. Methods: We selected 67 consecutive patientswith MAGI and persistently elevated bacteriospermia (≥ 106 colony forming units [CFU]/mL) after three antibioticcourses. Fourteen infertile patients with initial chronic microbial (≥ 106 CFU/mL) MAGI who responded to antibacterialtreatment (< 103 CFU/mL) served as a control group. All patients and controls underwent transrectal ultrasonography(TRUS) scans and semen analysis. Patients with low seminal plasma volume (< 1.5 mL) underwent both preejaculatoryand post-ejaculatory TRUS examination. Results: TRUS revealed multiple abnormalities indicative of: (i)bilaterally extended prostato-vesiculitis (group A: 52 cases, 77.6%) (nine of these patients also had micro-emphysematousprostate abscess); and (ii) prostato-vesiculitis with unilateral or bilateral sub-obstruction of the ejaculatoryducts (group B: 15 cases, 22.4%). Mean sperm concentration, total sperm number, ejaculate volume and pH valuewere significantly higher in group A than in group B. In addition, sperm forward motility and the percentage of normalforms were significantly worse than in controls, whereas leukocyte concentration was significantly higher in group A.Group B patients had all sperm parameters, but their pH values, significantly different from those of controls. Conclusion:Although antibiotic therapy is considered suitable when microbial MAGI is suspected, it is impossible to account for apoor response to antibiotics merely on the basis of conventional criteria (clinical history, physical and ejaculate signs).Thus, TRUS may be helpful in the follow-up of these patients. (Asian J Androl 2008 Sep; 10: 731–740)
2008
persistent bacteriospermia; prostato-vesiculitis; sub-obstruction of the ejaculatory ducts
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.11769/8344
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