Prostate; How does prostatitis affect male fertility?

What is prostatitis?

Bacterial prostatitis is a clinical condition caused by a bacterial infection in the prostate that produces urinary symptoms and affects fertility in males.

What are the prostatitis’ causes?

The causative germs are detected by routine methods in only 5-10% of cases, an antimicrobial therapy in these patients, has a rational basis. Impaired emptying of the bladder due to narrowing of the urethra is often the cause of prostatitis

The remaining patients are treated empirically with numerous medical and physical modalities. However, the recent improvement in the classification and application of modern methods, including molecular biology, should allow an adequate systematization of treatment.

What types of prostate infections are there?

The germs that produce it are usually bacteria, of intestinal origin, especially E. Coli, being predominant in acute bacterial prostatitis. In chronic bacterial prostatitis, the spectrum of germs is broader and their existence in semen and urine must be studied.

Can prostatitis cause infertility?

Prostatitis causes infertility, causing alteration in the spermiogram due to inflammation of the seminal tract, which can even lead to obstructive azoospermia, that is, the absence of sperm in the sediment due to an obstruction. Obstructive azoospermia is less common than non-obstructive (in which sperm are not produced) and occurs in 20-40% of men with azoospermia

Obstruction within the testicle occurs in 15% of men with obstructive azoospermia. Epididymal obstruction is the most common cause of obstructions, affecting 30-67% of azoospermic men.

Epididymitis that is associated without symptoms with prostatitis (p.ex., chlamydia) is most often due to prostate infections.

There are two fundamental aspects in prostatitis, the symptoms’ treatment, nicturia perineal pain, a sensation of incomplete emptying, which in some cases are very tedious, evolving in outbreaks; and the improvement of seminal quality when fertility is compromised.

For the former, factors of the infecting germ and factors of the patient (their immunity and defense mechanisms) influence. In addition, conditioners of symptoms such as stress, irrational weight loss diets influence, which indirectly condition defense mechanisms.

Regarding fertility, a complete urological diagnostic study, with cystourethrograms, microbiological examination and adequate treatment with bacteriostatic antibiotics that have a good target in the prostate (since all antibiotics do not reach) allows in some cases to improve seminal quality.

Dr Luís Prieto, director of urology at the Instituto Bernabeu