SEMINAL FLUID FINDINGS IN MEN WITH NONBACTERIAL PROSTATITIS AND PROSTATODYNIA

There is considerable confusion about the effects of prostatitis syndr omes on male reproductive physiology, Therefore, we correlated finding s on seminal fluid and expressed prostatic secretions from 100 men att ending a special prostatitis clinic. These men had symptoms:oi prostat itis but no evidence of urethritis, acute or chronic bacterial prostat itis, or significant urological abnormalities. Ail subjects were evalu ated following a standardized protocol, including lower urinary tract localization studies, expressed prostatic secretion analyses, and semi nal fluid analyses with Bryan-Leishman staining. Seminal fluid finding s were compared in men with inflammation (greater than or equal to 10( 6) leukocytes/ml) in their expressed prostatic secretions, i.e., nonba cterial prostatitis, and men without inflammation in prostatic secreti ons, i.e., prostatodynia. Of 23 men with inflammation (greater than or equal to 10(6) leukocytes/ml) in their seminal fluid, 6 (26%) had non bacterial prostatitis (mean leukocyte concentration 8.6 +/- 9.4 x 10(5 )/ml of semen) and 17 (74%) had prostatodynia (mean leukocyte concentr ation 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 pros tatodynia (mean leukocyte concentration 0.1 +/- 0.2 x 10(6)/ml, not si gnificant). Men with nonbacterial prostatitis had lower values for sev eral parameters associated with sperm motility, especially the proport ion of motile sperm (45% compared with 60% for men with prostatodynia. P = 0.08) and sperm subjective speed score (median 3 compared to 4 fo r men with prostatodynia, P = 0.03). In summary, a minority of men had seminal inflammation, even among men with nonbacterial prostatitis. T here was poor correlation between inflammation in the prostatic secret ions and in the semen, Nonbacterial prostatitis, bur. not seminal infl ammation, was associated with reduced sperm motility. Our findings hig hlight technical issues and the importance of investigating different sites and samples, including the urethra, expressed prostatic secretio ns, and seminal fluid.