Effectiveness and limits of antimicrobial treatment on seminal leukocyte concentration and related reactive oxygen species production in patients with male accessory gland infection

To evaluate whether bacteriological cure, sperm outcome, spontaneous pregna ncy rate and white blood cell (WBC)related reactive oxygen species (ROS) pr oduction were related to the extent of the infection and to an intermittent and repetitive antimicrobial treatment, 122 patients with bacterial [>10(5 ) colony-forming units (CFU)/ml] male accessory gland infections (MAGI) wer e studied. According to ultrasound criteria, patients had prostatitis (PR, it 52), prostatovesiculitis (PV, n = 32) or prostatovesiculoepididymitis (P VE, n = 38), Each group was further subdivided into two subsets: one subset (PR, n = 40; PV, n = 20; PVE, n = 25) was given ofloxacin or doxycycline f or 14 consecutive days per month for 3 months; the other subset (PR, n = 12 ; PV, n = 12; PVE, n = 13) received no treatment, The female partners were also treated. All patients were evaluated before, during (1 and 3 months) a nd after (3 months) treatment. The bacteriological cure rate was the highes t (92.5%) after the third antibiotic course in PR, followed by PV (70.4%), and the lowest in PVE (52.0%). At 3 months after therapy discontinuation, s ome sperm parameters, seminal WBC concentration and ROS generation (assesse d in the 45% Percoll fraction) were ameliorated in PR and PV, whereas no im provement occurred in patients with PVE, except for the percentage of coded tails, Antibiotic treatment in PR and PV patients led to positive effects on sperm output and spontaneous pregnancy rate (40%) by removing pro-oxidan t noxae (microbial and/or NBC-related ROS production). The persistent infer tility, dyspermia and sperm-derived ROS overproduction in PVE may relate to a significant percentage of antibiotic-independent re-infection and/or to low antioxidative epididymal properties, which persisted following antimicr obial treatment.