Male Infertility Azoospermia
While hematospermia is mainly caused by genitourinary inflammatory disorders, very few studies have been published on prostatitis-associated hematospermia PAH diagnosed using robust prostatitis evaluation methods. Therefore, we have evaluated the incidence of PAH by using systematic methods for evaluating prostatitis. We evaluated 37 hematospermia patients from a single hospital over the last five years. The mean age was PAH patients were further sub-classified: chronic bacterial prostatitis 3 patientschronic nonbacterial prostatitis 10 patientsprostadynia 7 patientsand asymptomatic prostatitis 5 patients.
We found Enterococcus faecalis zoospermia mit Prostatitis the three chronic bacterial prostatitis patients. We could not find any statistically significant difference between the PAH and the HWP groups in terms of the age interval, serum prostate-specific antigen zoospermia mit Prostatitis, and prostate volume.
Even though there was no statistically significant difference in the items about urination between the two groups, we found a statistically significant difference in the quality of life QoL impact for the patients in this study.
Two-thirds of the hematospermia patients were associated with some evidence of prostatitis. Therefore, we must evaluate the presence of prostatitis in hematospermia patients zoospermia mit Prostatitis alleviate the prostatitis-associated symptoms to improve their QoL. Hematospermia can be defined as the appearance of blood in ejaculate [ 123 ].
While it is usually self-limited in most patients, in some cases, persistent, recurrent symptoms have been reported, causing serious concerns. We could classify the many suggested etiologies for hematospermia into inflammatory or infectious diseases and anatomical abnormalities or disorders [ 1 zoospermia mit Prostatitis, 23 ].
Urethritis, prostatitis, and epididymitis are a prototype of inflammatory zoospermia mit Prostatitis, while posterior urethral obstruction, calculi in the zoospermia mit Prostatitis duct, and prostate cancer can be a prototype of anatomical hematospermia. Tests for evaluating lower urinary tract infection such as urine analysis and Gram staining are routine tests for hematospermia [ 245 ].
Because transrectal ultrasonography US can show the anatomical structures of the prostate, seminal vesicles, and adjacent structures, many urologists have applied this modality for evaluating the anatomical causes of hematospermia [ zoospermia mit Prostatitis56 ]. Prostatitis, an inflammatory zoospermia mit Prostatitis of the prostate, has been considered an important zoospermia mit Prostatitis causing bloody ejaculation [ 12345 ].
Unfortunately, very few studies on the determination of prostatitis-related etiologies for the origin of hematospermia have been performed using robust prostatitis evaluation methods. Therefore, in this study, we have aimed to evaluate the association between prostatitis and hematospermia by using systematic methods for evaluating prostatitis, and to clarify the role of prostate inflammation in bloody ejaculate.
Informed consent was obtained from the study participants. We collected data from 37 patients who visited a single university hospital complaining of hematospermia between April and November On the basis of these evaluations, eligible participants were classified into patients without any evidence of prostatitis negative prostatitiswith chronic bacterial prostatitis NIH-category IIwith chronic nonbacterial prostatitis NIH-category IIIAwith prostadynia NIH-category IIIBand with asymptomatic zoospermia mit Prostatitis prostatitis [ 810 ].
In particular, we defined the group of negative prostatitis patients as hematospermia patients who did not have a specific prostatitis symptom according to the NIH-CPSI questionnaire or display any relevant signs in the EPS studies. The exclusion criteria were the presence of genitourinary cancer, urinary stone disease, gonococcal or chlamydial urethritis, acute epididymitis, acute cystitis, acute prostatitis, traumatic urethral stricture, or seminal vesicle or ejaculatory duct calculi, as well as experience of prostate surgery or biopsy within the past 6 months.
The prostate size was automatically determined, and US-guided biopsy was mandatorily performed on the prostate nodule to differentiate prostate cancer.
Culture specimens for diagnosing prostatitis were obtained using the modified Meares-Stamey method [ zoospermia mit Prostatitis1112 ]. In brief, after periurethral cleansing with an alcohol sponge, the patient provided a VB1 specimen, followed by a VB2 urine specimen. After the production of EPS by a zoospermia mit Prostatitis prostatic massage, the patient provided zoospermia mit Prostatitis to 10 mL of voided urine for the VB3 specimen.
EPS was collected by a digital rectal massage into a sterile 1. At least 25 fields were examined. Zoospermia mit Prostatitis criterion zoospermia mit Prostatitis chronic bacterial prostatitis was that the bacterial colony concentration of the EPS specimens increased by at least fold one log compared with the colony numbers of the VB1 specimen.
Two-sided null hypotheses of no difference were rejected if p zoospermia mit Prostatitis were less than 0. From the items of the NIH-CPSI questionnaire, we found that the sum scores of the pain or discomfort, urination, quality of life impact, and total items were 3. Thirty-seven patients were classified into the following groups: no evidence of prostatitis 12 patients; We found Enterococcus faecalis in three chronic bacterial prostatitis patients.
We could not find any statistically significant differences between the two groups in terms of the age interval, serum PSA zoospermia mit Prostatitis, and zoospermia mit Prostatitis volume Table 2.
Even though the prevalence of hematospermia is not high in the general population and its clinical course is usually self-limited, it often causes considerable anxiety to patients [ 1231314 ]. Some patients presuppose hematospermia to be linked to sexual behaviors such as prolonged sexual abstinence or overindulgence, while others zoospermia mit Prostatitis that genitourinary malignancies and sexually transmitted diseases are the key causes of hematospermia [ 123456zoospermia mit Prostatitis16 ].
Theoretically, it may be derived from anatomical conditions along the sperm passageway, such zoospermia mit Prostatitis in the lesions of testis, epididymis, vas deferens, seminal vesicles, prostate, and posterior urethra. Urologists have also categorized hematospermia on the basis of pathophysiologic mechanisms such as inflammation and infections, ductal obstruction and cysts of accessory sexual glands, tumors, vascular abnormalities, and systemic and iatrogenic factors [ 3 ].
Inflammatory or infectious conditions in the genitourinary tract have appeared to be the most common causal factors of hematospermia [ 12345 ]. An irritation of the mucosa, mucosal edema, and hyperemia of the accessory sexual glands and their corresponding ducts may lead to bleeding and hematospermia [ 3 ]. The suggested infectious etiologies include viral, bacterial, mycobacterial, and parasitic infections such as bilharziasis [ 3 ]. We also evaluated the C.
However, we could not find any trace of the two pathogens in the specimens of urine or EPS. This discrepancy may be attributed to the difference in the age distributions between the two studies. The age range of Bamberger et al's zoospermia mit Prostatitis 16 ] study was 17 to 66 years median: 33 zoospermia mit Prostatitiswith 4 patients over the age of 40 years. In contrast, the mean age of the patients in this study was It has been well known that young age is an important factor associated with chlamydial infection [ 17 ].
Therefore, we easily presuppose the association between hematospermia and prostatitis. We found E. These bacteria frequently colonize the urinary tract zoospermia mit Prostatitis cause infection [ 11 ]. When we compare the incidence of E. Furthermore, the hematospermia symptoms of all E. Prostatitis, an inflammatory or infectious disorder of the prostate, can be classified into acute, chronic bacterial, chronic nonbacterial, prostadynia, and asymptomatic forms [ 820 ].
In this study, we could not find any acute prostatitis patients. Interestingly, 25 patients with hematospermia revealed prostatitis-like symptoms or signs. Among them, three patients revealed an E. From the meta-analysis studies, the mean age of hematospermia is 37 years, showing prevalence in young males [ 215 ].
However, the mean age in our study was From the data of the mean serum PSA level 2. Around this age, the major concern for many patients is to know whether they have prostate cancer. Zoospermia mit Prostatitis general, the incidence of prostate cancer is not high in patients with hematospermia. We could not find any statistically significant differences between the PAH patients and the patients without hematospermia in terms of the age interval, serum PSA level, prostate volume, and sum of items about urination items 5 and 6 of the NIH-CPSI questionnaire.
Interestingly, the PAH patients revealed a relatively poor quality of life compared with the patients without prostatitis. One of the treatment targets of prostatitis is to improve zoospermia mit Prostatitis quality of life in patients with chronic prostatitis [ 21 ].
Therefore, zoospermia mit Prostatitis must consider more specific treatments for hematospermia patients with prostatitis symptoms or signs. We recognize two limitations to this study.
Second, this study can be classified as a correlation study. While our results showed that the hematospermia patients were associated with a higher prevalence of prostatitis than the normal population, as well as for inflammatory prostatitis than prostadynia, we could not determine whether this association is a true etiologic factor in the manifestation of hematospermia. Two-thirds of the hematospermia patients were associated with evidence of prostatitis.
We must carefully evaluate the association of prostatitis in hematospermia patients. Further, hematospermia patients with prostatitis revealed a relatively poor quality of life compared with those without prostatitis. National Center for Biotechnology InformationU.
World J Mens Health. Published online Aug Gilho Lee. Find articles by Gilho Lee. Author information Article notes Copyright and License information Disclaimer. Corresponding author. Correspondence to: Gilho Lee. This article has been cited by other articles in PMC.
Abstract Purpose While hematospermia is mainly caused by genitourinary inflammatory disorders, very few studies have been published on prostatitis-associated hematospermia PAH diagnosed using robust prostatitis evaluation methods. Materials and Methods We evaluated 37 hematospermia patients from a single hospital over the last five years. Results The mean age was Conclusions Two-thirds of the hematospermia patients were associated with some evidence of prostatitis.
Keywords: Hematospermia, Prostate, Prostatitis. Study design and participant characteristics Informed consent was zoospermia mit Prostatitis from the zoospermia mit Prostatitis participants.
Table 1 Clinical characteristics of patients. Variable Value No. Open in a separate window. References 1. Haematospermia as a presenting symptom: outcomes of investigation in men. Ahmad I, Krishna NS.
J Urol. Szlauer R, Jungwirth A. Haematospermia: diagnosis and treatment. Evaluation and treatment of hematospermia. Am Fam Physician.