ABSTRACT
Association between chronic prostatitis (HP) and fertility disorders remains a controversial issue. The aim of this retrospective multicenter cross-sectional study was to examine clinical, disease history and microbiological risk factors for fertility deterioration in men with HP. Case records of 3174 men aged 20-45 years living in a heterosexual marriage and having a regular sexual life were analyzed. Examination of couples and sperm analysis was conducted in accordance with the requirements of the WHO. Leukocytospermia was present in 19% of infertile cases. In 54% of those cases chronic prostatitis was associated with aerobic bacterial infection, in 9% - with chlamydial and in 12% with urea- and mycoplasma. It was found that concentrations ofleukocytes in semen and clinical symptoms (pain and dysuria) were not independent risk factors for infertility. Infertile patients had higher incident rates of E. coli (OR=4,1) and bacterial associations (OR=6,9) with reduced antimicrobial resistance of seminal plasma(for E. coli OR=9,9; for Ps. aeruginosa OR=6,0). Other risk factors for fertility reduction in patients with HP are the duration of the disease (OR=2,7), frequency of exacerbations (OR=2,6), presence of fibrosis and prostatolites (OR=1,8) and functional prostate-vesicular obstruction (OR=1,4). Further studies are needed to understand HP pathogenesis and explain the negative impact of HP on male fertility.
