title: [Orchitis and male infertility].
abstract: Infections and inflammations of the genital tract are considered the most frequent causes of reduced male fertility, but conclusive epidemiological data are not available. In view of the exposure of germ cells to pathogenic components as well as the cells and mediators involved in the inflammatory processes, irreversible damage to spermatogenesis and corresponding decline of ejaculate quality are to be expected, particularly in cases of chronic orchitis. While the consequences of orchitis and epididymo-orchitis that exhibit clinical symptoms due to systemic or local infections are well known, including testicular atrophy and complete loss of fertility, those cases of inflammatory reactions of the testicles that manifest an asymptomatic or subclinical course, or are not even due to an infection, have received little attention until now. However, systematic histopathological analyses have shown a high prevalence of asymptomatic inflammatory reactions in testicular biopsies from infertile men. The mostly focal lymphocytic infiltrates correlate with the degree of damage to spermatogenesis and corresponding clinical and endocrinological parameters of testicular function. Noninvasive diagnostic techniques are not yet available so that chronic asymptomatic inflammations of the testicles as the primary cause or cofactor of male fertility disorders are underestimated. Except for administration of pathogen-specific antibiotics, treatment recommendations are to a large extent still lacking.
authors.affiliation: Klinik und Poliklinik für Urologie, Kinderurologie und Andrologie, Justus-Liebig-Universität Giessen, Gaffkystrasse 14, 35385, Giessen, Deutschland. Hans-Christian.Schuppe@derma.med.uni-giessen.de
authors.forename: H-C
authors.initials: HC
authors.lastname: Schuppe
authors.forename: A
authors.initials: A
authors.lastname: Pilatz
authors.forename: H
authors.initials: H
authors.lastname: Hossain
authors.forename: A
authors.initials: A
authors.lastname: Meinhardt
authors.forename: M
authors.initials: M
authors.lastname: Bergmann
authors.forename: G
authors.initials: G
authors.lastname: Haidl
authors.forename: W
authors.initials: W
authors.lastname: Weidner
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001284:Atrophy; D001424:Bacterial Infections / Q000145:classification / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D001706:Biopsy; D002908:Chronic Disease; D003937:Diagnosis, Differential; D004823:Epididymitis / Q000145:classification / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D007248:Infertility, Male / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D009920:Orchitis / Q000145:classification / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D011379:Prognosis; D013091:Spermatogenesis / Q000187:drug effects / Q000502:physiology; D013737:Testis / Q000473:pathology / Q000503:physiopathology; D018616:Ultrasonography, Doppler, Duplex
chemical_list: D000900:Anti-Bacterial Agents
references.citation: Urologe A. 1990 Sep;29(5):277-80
references.pmid: 2120839
references.citation: Pathol Annu. 1982;17 (Pt 1):101-28
references.pmid: 6750533
references.citation: Hum Reprod Update. 1999 Sep-Oct;5(5):421-32
references.pmid: 10582781
references.citation: Andrologia. 2008 Apr;40(2):76-80
references.pmid: 18336454
references.citation: Asian J Androl. 2004 Dec;6(4):305-11
references.pmid: 15546021
references.citation: Arch Pathol Lab Med. 2002 Jan;126(1):64-9
references.pmid: 11800649
references.citation: Fertil Steril. 2002 Jan;77(1):76-82
references.pmid: 11779594
references.citation: Eur Urol. 1991;19(3):204-8
references.pmid: 1855525
references.citation: Drugs. 2002;62(12):1741-53
references.pmid: 12149044
references.citation: Urology. 2000 Jun;55(6):931-3
references.pmid: 10840112
references.citation: Chem Immunol Allergy. 2005;88:1-14
references.pmid: 16129933
references.citation: Urology. 2005 Nov;66(5):935-40
references.pmid: 16286098
references.citation: Sex Transm Dis. 1984 Jul-Sep;11(3):173-81
references.pmid: 6390741
references.citation: Andrologia. 2008 Apr;40(2):84-91
references.pmid: 18336456
references.citation: Andrologia. 2008 Apr;40(2):92-6
references.pmid: 18336457
references.citation: BJU Int. 2006 Jan;97(1):138-41
references.pmid: 16336344
references.citation: Eur Urol. 2009 Oct;56(4):708-15
references.pmid: 18715698