title: Male accessory gland infection frequency in infertile patients with chronic microbial prostatitis and irritable bowel syndrome: transrectal ultrasound examination helps to understand the links.
abstract: The aim of this study was to evaluate the frequency of male accessory gland  infection (MAGI) in patients with chronic bacterial prostatitis (CBP) plus  irritable bowel syndrome (IBS) and to compare the sperm parameters of patients  with or without MAGI. In addition, another objective of this study was to  evaluate the ultrasound characterization of the anatomical space between the  posterior wall of the prostate and the anterior wall of the rectum using  transrectal ultrasonography. Fifty consecutive patients with the following  criteria were enrolled: 1) infertility, 2) diagnosis of CBP, and 3) diagnosis  of IBS according to the Rome III criteria. The following 2 age-matched control  groups were also studied: infertile patients with CBP alone (n = 56) and  fertile men (n = 30) who had fathered a child within the previous 3 months.  Patients and controls underwent an accurate patient history; administration of  the National Institutes of Health-Chronic Prostatitis Symptom Index and  the Rome III questionnaires for prostatitis and IBS, respectively; physical  examination; semen analysis; and transrectal ultrasound evaluation (limited to  patients with CBP and IBS or CBP alone). A significantly higher frequency of  MAGI was found in patients with CBP plus IBS (82.0%) compared with patients  with CBP alone (53.6%) or fertile men (0%). The presence of MAGI in patients  with CBP plus IBS was associated with a significantly lower sperm  concentration, total number, and forward motility, and with a higher seminal  leukocyte concentration compared with patients with CBP alone and MAGI. Sperm  normal morphology was similar in the groups of patients. All sperm parameters  did not differ significantly in both groups of patients without MAGI. With  ultrasound evaluation, a significantly higher frequency of dilatation of  prostatic venous plexus was found in patients with CBP plus IBS (75%) compared  with patients with CBP alone (10%). Patients with CBP plus IBS had a  significantly higher frequency of MAGI compared with patients with CBP alone.  This was associated with worse sperm parameters and, hence, poorer  reproductive prognosis. We suggest searching for the presence of IBS in  patients with prostatitis syndrome, in particular when CBP and/or worse sperm  parameters are present. Finally, this is the first observation on ultrasound  examination of the anatomical space between the posterior wall of the prostate  and the anterior wall of the rectum reported in patients with CBP and IBS.  Further studies should clarify the meaning of the ultrasound findings.
authors.affiliation: Section of Endocrinology, Andrology, and Internal Medicine, Master in Andrological, Human Reproduction, and Biotechnology Sciences, and Master in Experimental and Clinical Medicine and Cellular Physiopathology, Department of Internal Medicine and Systemic Diseases, University of Catania, Catania, Italy.
authors.forename: Enzo
authors.initials: E
authors.lastname: Vicari
authors.forename: Aldo E
authors.initials: AE
authors.lastname: Calogero
authors.forename: Rosita A
authors.initials: RA
authors.lastname: Condorelli
authors.forename: Lucia O
authors.initials: LO
authors.lastname: Vicari
authors.forename: Sandro
authors.initials: S
authors.lastname: La Vignera
mesh_terms: D000328:Adult; D001424:Bacterial Infections / Q000000981:diagnostic imaging* / Q000382:microbiology; D002908:Chronic Disease; D005832:Genital Diseases, Male / Q000000981:diagnostic imaging* / Q000382:microbiology; D006801:Humans; D007248:Infertility, Male / Q000000981:diagnostic imaging* / Q000382:microbiology; D043183:Irritable Bowel Syndrome / Q000000981:diagnostic imaging* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D011472:Prostatitis / Q000000981:diagnostic imaging* / Q000382:microbiology; D012007:Rectum / Q000000981:diagnostic imaging; D055101:Semen Analysis; D013094:Spermatozoa / Q000000981:diagnostic imaging / Q000382:microbiology; D011795:Surveys and Questionnaires; D014463:Ultrasonography / Q000379:methods*