title: Defining the "normal" postejaculate urinalysis.
abstract: Although sperm have been shown to be present in the postejaculate  urinalysis (PEU) of both fertile and infertile men, the number of sperm  present in the PEU of the general population has never been well defined. The  objective of this study was to describe the semen and PEU findings in both the  general and infertile population, in order to develop a better appreciation  for "normal." Infertile men (n = 77) and control subjects (n = 71)  were prospectively recruited. Exclusion criteria included azoospermia and  medications known to affect ejaculation. All men underwent a history, physical  examination, semen analysis, and PEU. The urine was split into 2 containers:  PEU1, the initial voided urine, and PEU2, the remaining voided urine.  Parametric statistical methods were applied for data analysis to compare sperm  concentrations in each sample of semen and urine between the 2 groups of men.  Controls had higher average semen volume (3.3 ± 1.6 vs 2.0 ± 1.4  mL, P < .001) and sperm concentrations (112 million vs 56.2  million, P = .011), compared with infertile men. The presence of  sperm in urine was common in both groups, but more prevalent among infertile  men (98.7% vs 88.7%, P = .012), in whom it comprised a greater  proportion of the total sperm count (46% vs 24%, P = .022). The  majority of sperm present in PEU were seen in PEU1 of both controls (69%) and  infertile men (88%). An association was noted between severe oligospermia  (<5 million/mL) with low semen volume (<0.5 mL), and significant sperm  counts in PEU (<5 million). Although infertile men tend to have a higher  proportion of their total sperm in the urine compared with control, there is a  large degree of overlap between the 2 populations, making it difficult to  identify a specific threshold to define a positive test. Interpretation of a  PEU should be directed by whether the number of sperm in the urine could  affect subsequent management.
authors.affiliation: Division of Urology, Warren-Alpert Medical School at Brown University, 2 Dudley St, Suite 175-185, Providence, RI 02905, USA.
authors.forename: Akanksha
authors.initials: A
authors.lastname: Mehta
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Jarow
authors.forename: Pat
authors.initials: P
authors.lastname: Maples
authors.forename: Mark
authors.initials: M
authors.lastname: Sigman
mesh_terms: D016022:Case-Control Studies; D004542:Ejaculation; D006801:Humans; D007248:Infertility, Male / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology / Q000652:urine; D008297:Male; D009845:Oligospermia / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology / Q000652:urine; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012016:Reference Values; D055101:Semen Analysis; D012720:Severity of Illness Index; D013076:Sperm Count; D013094:Spermatozoa / Q000473:pathology*; D016482:Urinalysis; D014556:Urine / Q000166:cytology