title: Prostatitis and andrological implications.
abstract: OBJECTIVE
  The prostatitis syndrome is a frequent disease affecting men in their reproductive age. The prostatitis syndrome is classified according to the National Institutes of Health (NIH) definition. Andrological implications of the prostatitis syndrome might encompass fertility issues, sexual dysfunctions and endocrinological alterations and influences.
  
  
  METHODS
  A medline query using the terms prostatitis AND andrological implication, fertility, sexual dysfunction or endocrinology was performed.
  
  
  RESULTS
  Acute bacterial prostatitis and andrological implications have not been adequately addressed. Patients with chronic bacterial prostatitis and chronic pelvic pain syndrome have been investigated evaluating sperm parameters. Some studies showed impaired sperm parameters. In chronic bacterial prostatitis, half of the patients reveal significant bacteriospermia with still debatable deleterious effects on sperm quality. Few interventional studies have addressed fertility issues in those patients. Anti-inflammatory treatment perhaps could have a positive impact on sperm parameters. Sexual dysfunction can be described by different components such as erectile, ejaculatory, orgasmic and sexual desire dysfunctions. Sexual dysfunction in chronic prostatitis adds to the number of positive symptom phenotypes and correlates therefore with increasing symptom scores in patients with chronic prostatitis syndromes. However, prospective interventional studies on the role of sexual dysfunctions are missing. Hormones have been found to modulate the inflammatory response via different receptors, particularly via estrogen receptor alpha. This evidence, however, is mainly limited to pre-clinical studies currently.
  
  
  CONCLUSIONS
  Andrological implications are heterogenous and frequently described in patients with chronic prostatitis syndrome. Nonetheless, andrological factors have not been routinely addressed as primary variables in the different studies, which makes further research necessary.
authors.affiliation: Department of Urology Pediatric Urology and Andrology Justus Liebig University of Giessen, D-35392 Giessen, Germany. Wagenlehner@AOL.com
authors.forename: F
authors.initials: F
authors.lastname: Wagenlehner
authors.forename: A
authors.initials: A
authors.lastname: Pilatz
authors.forename: T
authors.initials: T
authors.lastname: Linn
authors.forename: T
authors.initials: T
authors.lastname: Diemer
authors.forename: H C
authors.initials: HC
authors.lastname: Schuppe
authors.forename: U
authors.initials: U
authors.lastname: Schagdarsurengin
authors.forename: H
authors.initials: H
authors.lastname: Hossain
authors.forename: A
authors.initials: A
authors.lastname: Meinhardt
authors.forename: S
authors.initials: S
authors.lastname: Ellem
authors.forename: G
authors.initials: G
authors.lastname: Risbridger
authors.forename: W
authors.initials: W
authors.lastname: Weidner
mesh_terms: D000208:Acute Disease; D001424:Bacterial Infections / Q000150:complications; D004700:Endocrine System Diseases / Q000209:etiology; D006801:Humans; D007248:Infertility, Male / Q000209:etiology; D008297:Male; D011472:Prostatitis / Q000150:complications* / Q000382:microbiology; D012735:Sexual Dysfunction, Physiological / Q000209:etiology