title: Decline of seminal parameters in middle-aged males is associated with lower urinary tract symptoms, prostate enlargement and bladder outlet obstruction.
abstract: OBJECTIVE
  We aimed to compare the associations between semen quality, associated reproductive indicators and the main prostate-related parameters in middle-aged men.
  
  
  METHODS
  This is a prospective study on 422 middle-aged men who underwent the screening for prostate health. Their reproductive function, semen quality and prostate-related pathologies were investigated.
  
  
  RESULTS
  Significant associations between semen quality and prostate-related parameters could be seen. Total sperm count and sperm density decreased along with the increase of the I-PSS score and total prostate volume. Also, the related lower urinary tract characteristics showed a negative correlation with main semen parameters for all investigated subjects. No significant differences in age, testicular size, and hormonal parameters were found between the subjects with or without lower urinary tract symptoms and prostate enlargement.
  
  
  CONCLUSIONS
  Our study suggests that altered seminal parameters in middle-aged men are associated with LUTS, prostate enlargement and/or bladder outlet obstruction. Although the assessments of prostate and lower urinary tract symptoms may not replace the semen parameters evaluating the male reproductive status, there is a need for further and more detailed investigations about the pathways behind these associations as well as possible related conditions.
authors.affiliation: Department of Surgery, Tartu University Hospital, Tallinn, Estonia.
authors.forename: Kristo
authors.initials: K
authors.lastname: Ausmees
authors.forename: Paul
authors.initials: P
authors.lastname: Korrovits
authors.forename: Gennadi
authors.initials: G
authors.lastname: Timberg
authors.forename: Margus
authors.initials: M
authors.lastname: Punab
authors.forename: Reet
authors.initials: R
authors.lastname: Mändar
mesh_terms: D000367:Age Factors; D000368:Aged; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood; D011470:Prostatic Hyperplasia / Q000503:physiopathology*; D012016:Reference Values; D012044:Regression Analysis; D012098:Reproduction / Q000502:physiology*; D055101:Semen Analysis; D012680:Sensitivity and Specificity; D013094:Spermatozoa; D018709:Statistics, Nonparametric; D001748:Urinary Bladder Neck Obstruction / Q000503:physiopathology*
chemical_list: D017430:Prostate-Specific Antigen