男性不育患者慢性前列腺炎的发病调查及其对生育的影响

目的　研究慢性前列腺炎 (CP)在男性不育患者中的发生情况及其对精液参数的影响。方法　选择以男性不育为主诉就诊的 5 34例患者 ,详细询问前列腺炎相关病史和临床症状 ,通过直肠指诊前列腺、前列腺液分析 ,及对部分炎症性CP患者进行的按摩前列腺前后的尿液培养“二杯法”(PPMT)法来诊断CP ,并分析CP对男性精液的影响。结果　在 5 34例男性不育患者中 ,诊断CP者共 2 0 9例 ,CP发生率 39 1% ,其中Ⅱ型和ⅢA型前列腺炎发生率 8 6 % (46 / 5 34) ,ⅢB型前列腺炎5 2 % (2 8/ 5 34) ,Ⅳ型前列腺炎 2 5 3% (135 / 5 34)。选择 4 0例炎症性CP患者 ,PPMT确定 10例(2 5 0 % )存在前列腺内的细菌感染 ,其中Ⅳ型前列腺炎的细菌感染率为 2 4 2 % (8/ 33)。CP可以增加不育男性精液不液化的发生率 (2 2 7% ) ,明显高于无前列腺炎不育患者中的发生率 (14 3% ) (P <0 0 5 ) ,但是对精液的其他参数没有明显影响。结论　CP在男性不育患者中相当普遍 ,可以使精液不液化 ,但对精液的其他参数影响不明显。

Prevalence of chronic prostatitis and its effects on male infertility

OBJECTIVE: To investigate the prevalence of chronic prostatitis (CP) in male infertility patients and its effects on male infertility. METHODS: 534 male patients with complaints of male infertility were interviewed for the history of prostatic disease and underwent digital rectal examination of prostate, analysis of semen and express prostatic secretions (EPS). Bacterial culture of urine was done in 40 randomly selected inflammatory CP patients by pre- and post-message method (pre- and post-massage test, PPMT). RESULTS: 209 out of the 534 patients with male infertility were diagnosed as chronic prostatitis with a prevalence rate of 39.1%, among which 46 with CP type II and IIIA with the prevalence rate of 8.6%, 28 with CP type IIIB (5.2%), and 135 with CP type IV (25.3%) respectively. Positive bacterial culture was found in 10 out of the 40 cases of inflammatory chronic prostatitis (25.0%). The bacterial infection rate was 24.2% (8/33) in the cases of CP type IV. The prevalence rate of liquefaction dysfunction was much higher in the patients of male infertility with CP (22.7%) than in those without CP (14.3%, P < 0.05), however, it had little influence on the quality of semen, pH value, sperm density, and sperm motility. CONCLUSION: Quite common in patients with male infertility, CP prolongs the time of liquefaction, but has no other reverse influence on semen.