The seminal plasma components neutral alpha-glucosidase, carnitine, fructose, citrate, and polymorphonuclear granulocyte (PMN) elastase in 253 men were determined. The seminal plasma of 221 infertile men, a control group with proved fertility and 13 patients after vasectomy were investigated. The concentrations of free carnitine (212 versus 521 micromol/l, n = 219, P < 0.001), total carnitine (437 versus 743 micromol/l, n = 219, P < 0.001), and the activity of neutral alpha-glucosidase (15.1 versus 23.4 IU/l, n = 236, P < 0.05) were significantly reduced in the infertile patient group as compared to the fertile control group, the concentration of PMN elastase (102 versus 48 microg/l, n = 234, P < 0.05) being significantly increased in the infertile patients. In the patients after vasectomy the activity of neutral alpha-glucosidase was the only epididymal marker that was significantly reduced (4.3 versus 9. 8 IU/l, n = 35, P = 0.002) in comparison with the patients with testicular azoospermia. At a limit of 6 IU/l the sensitivity of the method was 92% and the specificity was 72%. Altogether, the epididymal markers were reduced in subfertile patients compared with the control group. For the differential diagnosis of azoospermia only the determination of the neutral alpha-glucosidase activity is useful.

MRI is the most accurate imaging procedure when penile fracture is suspected but clinical findings are unusual.

MRI is the most accurate imaging procedure when penile fracture is suspected but clinical findings are unusual.

The in vivo and in vitro examinations demonstrated deterioration in semen quality. Sperm density and sperm motility returned to normal 3 months after ESWL, indicating at least a transitory decrease in male fertility may occur.

The in vivo and in vitro examinations demonstrated deterioration in semen quality. Sperm density and sperm motility returned to normal 3 months after ESWL, indicating at least a transitory decrease in male fertility may occur.