MAGI is the inflammation of the accessory male glands that notoriously exerts a negative influence on male fertility. The diagnosis is integrated by clinical, laboratory and ultrasound evaluation. In particular, the ultrasound criteria were published in 1999. The aim of this study was to analyse the sensitivity and specificity of additional diagnostic ultrasound criteria as well as of conventional criteria in a selected category of infertile patients with MAGI. To accomplish this, 100 patients with MAGI were evaluated by scrotal and transrectal ultrasound by three different operators. The control group consisted of 100 age-matched healthy men. Statistical analysis was performed to evaluate sensitivity, specificity, positive and negative predictive values, and ROC curve analysis. The results showed that additional ultrasound criteria had a diagnostic accuracy similar to traditional criteria. The threshold value of two criteria for each diagnostic category (traditional and additional criteria) obtained high values of sensitivity and specificity. In conclusion, this study confirms the validity of the ultrasound criteria of MAGI previously published; in addition, it suggests the clinical utility of other indicators in clinical practice with good diagnostic accuracy and finally it establishes a clear threshold ultrasonographic value for the diagnosis of MAGI.

Changes in levels of oxidative damage products in semen and their relationship to seminal fluid viscosity (SFV) have recently received increasing research interest. We analysed whether SFV was associated with ROS generation, levels of cytokines TNF-alpha (TNF-α), IL-6 and IL-10 and seminal leucocyte concentration, and whether ROS production was related to the extent of infections/inflammations at one (prostatitis) or two (prostato-vesiculitis) male accessory glands. We studied 169 infertile patients, with chronic bacterial prostatitis (PR, n = 74) and/or bilateral prostato-vesiculitis (PV, n = 95), as diagnosed by the ultrasound (US) criteria. Healthy fertile men (n = 42) served as controls. In the PV patient group, SFV, semen characteristics and ROS production had median values that were significantly higher than those found in PR patients and controls, although other sperm variables had values significantly lower than those found in PR patients or controls. In PV infertile patients, ROS generation and pro-inflammatory cytokines levels were higher than those found in PR infertile patients and controls, although seminal IL-10 levels in PV and PR patients were lower than those found in the controls. In PR patients, the levels of SFV were positively related to TNF-α (r = 0.67; P < 0.01), fMLP-stimulated ROS production in the 45% Percoll fraction (r = 0.687, P < 0.01) and the 90% Percoll fraction in basal condition (r = 0.695, P < 0.01), and after fMLP-stimulation (r = 0.688, P < 0.01). Thus, our data indicated that seminal hyperviscosity is associated with increased oxidative stress in infertile men and increased pro-inflammatory interleukins in patients with male accessory gland infection, more when the infection was extended to the seminal vesicles.

This study showed that car exhaust exposure has a genotoxic effect on human spermatozoa. This may be of relevant importance not only for the reproductive performance of the men exposed, but also for the offspring health.

BackgroundAlthough prostatitis syndrome (PS) and irritable bowel syndrome (IBS) are common disorders, information on the prevalence of IBS in infertile patients with PS is relatively scanty. Therefore, this study was undertaken to estimate the frequency of PS and IBS and to evaluate the prevalence of the various diagnostic categories of prostatitis.Methodology/Principal FindingsThis study enrolled 152 patients with PS, diagnosed by the NIH-Chronic Prostatitis Symptom Index (NIH-CPSI) in an andrological setting, and 204 patients with IBS, diagnosed according to the Rome III diagnostic criteria in a gastroenterological setting. The patients with PS were asked to fulfill the Rome III questionnaire for IBS, whereas patients with IBS were asked to complete the NIH-CPSI. The simultaneous presence of PS and IBS was observed in 30.2% and 31.8% of the patients screened by andrologists and gastroenterologists, respectively. Altogether, 111 patients had PS plus IBS (31.2%). They had a total NIH-CPSI and pain subscale scores significantly higher than patients with PS alone. Gastrointestinal symptoms in patients with PS plus IBS were similar to those reported by patients with IBS alone and significantly greater in patients with PS alone. Patients with PS plus IBS had a significantly higher frequency of chronic bacterial prostatitis (category II) and lower of non-inflammatory prostatitis (category IIIB), compared to patients with PS alone. The frequency of inflammatory prostatitis (category IIIA) resulted similar.Conclusions/SignificanceProstatitis syndromes and IBS are frequently associated in patients with PS- or IBS-related symptoms. These patients have an increased prevalence of chronic bacterial and non-inflammatory prostatitis.

The aim of this study was to evaluate the frequency of male accessory gland infection (MAGI) in patients with chronic bacterial prostatitis (CBP) plus irritable bowel syndrome (IBS) and to compare the sperm parameters of patients with or without MAGI. In addition, another objective of this study was to evaluate the ultrasound characterization of the anatomical space between the posterior wall of the prostate and the anterior wall of the rectum using transrectal ultrasonography. Fifty consecutive patients with the following criteria were enrolled: 1) infertility, 2) diagnosis of CBP, and 3) diagnosis of IBS according to the Rome III criteria. The following 2 age-matched control groups were also studied: infertile patients with CBP alone (n 5 56) and fertile men (n 5 30) who had fathered a child within the previous 3 months. Patients and controls underwent an accurate patient history; administration of the National Institutes of Health-Chronic Prostatitis Symptom Index and the Rome III questionnaires for prostatitis and IBS, respectively; physical examination; semen analysis; and transrectal ultrasound evaluation (limited to patients with CBP and IBS or CBP alone). A significantly higher frequency of MAGI was found in patients with CBP plus IBS (82.0%) compared with patients with CBP alone (53.6%) or fertile men (0%). The presence of MAGI in patients with CBP plus IBS was associated with a significantly lower sperm concentration, total number, and forward motility, and with a higher seminal leukocyte concentration compared with patients with CBP alone and MAGI. Sperm normal morphology was similar in the groups of patients. All sperm parameters did not differ significantly in both groups of patients without MAGI. With ultrasound evaluation, a significantly higher frequency of dilatation of prostatic venous plexus was found in patients with CBP plus IBS (75%) compared with patients with CBP alone (10%). Patients with CBP plus IBS had a significantly higher frequency of MAGI compared with patients with CBP alone. This was associated with worse sperm parameters and, hence, poorer reproductive prognosis. We suggest searching for the presence of IBS in patients with prostatitis syndrome, in particular when CBP and/or worse sperm parameters are present. Finally, this is the first observation on ultrasound examination of the anatomical space between the posterior wall of the prostate and the anterior wall of the rectum reported in patients with CBP and IBS. Further studies should clarify the meaning of the ultrasound findings.