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Medical Forum / Diseases and Disorders / Prostatitis / October 2003Andrologia Part 1
The journal Andrologia has a series of review articles in their Oct 2003 edition. By the titles and authors I am guessing that these come from the Giessen conference on infertility and prostatitis. Here are the titles of the review articles: you don't get much in the way of data or conclusions from the abstracts: Naber KG, Sorgel F. Antibiotic therapy - rationale and evidence for optimal drug concentrations in prostatic and seminal fluid and in prostatic tissue. Andrologia. 2003 Oct;35(5):331-5. PMID: 14535866 [PubMed - in process] Everaert K, Mahmoud A, Depuydt C, Maeyaert M, Comhaire F. Chronic prostatitis and male accessory gland infection - is there an impact on male infertility (diagnosis and therapy)? Andrologia. 2003 Oct;35(5):325-30. PMID: 14535865 [PubMed - in process] Dohle GR. Inflammatory-associated obstructions of the male reproductive tract. Andrologia. 2003 Oct;35(5):321-4. PMID: 14535864 [PubMed - in process] Papp GK, Kopa Z, Szabo F, Erdei E. Aetiology of haemospermia. Andrologia. 2003 Oct;35(5):317-20. PMID: 14535863 [PubMed - in process] Potts JM, Pasqualotto FF. Seminal oxidative stress in patients with chronic prostatitis. Andrologia. 2003 Oct;35(5):304-8. PMID: 14535860 [PubMed - in process] Hochreiter WW. Male accessory gland infection: standardization of inflammatory parameters including cytokines. Andrologia. 2003 Oct;35(5):300-3. PMID: 14535859 [PubMed - in process] Menkveld R, Huwe P, Ludwig M, Weidner W. Morphological sperm alternations in different types of prostatitis. Andrologia. 2003 Oct;35(5):288-93. PMID: 14535857 [PubMed - in process] Punab M, Loivukene K, Kermes K, Mandar R. The limit of leucocytospermia from the microbiological viewpoint. Andrologia. 2003 Oct;35(5):271-8. PMID: 14535854 [PubMed - in process] Krieger JN, Ross SO, Deutsch L, Riley DE. Seminal fluid analysis in chronic prostatitis/chronic pelvic pain syndrome. Andrologia. 2003 Oct;35(5):266-70. PMID: 14535853 [PubMed - in process] Good job there Pub - can I call you by your first name? These articles sound interesting hope that something more detailed comes out in PubMed. I would recommend to all sufferers - get a semen analysis done, especially if your semen has undergone a major change. You may be infertile. This may be temporary as your prostatic secretions may be toxic to sperm. Something like: >Seminal fluid analysis in chronic prostatitis/chronic pelvic pain >syndrome. >Andrologia. 2003 Oct;35(5):266-70. >PMID: 14535853 [PubMed - in process] would be interesting to read. The following was presented at the International Prostatitis and Fertility Meeting in Giessen, Germany, September, 2002: CYTOLOGIC COMPARISON OF SEMEN AND EXPRESSED PROSTATIC SECRETIONS FROM PATIENTS WITH CHRONIC PROSTATITIS John W. Polacheck, Tucson, AZ, L. Eduardo Vega The Prostatitis Center and Carondelet St. Joseph’s Hospital: Tucson, AZ, U.S.A. Introduction: We decided to compare semen and expressed prostatic secretions (EPS) from patients with chronic prostatitis using cytopathologic techniques in order to learn more about the pathophysiology of this disorder. Methods: In patients with signs and symptoms of chronic prostatitis, we compared the cytopathology of their expressed prostatic secretions (EPS) obtained by prostatic massage to that of their semen obtained by ejaculation. Ten patients were studied (mean age 42 years, range 29-66). Semen was collected shortly after patients woke-up in the morning, and in each case they were instructed to void before collecting their sample. Immediately after obtaining the sample, 35 ml of preservative (50 percent isopropyl alcohol) was added, and the mixture was kept cool. Smears and cell blocks were prepared and staining was done with a modified Wright's, PAS, H&E and Papanicolau stains. For the EPS, two slides were made and stained with a modified Wright's stain and PAS. Results: In 8 cases (80%), the EPS showed signs of acute inflammation, containing both individual polymorphonuclear leukocytes (PMNs) and cohesive aggregates of PMNs. We call these aggregates "PIAs", prostatic inflammatory aggregates. By sharp contrast, the semen from all the patients showed either no findings of inflammation (no PMNs nor PIAs) or only very mild changes (rare PMNs). In this small series, we did not observe PIAs in semen. Conclusion: Our observations suggest that the muscular force of ejaculation is not sufficiently strong to express PIAs from the prostate, at least in the majority of patients with chronic prostatitis. PIAs can, however, be expressed by digital-rectal prostate massage. This provides objective evidence that digital-rectal massage of the prostate has a beneficial effect in patients with chronic Prostatitis. Furthermore, we see only scanty amounts of PAS positive protein in the total ejaculate specimens whereas it is prominent in EPS specimens. This suggests the total ejaculate of prostatitis patients contains only a minimal amount of prostate secretions. These observations have implications pertaining to fertility in patients with untreated chronic Prostatitis. > Good job there Pub - can I call you by your first name? > [quoted text clipped - 13 lines] > > would be interesting to read. > Semen was collected shortly after patients woke-up in the morning, and For a guy who supposedly makes his living mainly from doing prostatic massage, one would think you'd enlighten us also on the timing and method of collecting the EPS sample. OR DID I MISS SOMETHING? The EPS samples were obtained by prostate massage...... JWP >Oldbie wrote: > > Semen was collected shortly after patients woke-up in the morning, and > > For a guy who supposedly makes his living mainly from doing prostatic massage, one would think you'd > enlighten us also on the timing and method of collecting the EPS sample. > > OR DID I MISS SOMETHING? >The EPS samples were obtained by prostate massage...... JWP Duh? "John W. Polacheck, M.D." Do you think it is important, in your role as an emdee, whether these were taken before or after the semen samples, and how long before or after, or are you being conspicuously terse here because you do not want us to come to any conclusions other than your own ????????????????????????????? In this small series which I posted above (earlier this morning), the EPS samples (obtained by prostate massage) were taken a "few" hours (3-6 hours) after the semen samples were obtained. In all cases, the patients voided urine (to "clean" the urethra) at least two times after collecting the semen samples, before the prostate massages. In a previous report (which I will repost here soon) we compared EPS samples and semen samples using the following protocol (a "sandwich"): Day #1 - - - EPS was obtained by prostate massage. Day #2 - - - semen was collect by ejaculation Day #3 - - - EPS was collected again by another prostate massage The results of that study showed inflammation (WBCs and PIAs) in the EPS samples, and essentially no inflammation in the semen (only sperm). By the way, we believe that PIAs (prostate inflammatory aggregates) are "specific" (pathognomonic) for prostatitis - - - in other words, they can only be observed in the EPS when a patient has prostatitis. I hope that this answers your question(s). Do you have any further comments or questions ??? Yours, John Polacheck, M.D. Medical Director Prostatitis Center Tucson, Arizona >Oldbie wrote: > [quoted text clipped - 7 lines] > semen samples, and how long before or after, or are you being conspicuously terse here because you > do not want us to come to any conclusions other than your own ????????????????????????????? We do, in fact, welcome feedback. Copied here (below) is an abstract which we presented at the NIH International Prostatitis Collaborative Network Conference Meeting in Washington, D.C in October, 2000. This study is quite similar to the one which I posted on this Newsgroup on 10/18/2003 at 5:52 AM. Although the methods and results are nearly the same, we were looking at the data from a different perspective and our conclusions, therefore, were somewhat different. Yours, John Polacheck, M.D. Medical Director Prostatitis Center Tucson, Arizona E-mail: jpolacheck@earthlink.net ************************************************************************* A BENEFICIAL EFFECT OF PROSTATE MASSAGE FOR PATIENTS WITH CHRONIC PROSTATITIS: THE EXPRESSION OF INTRAGLANDULAR PROSTATIC INFLAMMATORY AGGREGATES (PIAs) J. W. Polacheck and L. E. Vega Prostatitis Center and Carondelet St. Joseph’s Hospital; Tucson, Arizona We decided to obtain objective evidence that digital-rectal massage of the prostate has a beneficial effect. The following study has been initiated. In patients with signs and symptoms of chronic prostatitis, we compared the cytopathology of their expressed prostatic secretions (EPS) obtained by prostatic massage to that of their semen obtained by ejaculations. We would like to report our preliminary findings from a small sample (N=10) of patients (mean age 42 years, range 29-66). Semen was collected shortly after patients woke up in the morning, and in each case they were instructed to void before collecting their sample. Immediately after obtaining the ejaculatory sample, 35 ml of preservative (50 percent isopropyl alcohol) was added, and the mixture was kept cool. Smears and cell blocks were prepared and staining was done with a modified Wright’s, PAS, H&E and Papanicolau stains. For the EPS, two slides were made and stained with a modified Wright’s stain and PAS. In eight (8) cases (80%), the EPS showed signs of acute inflammation, containing both individual polymorphonuclear leukocytes (PMNs) and cohesive aggregates of PMNs. We call these aggregates “PIAs” (prostatic inflammatory aggregates). By sharp contrast, the semen from all the patients showed either no findings of inflammation (no PMNs nor PIAs) or only very mild changes (rare PMNs). In this small series, we did not observe PIAs in semen. Our observations suggest that the muscular force of ejaculation is not sufficiently strong to express PIAs from the prostate, at least in the majority of patients with chronic prostatitis. PIAs can, however, be expressed by digital-rectal prostate massage. Further-more, we see scanty amount of PAS positive protein in the total ejaculate specimens whereas it is prominent in EPS specimens. This suggests the total ejaculate of prostatitis patients contains only a minimal amount of prostate secretions. Additional studies are in progress. ************************************************************************* >Oldbie wrote: > [quoted text clipped - 7 lines] > semen samples, and how long before or after, or are you being conspicuously terse here because you > do not want us to come to any conclusions other than your own ????????????????????????????? You are a friggen retard. >>The EPS samples were obtained by prostate massage...... JWP > [quoted text clipped - 8 lines] >do not want us to come to any conclusions other than your own >????????????????????????????? >The following was presented at the International Prostatitis and >Fertility Meeting in Giessen, Germany, September, 2002: [quoted text clipped - 66 lines] >> >> would be interesting to read. >These observations have >>implications pertaining to fertility in patients with untreated chronic >>Prostatitis. I have a basic question, several posters have asked about the consistency of their semen. In my case, the semen turned watery and alkaline. It stayed that way for about six months - clear water - mixed with some gel like substance on occasion. When I took Levaquin at about the six to eight month mile marker my ejaculation started to change - there was more of a consistency to it - but it was still gray in color and alkaline and low in volume. At the time I assumed that I was infertile due to the make up of my ejaculate - low volume, watery, gel like and alkaline. Four years later my ejaculate has returned to semi-normal (still a bit water and low volume but now mostly white in color) and I had my semen tested and I am fertile. My question is this - was I correct in my assumption that sperm could not live in the gray alkaline muck that was coming out of me at the time? What if anything can you attribute to the changes in consistency and volume of ejaculate? Some report that their ejaculate comes out watery and some say it is all clumpy. Adding to the mental torture of CP is the possibility of infertility. That is one reason I stuck with Levaquin even though I had signs of adverse reaction, because I was afraid of becoming infertile. Any comments on this subject would be welcome. >The following was presented at the International Prostatitis and >Fertility Meeting in Giessen, Germany, September, 2002: [quoted text clipped - 66 lines] >> >> would be interesting to read. |
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