Chronic Prostatitis – What Should You Know About It?

Prostate gland is a small but significant male sexual gland which is about the size of a walnut. The prostate gland secretes a fluid as part of its normal metabolic functions. This fluid forms a major component of the semen; thus providing nourishment to the sperms.

However, in some undesired situations, the glandular tissue becomes inflamed. This process is referred to as prostatitis.

What Is Chronic Prostatitis?

Traditionally, the glandular inflammation is a rather trivial and easily treatable situation and is therefore referred to as acute bacterial prostatitis. Acute prostatitis can be managed by taking antibiotics. A more complex form of this condition is chronic prostatitis. Although, chronic prostatitis is more common than acute, it is also more difficult to diagnose and treat this condition properly.

Chronic prostatitis is very frequently linked with male fertility issues and occurs in about 9% men (aged 18 or above). Chronic prostatitis itself is divided into sub-types and not all of clinical types are associated with infertility in men.

Types Of Chronic Prostatitis

It is very important to identify the type and cause of bacterial prostatitis in order to diagnose and manage the symptoms and minimize the risk of complications.

• Chronic bacterial prostatitis

The pathophysiology revolves around untreated or poorly managed acute bacterial attack on the gland. In some cases, this variety may not even respond to traditional antibiotic therapy.

• Chronic Pelvic Pain Syndrome

It is one of the most common cause of chronic prostatitis. Unfortunately, the exact pathophysiology in most cases in not clear. What makes it least understandable is that it occurs without any evidence of bacterial involvement.

• Asymptomatic inflammatory prostatitis

As the name indicates, this type does not present with any symptoms and is usually diagnosed during the infertility assessment (especially if the percentage of white blood cells in semen are significantly high without any noticeable complaints).

It is believed that if the percentage of white blood cells increases in the semen, the risk of infertility rises significantly. This also means that except chronic pelvic pain syndrome, the other two clinical types may cause fertility problems.

How Fertility Is Affected Due To White Blood Cells?

White blood cells also known as leukocytes are an important part of your immune system. These cells help in fighting against the infection causing pathogens. However, when these fighter cells are mixed with semen, the quality of sperms along with their motility suffers a great deal. The exact reason why leukocytes impair sperm’s functions is not clear but the most possible mechanism is believed to be “reactive oxygen species”. These molecules are produced as a part of leukocyte disease fighting properties. In infertile men’s seminal fluid these molecules are found to be elevated by up to 40%.

Another likeable mechanism is formation of tissue scar on the prostate gland, due to prolong, untreated bacterial prostatitis. These scars block the pathway of sperms, thus not allowing them to flow in the semen.

Is Chronic Prostatitis Induced Infertility Curable?

Infertility due to chronic prostatitis is rare but removable. If the cause of infertility is bacterial inflammation, then antibiotics can be helpful in treating both inflammation and infertility. However, if leukocytes are the causative agents, without bacterial presence, then antioxidants may be beneficial in reversing the condition.

Vitamins A, C and E are antioxidants that are believe to protect the sperms from the damaging effects of oxygen reactive species. Antioxidants are abundantly found in some fruits and vegetables, grains and nuts. Besides natural sources, they are also available in form of nutritional supplements.

One third of male infertility cases are due to chronic prostatitis. But, infertility is a complex mechanism which depends upon several factors. Speak to your doctor if you are experiencing unexplained fertility for assessment of prostate functions.

References

• Zhang, R., Sutcliffe, S., Giovannucci, E., Willett, W. C., Platz, E. A., Rosner, B. A., ... & Wu, K. (2015). Lifestyle and risk of chronic prostatitis/chronic pelvic pain syndrome in a cohort of United States male health professionals. The Journal of urology, 194(5), 1295-1300.
• Bowen, D. K., Dielubanza, E., & Schaeffer, A. J. (2014). Chronic bacterial prostatitis and chronic pelvic pain syndrome. BMJ clinical evidence, 2015.
• Wagenlehner, F. M., van Till, J. O., Magri, V., Perletti, G., Houbiers, J. G., Weidner, W., & Nickel, J. C. (2013). National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) symptom evaluation in multinational cohorts of patients with chronic prostatitis/chronic pelvic pain syndrome. European urology, 63(5), 953-959.