What is the relationship between severity of chronic bacterial prostatitis (CBP) and erectile dysfunction?

Updated: Jan 15, 2019
  • Author: Samantha D Kraemer, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

A retrospective study suggested that a relationship exists between the severity of chronic prostatitis symptoms and erectile dysfunction frequency. Whether this relationship is mediated through organic or psychological mechanisms has remained unclear. [22] In a comparison of data from 317 patients with chronic bacterial prostatitis (CBP) due to C trachomatis and 639 patients with CBP caused by common uropathogenic bacteria, Cai and colleagues reported that patients with chlamydial CBP reported a higher prevalence of premature ejaculation and lower quality of life. [23]

Alkan et al reported that levels of superoxide anion and total reactive oxygen species (ROS) were significantly higher in the semen of men with category IIIA chronic prostatitis/chronic pelvic pain syndrome compared with healthy controls, and that those levels correlated negatively with scores on an erectile dysfunction questionnaire. These authors suggest that overproduction of superoxide anion and ROS could be one of the important mechanisms for erectile dysfunction in these patients. [68]

In a study of 110 infertile men with CBP, the 78 patients who responded to levofloxacin treatment (as indicated by eradication of bacteria from sperm cultures) showed showed a significant increase in sperm progressive motility and a significant decrease in seminal leukocyte count, seminal fluid viscosity, liquefaction time, reactive oxygen species production, and seminal tumor necrosis factor-α and interleukin-6 levels. None of those posttreatment variables were significantly different than those in a control group of 37 fertile men. In the patients with poor antibiotic responsiveness, however, all measured semen variables showed deterioration. [24]


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