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S20 The prevalence and correlatioin of seminal elastase and sperm parameters in infertile men
S20
The prevalence and correlatioin of seminal elastase and sperm parameters in infertile men Eur Urol Suppl 2013;12;e1128
Andrejevic V., Djordjevic D., Lalic N., Vukovic I., Dragicevic S., Micic S. Urology Clinic, Clinical Centre Of Serbia, Dept. of Urology, Belgrade, Serbia INTRODUCTION & OBJECTIVES: The association between genital tract infection and abnormal semen parameters such as oligospermia, oligoasthenospermia, azoospermia, increased antisperm antibodies, is accepted by World Health Organisation (WHO 2004).The significance of leukocytes in semen samples is controversial (Aitiken and Baker 1995), but its presence is regarded as a indicator of genital tract infection. In many men with leukocytospermia, the condition will resolve without treatment (Yanushpolsky et al,1999) Wolf (2002) showed that 54 % of 100 men with leucocytospermia had completely negative semen microbiology and serology. Enzyme elastase particulary elastase-alfa- protease inhibitor complex has been suggested as a sensitive and quantitative marker of genital tract infection. The aim of the study was to correlate seminal elastase and seminal parameters. MATERIAL & METHODS: We analysed microbiological findings in 496 infertile men and also seminal elastase and spermogram. Seminal plasma elastase was measured by Elisa test (Merck). The values of elastase ranged from 80 to 1280 ng/ ml in the patients with confirmed genital tract infection (andological and microbiological examination). Cut off of the seminal elatase was 110 ng/ml (85% sensitivity, 61 % specificity by ROC curve ). In this study we anallysed : the semen was assessed according the WHO Manual (2012); leucocytes were deterimend using peroxidase test; the bacteriological exmqanination was done in patients with leucocytes >1mil/mL. RESULTS: In the whole group of 496 infertile men negative culture had 64% patients. In the those with positive sperm-culture 17% had 1 bacterial specie, 12% haad 2 and 7 % had 3 or more bacterial species.The most common bacteria were : Enterococcus faecalis, coagulase-negative Staphylococcus and species Streptococcus.. There is no significant difference (r=0.44; p>0.05) between the number of leucocytes in patinets with posistive culture ( 3.44-2.1 ng/mL) and with negative culture (2.95-2.9 ng/mL). The prevalence of increased seminal elastase was significicantly higher as compared to fertile men. High seminal elastase was observed in 26% infertile men without leucocytospermie. Correlation of seminal elastase concentration with age, of male partner, semen volume (r=0.0147; p<0.01), and seminal leucocytes (r=0.330; p<0.001) showed significant correlation, but not with duration of infertility, semen pH, sperm count and rapid spem motility and MARtest (antisperm antibodies) CONCLUSIONS: Seminal granulocyte elastase is a reliable screening test and good marker for silent genital tract inflammation and also elastase could be a useful tool in following patients after antibiotic therapy.
The prevalence and correlatioin of seminal elastase and sperm parameters in infertile men Eur Urol Suppl 2013;12;e1128
Andrejevic V., Djordjevic D., Lalic N., Vukovic I., Dragicevic S., Micic S. Urology Clinic, Clinical Centre Of Serbia, Dept. of Urology, Belgrade, Serbia INTRODUCTION & OBJECTIVES: The association between genital tract infection and abnormal semen parameters such as oligospermia, oligoasthenospermia, azoospermia, increased antisperm antibodies, is accepted by World Health Organisation (WHO 2004).The significance of leukocytes in semen samples is controversial (Aitiken and Baker 1995), but its presence is regarded as a indicator of genital tract infection. In many men with leukocytospermia, the condition will resolve without treatment (Yanushpolsky et al,1999) Wolf (2002) showed that 54 % of 100 men with leucocytospermia had completely negative semen microbiology and serology. Enzyme elastase particulary elastase-alfa- protease inhibitor complex has been suggested as a sensitive and quantitative marker of genital tract infection. The aim of the study was to correlate seminal elastase and seminal parameters. MATERIAL & METHODS: We analysed microbiological findings in 496 infertile men and also seminal elastase and spermogram. Seminal plasma elastase was measured by Elisa test (Merck). The values of elastase ranged from 80 to 1280 ng/ ml in the patients with confirmed genital tract infection (andological and microbiological examination). Cut off of the seminal elatase was 110 ng/ml (85% sensitivity, 61 % specificity by ROC curve ). In this study we anallysed : the semen was assessed according the WHO Manual (2012); leucocytes were deterimend using peroxidase test; the bacteriological exmqanination was done in patients with leucocytes >1mil/mL. RESULTS: In the whole group of 496 infertile men negative culture had 64% patients. In the those with positive sperm-culture 17% had 1 bacterial specie, 12% haad 2 and 7 % had 3 or more bacterial species.The most common bacteria were : Enterococcus faecalis, coagulase-negative Staphylococcus and species Streptococcus.. There is no significant difference (r=0.44; p>0.05) between the number of leucocytes in patinets with posistive culture ( 3.44-2.1 ng/mL) and with negative culture (2.95-2.9 ng/mL). The prevalence of increased seminal elastase was significicantly higher as compared to fertile men. High seminal elastase was observed in 26% infertile men without leucocytospermie. Correlation of seminal elastase concentration with age, of male partner, semen volume (r=0.0147; p<0.01), and seminal leucocytes (r=0.330; p<0.001) showed significant correlation, but not with duration of infertility, semen pH, sperm count and rapid spem motility and MARtest (antisperm antibodies) CONCLUSIONS: Seminal granulocyte elastase is a reliable screening test and good marker for silent genital tract inflammation and also elastase could be a useful tool in following patients after antibiotic therapy.