Journal of Endocrinological Investigation

, Volume 40, Issue 11, pp 1209–1218 | Cite as

Chronic prostatitis and its detrimental impact on sperm parameters: a systematic review and meta-analysis

  • R. A. Condorelli
  • G. Ivan Russo
  • A. E. Calogero
  • G. Morgia
  • S. La Vignera
Original Article



Prostatitis is a very common urogenital disease of the male with prevalence ranging from 2.2 to 9.7% worldwide. Interestingly, some recent evidences have showed a significant association between chronic prostatitis (CP) and male infertility including a detrimental effect on sperm parameters, reduction of zinc concentration on semen sperm and production of anti-semen antibodies (ASAs). The aim of the current meta-analysis was to evaluate the association between CP and alteration of semen parameters.


This analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines and we included in the final analysis 27 studies, with a total of 3241 participants, including 381 (11.75%) with chronic bacterial prostatitis (CBP), 1670 (51.53%) with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and 1190 (36.72%) controls.


CBP was associated with reduction of sperm concentration, sperm vitality, sperm total and progressive motility, while CP/CPPS was related to the reduction of semen volume, sperm concentration, sperm progressive motility and sperm normal morphology. We found that CP was significantly associated with reduced zinc concentration on seminal plasma (SMD: −20.73; p = 0.005). Finally, CP statistically increased the risk of developing ASA on seminal plasma (OR 3.26; p < 0.01).


In conclusion, chronic prostatitis showed a detrimental effect on sperm and both CPB or CP/CPPS may differently show negative impact on sperm.


Chronic prostatitis Chronic bacterial prostatitis Chronic prostatitis CP/CPSS Sperm Alterations Semen Meta-analysis 


Compliance with ethical standards

Conflict of interest

All authors declare no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed Consent

No informed consent.

Supplementary material

40618_2017_684_MOESM1_ESM.pptx (3 mb)
Suppl. Figure 1 Funnel plot showing publication bias for studies investigating (a) sperm concentration, (b) semen volume and (c) progressive total motility (PPTX 3066 kb)


  1. 1.
    Krieger JN, Lee SW, Jeon J, Cheah PY, Liong ML, Riley DE (2008) Epidemiology of prostatitis. Int J Antimicrob Agents 31(Suppl 1):S85–90. doi: 10.1016/j.ijantimicag.2007.08.028 CrossRefPubMedGoogle Scholar
  2. 2.
    Krieger JN, Nyberg L Jr, Nickel JC (1999) NIH consensus definition and classification of prostatitis. JAMA 282(3):236–237CrossRefPubMedGoogle Scholar
  3. 3.
    Fu W, Zhou Z, Liu S, Li Q, Yao J, Li W, Yan J (2014) The effect of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) on semen parameters in human males: a systematic review and meta-analysis. PLoS ONE 9(4):e94991. doi: 10.1371/journal.pone.0094991 CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Jiang Y, Cui D, Du Y, Lu J, Yang L, Li J, Zhang J, Bai X (2016) Association of anti-sperm antibodies with chronic prostatitis: a systematic review and meta-analysis. J Reprod Immunol 118:85–91. doi: 10.1016/j.jri.2016.09.004 CrossRefPubMedGoogle Scholar
  5. 5.
    La Vignera S, Condorelli R, Vicari E, D’Agata R, Calogero AE (2012) High frequency of sexual dysfunction in patients with male accessory gland infections. Andrologia 44(Suppl 1):438–446. doi: 10.1111/j.1439-0272.2011.01202.x CrossRefPubMedGoogle Scholar
  6. 6.
    Condorelli RA, Calogero AE, Vicari E, Favilla V, Cimino S, Russo GI, Morgia G, La Vignera S (2014) Male accessory gland infection: relevance of serum total testosterone levels. Int J Endocrinol 2014:915752. doi: 10.1155/2014/915752 PubMedPubMedCentralGoogle Scholar
  7. 7.
    La Vignera S, Condorelli RA, Vicari E, Tumino D, Morgia G, Favilla V, Cimino S, Calogero AE (2013) Markers of semen inflammation: supplementary semen analysis? J Reprod Immunol 100(1):2–10. doi: 10.1016/j.jri.2013.05.001 CrossRefPubMedGoogle Scholar
  8. 8.
    Zhang J, Wang Y, Zhou S (2004) Effect of chronic abacterial prostatitis on semen quality and efficacy of antibacterial agents. Zhonghua Nan Ke Xue 10(8):598–600PubMedGoogle Scholar
  9. 9.
    Zhao J, Dong X, Hu X, Long Z, Wang L, Liu Q, Sun B, Wang Q, Wu Q, Li L (2016) Zinc levels in seminal plasma and their correlation with male infertility: a systematic review and meta-analysis. Sci Rep 6:22386. doi: 10.1038/srep22386 CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Cooper TG, Noonan E, von Eckardstein S, Auger J, Baker HW, Behre HM, Haugen TB, Kruger T, Wang C, Mbizvo MT, Vogelsong KM (2010) World Health Organization reference values for human semen characteristics. Hum Reprod Update 16(3):231–245. doi: 10.1093/humupd/dmp048 CrossRefPubMedGoogle Scholar
  11. 11.
    Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med 6(7):e1000100. doi: 10.1371/journal.pmed.1000100 CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Wells GA, Shea B, O’Connell D, Peterson J, Welch V, Losos M, Tugwell P (2012) The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses.
  13. 13.
    Vicari E, La Vignera S, Arcoria D, Condorelli R, Vicari LO, Castiglione R, Mangiameli A, Calogero AE (2011) High frequency of chronic bacterial and non-inflammatory prostatitis in infertile patients with prostatitis syndrome plus irritable bowel syndrome. PLoS ONE 6(4):e18647. doi: 10.1371/journal.pone.0018647 CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Shang Y, Liu C, Cui D, Han G, Yi S (2014) The effect of chronic bacterial prostatitis on semen quality in adult men: a meta-analysis of case-control studies. Sci Rep 4:7233. doi: 10.1038/srep07233 CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Cui D, Han G, Shang Y, Mu L, Long Q, Du Y (2015) The effect of chronic prostatitis on zinc concentration of prostatic fluid and seminal plasma: a systematic review and meta-analysis. Curr Med Res Opin 31(9):1763–1769. doi: 10.1185/03007995.2015.1072707 CrossRefPubMedGoogle Scholar
  16. 16.
    Jungwirth A, Giwercman A, Tournaye H, Diemer T, Kopa Z, Dohle G, Krausz C, European Association of Urology Working Group on Male I (2012) European Association of Urology guidelines on Male Infertility: the 2012 update. Eur Urol 62(2):324–332. doi: 10.1016/j.eururo.2012.04.048 CrossRefPubMedGoogle Scholar
  17. 17.
    Lotti F, Corona G, Mondaini N, Maseroli E, Rossi M, Filimberti E, Noci I, Forti G, Maggi M (2014) Seminal, clinical and colour-Doppler ultrasound correlations of prostatitis-like symptoms in males of infertile couples. Andrology 2(1):30–41. doi: 10.1111/j.2047-2927.2013.00156.x CrossRefPubMedGoogle Scholar
  18. 18.
    Walczak-Jedrzejowska R, Wolski JK, Slowikowska-Hilczer J (2013) The role of oxidative stress and antioxidants in male fertility. Cent Eur J Urol 66(1):60–67. doi: 10.5173/ceju.2013.01.art19 CrossRefGoogle Scholar
  19. 19.
    Orhan I, Onur R, Ilhan N, Ardicoglu A (2001) Seminal plasma cytokine levels in the diagnosis of chronic pelvic pain syndrome. Int J Urol 8(9):495–499CrossRefPubMedGoogle Scholar
  20. 20.
    Penna G, Mondaini N, Amuchastegui S, Degli-Innocenti S, Carini M, Giubilei G, Fibbi B, Colli E, Maggi M, Adorini L (2007) Seminal plasma cytokines and chemokines in prostate inflammation: interleukin 8 as a predictive biomarker in chronic prostatitis/chronic pelvic pain syndrome and benign prostatic hyperplasia. Eur Urol 51(2):524–533; discussion 533. doi: 10.1016/j.eururo.2006.07.016
  21. 21.
    Hochreiter WW, Nadler RB, Koch AE, Campbell PL, Ludwig M, Weidner W, Schaeffer AJ (2000) Evaluation of the cytokines interleukin 8 and epithelial neutrophil activating peptide 78 as indicators of inflammation in prostatic secretions. Urology 56(6):1025–1029CrossRefPubMedGoogle Scholar
  22. 22.
    Lotti F, Maggi M (2015) Ultrasound of the male genital tract in relation to male reproductive health. Hum Reprod Update 21(1):56–83. doi: 10.1093/humupd/dmu042 CrossRefPubMedGoogle Scholar
  23. 23.
    Lotti F, Maggi M (2013) Interleukin 8 and the male genital tract. J Reprod Immunol 100(1):54–65. doi: 10.1016/j.jri.2013.02.004 CrossRefPubMedGoogle Scholar
  24. 24.
    Lotti F, Corona G, Vignozzi L, Rossi M, Maseroli E, Cipriani S, Gacci M, Forti G, Maggi M (2014) Metabolic syndrome and prostate abnormalities in male subjects of infertile couples. Asian J Androl 16(2):295–304. doi: 10.4103/1008-682X.122341 CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Rossato M, Galeazzi C, Ferigo M, Foresta C (2004) Antisperm antibodies modify plasma membrane functional integrity and inhibit osmosensitive calcium influx in human sperm. Hum Reprod 19(8):1816–1820. doi: 10.1093/humrep/deh317 CrossRefPubMedGoogle Scholar
  26. 26.
    Steen Y, Forssman L, Lonnerstedt E, Jonasson K, Wassen AC, Lycke E (1994) Anti-sperm IgA antibodies against the equatorial segment of the human spermatozoon are associated with impaired sperm penetration and subfertility. Int J Fertil Menopausal Stud 39(1):52–56PubMedGoogle Scholar
  27. 27.
    Bjorndahl L, Kvist U (2010) Human sperm chromatin stabilization: a proposed model including zinc bridges. Mol Hum Reprod 16(1):23–29. doi: 10.1093/molehr/gap099 CrossRefPubMedGoogle Scholar
  28. 28.
    Bjorndahl L, Kvist U (2011) A model for the importance of zinc in the dynamics of human sperm chromatin stabilization after ejaculation in relation to sperm DNA vulnerability. Syst Biol Reprod Med 57(1–2):86–92. doi: 10.3109/19396368.2010.516306 CrossRefPubMedGoogle Scholar
  29. 29.
    Jacobo P, Guazzone VA, Theas MS, Lustig L (2011) Testicular autoimmunity. Autoimmun Rev 10(4):201–204. doi: 10.1016/j.autrev.2010.09.026 CrossRefPubMedGoogle Scholar
  30. 30.
    Ausmees K, Korrovits P, Timberg G, Punab M, Mandar R (2013) Semen quality and associated reproductive indicators in middle-aged males: the role of non-malignant prostate conditions and genital tract inflammation. World J Urol 31(6):1411–1425. doi: 10.1007/s00345-013-1078-3 CrossRefPubMedGoogle Scholar
  31. 31.
    Colleen S, Mardh PA, Schytz A (1975) Magnesium and zinc in seminal fluid of healthy males and patients with non-acute prostatitis with and without gonorrhoea. Scand J Urol Nephrol 9(3):192–197CrossRefPubMedGoogle Scholar
  32. 32.
    Chen GB (1998) The effect of chronic bacterial prostatitis on the semen quality and function. Chin J Androl 12:78–81Google Scholar
  33. 33.
    Deng CH, Yang H, Mai GJ, Zhang XW, Zhang YJ, Feng HM, Li SQ (1992) The research of chronic prostatitis and antisperm antibody in serum and seminal plasma. J Androl 6:208–211Google Scholar
  34. 34.
    Evliyaoglu Y, Kumbur H (1995) Seminal plasma zinc analysis and bacteriological cultures in chronic staphylococcal prostatitis. Int Urol Nephrol 27(3):341–345CrossRefPubMedGoogle Scholar
  35. 35.
    Guan J, Meng L, Wang F (2002) A primary study of copper and zinc in semen of infertile men with chronic prostatitis. Guangdong Weiliang Yuansu Kexue 9:63–65Google Scholar
  36. 36.
    Henkel R, Ludwig M, Schuppe HC, Diemer T, Schill WB, Weidner W (2006) Chronic pelvic pain syndrome/chronic prostatitis affect the acrosome reaction in human spermatozoa. World J Urol 24(1):39–44. doi: 10.1007/s00345-005-0038-y CrossRefPubMedGoogle Scholar
  37. 37.
    Hoover P, Naz RK (2012) Do men with prostate abnormalities (prostatitis/benign prostatic hyperplasia/prostate cancer) develop immunity to spermatozoa or seminal plasma? Int J Androl 35(4):608–615. doi: 10.1111/j.1365-2605.2011.01246.x CrossRefPubMedGoogle Scholar
  38. 38.
    Hu XY, Xu YM, Qiao Y, Wu DL, Sa YL, Fu Q, Yu JJ, Zhang XR, Zhang J, Gu BJ, Chen R, Xie H (2007) Reduced semen quality in chronic prostatitis patients that induce the release of apoptotic protein Omi/HtrA2 from spermatozoa. Prostate Cancer Prostatic Dis 10(1):104–108. doi: 10.1038/sj.pcan.4500919 CrossRefPubMedGoogle Scholar
  39. 39.
    Hu XY, Xu YM, Qiao Y, Liu ZS, Song LJ, Li C (2008) Expression of Omi/HtrA2 UP-regulated in the spermatozoa of chronic bacterial prostatitis patients. Zhonghua Nan Ke Xue 14(1):47–50PubMedGoogle Scholar
  40. 40.
    Leib Z, Bartoov B, Eltes F, Servadio C (1994) Reduced semen quality caused by chronic abacterial prostatitis: an enigma or reality? Fertil Steril 61(6):1109–1116CrossRefPubMedGoogle Scholar
  41. 41.
    Li YH, Liu WS (1990) Relationship between seminal plasma fructose and trace elements and serum hormone profile in men with chronic prostatitis. J Androl 4:29–32Google Scholar
  42. 42.
    Liu RHG, Wan J, Du Y (2013) The value of prostate fluid zinc and CRP detection in the diagnosis and treatment of patients with chronic prostatitis. Chin J Gen Pract 11:11Google Scholar
  43. 43.
    Marconi M, Pilatz A, Wagenlehner F, Diemer T, Weidner W (2009) Are antisperm antibodies really associated with proven chronic inflammatory and infectious diseases of the male reproductive tract? Eur Urol 56(4):708–715. doi: 10.1016/j.eururo.2008.08.001 CrossRefPubMedGoogle Scholar
  44. 44.
    Mie PX (2009) The significance of the detection of sperm surface antisperm antibodies in patients with chronic prostatitis patients. Natl J Androl 15:750–751Google Scholar
  45. 45.
    Motrich RD, Maccioni M, Molina R, Tissera A, Olmedo J, Riera CM, Rivero VE (2005) Reduced semen quality in chronic prostatitis patients that have cellular autoimmune response to prostate antigens. Hum Reprod 20(9):2567–2572. doi: 10.1093/humrep/dei073 CrossRefPubMedGoogle Scholar
  46. 46.
    Motrich RD, Maccioni M, Ponce AA, Gatti GA, Oberti JP, Rivero VE (2006) Pathogenic consequences in semen quality of an autoimmune response against the prostate gland: from animal models to human disease. J Immunol 177(2):957–967CrossRefPubMedGoogle Scholar
  47. 47.
    Pasqualotto FF, Sharma RK, Potts JM, Nelson DR, Thomas AJ, Agarwal A (2000) Seminal oxidative stress in patients with chronic prostatitis. Urology 55(6):881–885CrossRefPubMedGoogle Scholar
  48. 48.
    Qin S, Zheng X, Li L (2005) The semen quality and function change of 154 cases of chronic prostatitis patients. Sichuan Med J 26:1430–1431Google Scholar
  49. 49.
    Wang W, Hu WL, Wang YL, Qiu XF, Yang H (2006) Seminal parameter analysis in noninflammatory chronic prostatitis/chronic pelvic pain syndrome. Zhonghua Nan Ke Xue 12(3):228–229, 233Google Scholar
  50. 50.
    Wang W, Ding G, Wang Q (2008) Analysis of zinc and acid phosphatase in seminal plasma of infertile male with chronic prostatitis. J Nongken Med 3:192–193Google Scholar
  51. 51.
    Weidner W, Jantos C, Schiefer HG, Haidl G, Friedrich HJ (1991) Semen parameters in men with and without proven chronic prostatitis. Arch Androl 26(3):173–183CrossRefPubMedGoogle Scholar
  52. 52.
    Yu J, Zhang YS (1992) Zinc and SOD activity in seminal plasma of chronic prostatitis patients. Chin J Urol 13:402–404Google Scholar
  53. 53.
    Zhang J, Zhang L, Meng L (1999) The research of seminal plasma zinc and SOD content in patients with chronic bacterial prostatitis. Jining Med Coll 22:26–27Google Scholar
  54. 54.
    Zhao H, Shen JH, Chen YP, Yu ZY, Dong Q, Li H (2008) Changes of seminal parameters, zinc concentration and antibacterial activity in patients with non-inflammatory chronic prostatitis/chronic pelvic pain syndrome. Zhonghua Nan Ke Xue 14(6):530–532PubMedGoogle Scholar

Copyright information

© Italian Society of Endocrinology (SIE) 2017

Authors and Affiliations

  1. 1.Unit of Andrology and Endocrinology, Department of Clinical and Experimental MedicineUniversity of CataniaCataniaItaly
  2. 2.Urology Section, Department of SurgeryUniversity of CataniaCataniaItaly

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