Semen Analysis Of Varicocele With Chronic Prostatitis

Objective:To explore the effect of chronic prostatitis(CP)on sperm quality of patients with varicocele(VC)and male infertility(MI),and to analyze the correlation between the grading of VC and the grading of CP symptoms,so as to further increase understanding of the effect of VC and CP on male infertility.Methods and Objects:We selected 180 young patients(25-35 years old)who were hospitalized in the department of urology,andrology and reproductive center of our hospital from September 2018 to June 2019 due to infertility as the observation group,including 60 patients with simple VC and infertility,60 patients of infertility with VC and CP,60 patients with simple CP and infertility.They were named as the simple VC group,the combined group and the simple CP group,respectively;Meanwhile,60 healthy men of the same age without fertility diseases were selected as the control group in the physical examination center.And the important parameters of semen were analyzed and recorded.Using the statistical method of one-way ANOVA and SPSS 25.0 statistical software,we compared the five factors of semen liquefaction time,sperm concentration,sperm viability,sperm activity and sperm volume in each group,P<0.05 can be regarded as the difference of statistical significance.The patients in the combined group were divided into four grades(grade 0-III)according to guidelines for diagnosis and treatment of urological diseases in China.The CP was divided into three severity levels: mild,moderate and severe by the National Institute of Health-chronic prostatitis symptom index(NIH-CPSI).The correlation between the grading of varicocele and the symptoms of chronic prostatitis was analyzed by Spearman rank correlation.Results:1.The results of semen quality analysis:(1)Liquefaction time: there was no significant difference between the VC group and the control group(P=0.094);the liquefaction time of semen in the CP group and the combined group was significantly longer than that in the control group(P<0.05);The liquefaction time of the combined group was significantly longer than that of the simple VC group(P<0.05),and there was no significant difference between the combined group and the simple CP group(P =0.219).(2)Semen concentration: the semen concentration of the three observation groups was significantly different from that of the control group(P<0.05);the semen concentration of the combined group was statistically different from that of the simple CP group(P<0.05);there was no statistical difference between the combined group and the simple VC group(P=0.30).(3)Sperm viability: there was significant difference between the three groups and the control group(P<0.05);there was significant difference between the combined group and the simple VC group(P<0.05);there was also significant difference between the combined group and the simple CP group(P<0.05).(4)Sperm motility: the sperm motility of the three observation groups was statistically different from that of the control group(P<0.05);the sperm motility of the combined group was significantly different from that of the simple VC group;the sperm motility of the combined group was also significantly different from that of the simple CP group(P<0.05).(5)Semen quantity: there was no significant difference in semen quantity between different groups,and the statistical data was not statistically significant(F=1.582,P=0.194).2.The correlation between the grade of VC and the score of CP symptoms: there was a significant positive correlation between the grade of VC and the severity of CP symptoms(Rs=0.368,P<0.05).Conclusion:1.CP can prolong the time needed for semen liquefaction,and can cause the decrease of sperm concentration,viability and motility,but has little effect on semen quantity.2.VC can significantly affect the concentration of semen,sperm viability and motility,but not the liquefaction time and semen volume.3.VC combined with CP can further damage the quality of semen,further reduce the liquefaction time,sperm viability and motility,but have no obvious effect on the concentration and quantity of semen.4.There is a significant positive correlation between the clinical grade of VC and the severity of chronic prostatitis.If patients with VC have CP symptoms at the same time,with the increase of clinical grade of VC,the CP symptoms of patients will be further aggravated.