Marko Vukovic

Semen analysis before and after antibiotic treatment of asymptomatic chlamydia‐ and ureaplasma‐related pyospermia

Pyospermia is the abnormally high concentration of white blood cells in human ejaculate, as caused by a bacterial infection. This study addresses the evaluation of the use of an antibiotic treatment in infertile patients who show asymptomatic pyospermia through the monitoring of semen analysis parameters. The study was carried out on 60 infertile patients who were diagnosed with asymptomatic genital infections, focused on pyospermia caused by Chlamydia trachomatis and Ureaplasma urealyticum. The volume of the ejaculate, pH, sperm concentration and progressive motility, as well as the viability of the spermatozoa and their morphology, were all observed before therapy, 10 and 30 days after. Patients were treated with antibiotics in accordance with the recommendations given by the European Urology Association. The results showed a clear effect of antibiotic therapy on the volume and pH of the seminal fluid; moreover, only 30 days after completion of the therapy sperm concentration itself significantly increased, and progressive motility greatly improved, albeit slowly. However, it must be noted that the antibiotic therapy had no significant effect on the viability of the spermatozoa within 30 days of beginning the treatment.

The therapeutic potential of royal jelly in benign prostatic hyperplasia. Comparison with contemporary literature.

Abstract The aim of this study is to establish the scientific benefit of royal jelly (RJ) on prostatic-specific antigen (PSA), post-void residual (PVR) volume and International Prostate Symptom Score (IPSS) in benign prostatic hyperplasia. For the study, a group of 40 men were administered 38 mg of RJ over a period of three months, their PSA values, prostate volumes and the volumes of their transitory prostate zones, PVR and IPPS values were measured at the end of the first month, and at the end of the third month. The results of this study confirm the potential of RJ in reducing PSA scores and improving IPSS values. Since the use of RJ did not lead to any significant reduction in PVR, prostate volume, or to any involution of the transitory zone, it appears that it may only affect the blood marker of prostatic hyperplasia and to improve quality-of-life (QoL) in those patients. Overall, in comparison to phytotherapy and conventional therapy, RJ had similar positive effects on QoL in patients with BPH, however it exhibited markedly better effects on reducing PSA levels in blood. The therapeutical use of RJ exhibited no side effects.

Comparison of the efficiency of combined extracorporeal shock-wave therapy and triple therapy versus triple therapy itself in Category III B chronic pelvic pain syndrome (CPPS)

Abstract The aim of this study is to determine the effect of combining extracorporeal shock-wave therapy (ESWT) and triple therapy versus triple therapy alone, when treating Category III B chronic prostatitis (CPPS). Study included 60 patients, classified as having CPPS, divided into two groups: the first group numbered 30 patients, who were treated with a combination of an α-blocker, an anti-inflammatory agent and a muscle relaxant; the second group consisted of 30 patients who received a combination of ESWT and the fore-mentioned triple therapy. Patients were treated for 12 weeks. The primary criterion of a response to therapy was scoring 2 or less on the NIH-CPSI quality of life item, while the secondary criterion of a response to therapy was a greater than a 50% reduction in NIH-CPSI pain score. Patients who received triple therapy did not show a significant change neither in post void residual urine (PVR) nor in maximum flow rate (QMAX), while the second group of patients exhibited significant improvement in both PVR and QMAX values. Both groups of patients showed statistically significant improvement in all items of the NIH-CPSI score after the treatment, with significantly better results in the second group.

Vacuum erection device in treatment of organic erectile dysfunction and penile vascular differences between patients with DM type I and DM type II.

Abstract The aim of this study is to investigate changes in the vascular system and hemodynamics between patients with organic erectile dysfunction (ED) (DM type I and II), as well as to compare the quality of sexual life between those two groups after the treatment with vacuum erection device (VED). Study enrolled 50 males with DM, aged from 35 to 67 years, who have attended the urologic clinic due to inability to attain and maintain an erection of the penis sufficient to permit satisfactory sexual intercourse. Patients were using VED and six months later were assessed for therapy results. The International Index of Erectile Function (IIEF) was used to quantify erectile dysfunction. Alprostadil injection test was also used, with Doppler color flow imaging system, to evaluate the peak systolic velocity (PSV) and diameter of cavernosal artery (DCA). Significantly higher values of PSV were obtained in patients with DM type II. Also, DCA showed significant difference between two groups of patients. There was significant improvement in three items of IIEF after six months of treatment among both groups of examinees. Patients with DM type I had more serious risk for development of arteriogenic ED. VED could be a good alternative therapy for patients who denied peroral therapy.

Comparison of Sperm Parameters in Patients with Infertility Induced by Genital Infection versus Varicocele

BACKGROUND Male infertility is a common and complex problem and, despite much research in this field, the major cause of infertility unfortunately remains unknown. Genital infection and varicocele are important causes of infertility. AIMS To compare the influence of genital infection and varicocele individually on male infertility based on semen analysis. STUDY DESIGN Cross-sectional study. METHODS The study included 120 infertile patients divided into two groups according to the presence of genital infection or varicocele. The first group included 60 examinees with proven genital infection, but without varicocele formation. The second included 60 patients with varicocele, regardless of the varicocele grade, but without genital infection. The fertile parameters were compared and an assessment was performed on the impact on quality of spermatogenesis due to infection and varicocele. RESULTS There is a statistically significant difference regarding abnormal forms of spermatozoids (45.94±9.79 vs. 25.27±6.54) and progressive motility (8.15±1.24 vs. 24.95±7.2), between two groups of patients. However, acidity of ejaculates, minimum sperm concentration, total spermatozoid motility and ejaculate volume showed no statistically significant difference. CONCLUSION The study showed a stronger negative influence of genital infection on fertile parameters over varicocele. The significance of our study is the lack of contemporary researches comparing varicocele and genital infection influence on male infertility individually.

Effectiveness of antibiotic treatment in infertile patients with sterile leukocytospermia induced by tobacco use

ABSTRACT Our study investigated whether antibiotic therapy in infertile tobacco users with sterile leukocytospermia and a history of former sexual transmitted disease (STD) has an advantage over cessation of smoking alone. For this study, 80 male infertile smokers were divided into two subgroups. The first group numbered 40 patients treated with a two week course of doxycycline, 100 mg, twice daily, while the second group simply ceased smoking. A control group of 20 patients with chronic abacterial prostatitis (CPPS III a) were treated with the same antibiotic for two weeks. Patients from the first group exhibited significantly higher values in semen volume, total motility, and progressive motility of spermatozoa, when compared with the second group, two weeks post treatment. The latter two measures persisted during the 12 week follow up period. In both groups of patients, the correlation coefficient between the number of leukocytes and progressive motility was determined as statistically significant. However, in the control group the correlation was not statistically significant; however progressive motility, total motility, and vitality were significantly improved after a two week course of antibiotics. Our study implies that antibiotic treatment is perhaps effective in treating sterile leukocytospermia in smokers with a former STD and is a more effective treatment option in improving sperm parameters over smoking cessation alone. Abbreviations: STD: sexual transmitted disease; CPPS IIIa: chronic abacterial prostatitis; PSA: prostatic specific antigen; EPS: expressed prostatic secretion; WBC: white blood count; LUTS: lower urinary tract symptoms; PPMT: pre-massage and post-massage urine test; VAS: visual analogue scale