Can sperm testing tell if there is prostate inflammation?

The most important thing for a man's body is the production of sperm and the occurrence of prostate diseases. When infertility occurs, both men and women need to be examined, and the problem examined for men is the sperm problem. Some people want to be examined for prostate disease, but they also need to be examined for semen problems. The two problems are more complicated, and I hope they can be examined at the same time to get the results. Can I only examine the sperm to see if there is prostate inflammation?

Prostatitis cannot be detected by semen examination.

Prostatitis refers to a prostate disease caused by a variety of complex reasons, with urethral irritation symptoms and chronic pelvic pain as the main clinical manifestations. Prostatitis is a common disease in urology, and ranks first among male patients under 50 years old in urology. Although the incidence of prostatitis is very high, its cause is still not very clear, especially non-bacterial prostatitis, so its treatment focuses on improving symptoms. In 1995, the National Institutes of Health (NIH) of the United States developed a new classification method for prostatitis, Type I: equivalent to acute bacterial prostatitis in the traditional classification method, Type II: equivalent to chronic bacterial prostatitis in the traditional classification method, Type III: chronic prostatitis/chronic pelvic pain syndrome, Type IV: asymptomatic prostatitis. Among them, non-bacterial prostatitis is far more common than bacterial prostatitis.

Check

1. Rectal examination

In type I prostatitis, rectal examination can reveal enlarged prostate, obvious tenderness, and increased local temperature. It should be noted that prostate massage should be avoided in acute prostatitis to prevent the spread of infection.

For type II and type III prostatitis, digital rectal examination can reveal the size, texture, presence of nodules, tenderness and its range and degree of the prostate, the tightness of the pelvic floor muscles, and tenderness of the pelvic wall. Prostate massage can obtain prostatic fluid for laboratory testing.

2. Routine examination of prostatic fluid (EPS)

Routine examination of EPS usually adopts wet image method and blood cell counting plate microscopy, the latter has better accuracy. The content of white blood cells in normal prostatic fluid sediment should be less than 10 per field of view under a high-power microscope. If the number of white blood cells in the prostatic fluid is >10/field of view, prostatitis is highly suspected, especially when fat-containing macrophages are found in the prostatic fluid, prostatitis can be basically confirmed. However, the number of white blood cells in the prostatic fluid of some patients with chronic bacterial prostatic fluid may be less than 10/field of view; some normal men have more than 10 white blood cells in their prostatic fluid/field of view. Therefore, the examination of white blood cells in prostatic fluid is only an auxiliary method for bacteriological examination of prostatic fluid.

3. Routine urine analysis and urine sediment examination

Routine urine analysis and urine sediment examination can be used to determine whether there is a urinary tract infection and is an auxiliary method for diagnosing prostatitis.

4. Bacteriological examination

The two-cup method or the four-cup method is commonly used. These methods are particularly suitable before antibiotic treatment. Specific methods: Before collecting urine, tell the patient to drink more water, and if the foreskin is too long, the foreskin should be turned up. After cleaning the glans penis and urethral opening, the patient urinates and collects 10ml of urine; after continuing to urinate about 200ml, 10ml of midstream urine is collected; then stop urinating, do prostate massage and collect prostate fluid; finally collect 10ml of urine again. Each specimen is examined microscopically and cultured separately. By comparing the number of bacterial colonies in the above specimens, it can be identified whether there is prostatitis or urethritis.

5. Other inspections

Patients with prostatitis may experience abnormal semen quality, such as leukocytosis, semen liquefaction, hematospermia and decreased sperm motility.

Ultrasound examination can reveal uneven prostate echo, prostate stones or calcification, and dilation of the venous clusters around the prostate.

Urine flow rate test can give a general understanding of the patient's urination status and help to distinguish between prostatitis and diseases related to urination disorders.

Diagnosis

The diagnosis can be made based on the patient's medical history, symptoms, rectal indications, prostatic fluid examination, and four-cup test results. Since prostatitis often develops from other infections in the body, such as urinary tract infection, seminal vesiculitis, epididymitis, and inflammation near the rectum, a comprehensive examination of the urogenital system and rectum is necessary when diagnosing prostatitis.