[Infections and male infertility]. / Infections et infertilité masculine.

BACKGROUND: The role of urogenital infections in male infertility has long been the subject of debate. METHODS: A bibliographic search limited to English-language literature on human subjects published before 5/2023 resulted in the selection of 189 articles. RESULTS: Male infertility is often of multifactorial aetiology, and to optimise the prognosis it is important to manage all the factors that can be corrected, including infectious causes, which represent one of the most frequent aetiologies. The infectious agents involved in urogenital infections are most often bacterial or viral, and more rarely parasitic. They can infect the seminal tract, male accessory glands and/or testicles, and usually result in inflammation and increased oxidative stress. These infections reduce male fertility, in particular by altering spermogram parameters and increasing sperm DNA fragmentation. For these reasons, the search for a urogenital infection should be systematic, involving a careful history and clinical examination, ultrasound and systematic bacteriological tests guided by clinical findings. Aetiological treatment may be proposed depending on the picture and the germ involved. CONCLUSION: This review should help the urologist to establish an accurate diagnosis of the form and extent of the infection, and enable him to define an appropriate therapeutic strategy, tailored to the patient, in order to obtain the best chances of improving male fertility.

Scrotal orchidopexy for perineal ectopic testis.

Perineal ectopic testis (PET) is a rare form of testicular migration abnormality. We report a case of neonatal PET diagnosis and early management. In reported cases, diagnosis is often late, well after the age of 1 year, and surgery is conventionally performed by an inguinal and scrotal approach. Here, surgery consisted of scrotal orchidopexy, with placement in the dartos, at the age of 6 months. Follow-up was uncomplicated. This approach has not been reported for this form of ectopy, but seems perfectly suitable. There is no advantage to delaying the treatment of this type of ectopy.