[Male urogenital amicrobial phlogosis: effects of the treatment with amtolmetin guacyl on some sperm parameters]. / Flogosi uro-genitali amicrobiche maschili: efficacia del trattamento con amtolmetina guacil su alcuni parametri spermatici.

To examine if some inflammation-related sperm abnormalities were influenced by leucocytospermia (sWBC) alone, WBC-specific Radical oxygen species (WBC-ROS) over-production, and/or by different infected sexual gland sites and if these abnormalities were possibly reversible following treatment with an antiphlogistic drug, a total of 43 infertile male patients with amicrobial male accessory gland infections (MAGI) associated with prostatitis (P, n = 16), prostato-vesiculitis (PV, n = 14) or prostato-vesiculo-epididymitis (PVE, n = 13) as confirmed by ultrasound, were studied. The patients were then further subdivided into two subsets: one of the subsets (P, n = 10; PV, n = 8; PVE, n = 7) was administered amtolmetina guacyl (Eufans) 600 mg once daily for 14 consecutive days per month, for a 2-months period. The second subset (six patients for each category) received no treatment (matched-control). Mean outcome measures included a follow-up of sperm analysis with assessment of sperm forward motility (M), sperm viability (V). In addition, sWBC as well as basal and maximal fMLP-mediated WBC-ROS production were also carried out by conventional immunocytochemistry staining and chemiluminescence analysis respectively. In the pre-treatment, in all patients (treated and not treated subsets) median values of the sperm M and V were significantly different among categories (P > PV > PVE), and necrozoospermia (sperm viability < 25%) were present in the 70% out of group P patients and in all (100%) patients from groups PV and PVE. Median sWBC concentrations, elevated (values > 1 mil/ml) in all groups, in the PV and PVE groups were significantly higher compared to those found in the group P. Furthermore, PVE group generated baseline and fMLP-stimulated ROS productions from low density 45% Percoll fraction (Pc45), significantly higher than those found in P or PV groups. Sperm outcome measures were significantly different compared with the matched-controls (exhibiting 0% case-responders), in a time- and infected gland site-dependent manner. Thus, either in terms of median values and percentages of responders (defined as parameters ensued within the conventional normal range) sperm M and V percentages, as well as sWBC improved after the first (T1) antiphlogistic course in the group P only, but after the second (T2) antiphlogistic course in the other groups (PV or PVE). Moreover, treated patients of each group had amounts of generated basal and fMLP-stimulated ROS signals significantly reduced, with values ensued within a fertile control range at T2, in 80, 62.5 and 42.8% out of the P, PV and PVE groups respectively. We concluded that long-term amtolmetina-guacyl administration demonstrated efficacy and safety in the treatment of amicrobial MAGI, exhibiting a positive impact on all sperm parameters studied and no side-effects.