Decline of seminal parameters in middle-aged males is associated with lower urinary tract symptoms, prostate enlargement and bladder outlet obstruction.

PURPOSE We aimed to compare the associations between semen quality, associated reproductive indicators and the main prostate-related parameters in middle-aged men. MATERIALS AND METHODS This is a prospective study on 422 middle-aged men who underwent the screening for prostate health. Their reproductive function, semen quality and prostate-related pathologies were investigated. RESULTS Significant associations between semen quality and prostate-related parameters could be seen. Total sperm count and sperm density decreased along with the increase of the I-PSS score and total prostate volume. Also, the related lower urinary tract characteristics showed a negative correlation with main semen parameters for all investigated subjects. No significant differences in age, testicular size, and hormonal parameters were found between the subjects with or without lower urinary tract symptoms and prostate enlargement. CONCLUSIONS Our study suggests that altered seminal parameters in middle-aged men are associated with LUTS, prostate enlargement and/or bladder outlet obstruction. Although the assessments of prostate and lower urinary tract symptoms may not replace the semen parameters evaluating the male reproductive status, there is a need for further and more detailed investigations about the pathways behind these associations as well as possible related conditions.

[1]  P. Korrovits,et al.  Reproductive function in middle‐aged males: healthy men versus male partners of infertile couples , 2014, Andrologia.

[2]  K. Jarvi,et al.  Steps in the investigation and management of low semen volume in the infertile man. , 2013, Canadian Urological Association journal = Journal de l'Association des urologues du Canada.

[3]  P. Korrovits,et al.  Semen quality and associated reproductive indicators in middle-aged males: the role of non-malignant prostate conditions and genital tract inflammation , 2013, World Journal of Urology.

[4]  S. Kaplan,et al.  Optimizing the management of benign prostatic hyperplasia , 2012, Therapeutic advances in urology.

[5]  A. Stewart,et al.  Fertility concerns for the aging male. , 2011, Urology.

[6]  C. Roehrborn,et al.  Clinical outcomes after combined therapy with dutasteride plus tamsulosin or either monotherapy in men with benign prostatic hyperplasia (BPH) by baseline characteristics: 4‐year results from the randomized, double‐blind Combination of Avodart and Tamsulosin (CombAT) trial , 2011, BJU international.

[7]  A. Vikram,et al.  Insulin-resistance and benign prostatic hyperplasia: the connection. , 2010, European journal of pharmacology.

[8]  G. Berglund,et al.  Male infertility and prostate cancer risk: a nested case–control study , 2010, Cancer Causes & Control.

[9]  Thomas J Walsh,et al.  Increased risk of high‐grade prostate cancer among infertile men , 2010, Cancer.

[10]  W. Hellstrom,et al.  Ejaculatory dysfunction and its association with lower urinary tract symptoms of benign prostatic hyperplasia and BPH treatment. , 2009, Urology.

[11]  M. Emberton,et al.  Benign prostatic hyperplasia as a progressive disease: a guide to the risk factors and options for medical management , 2008, International journal of clinical practice.

[12]  J. Parsons,et al.  Physical activity, benign prostatic hyperplasia, and lower urinary tract symptoms. , 2008, European urology.

[13]  K. Korach,et al.  The role of estrogens and estrogen receptors in normal prostate growth and disease , 2008, Steroids.

[14]  D. Baird,et al.  Reduced Fertility Among Overweight and Obese Men , 2006, Epidemiology.

[15]  P. Korrovits,et al.  The Estonian version of the National Institutes of Health chronic prostatitis symptom index , 2006, Andrologia.

[16]  K. McVary.  Lower urinary tract symptoms and sexual dysfunction: epidemiology and pathophysiology , 2006, BJU international.

[17]  L. Gianaroli,et al.  Fertility and ageing. , 2005, Human reproduction update.

[18]  T. Kirkwood,et al.  Understanding the Odd Science of Aging , 2005, Cell.

[19]  S. Lambert,et al.  The male biological clock , 2004, World Journal of Urology.

[20]  T. K. Jensen,et al.  Body mass index in relation to semen quality and reproductive hormones among 1,558 Danish men. , 2004, Fertility and sterility.

[21]  David Handelsman,et al.  Sperm output of older men. , 2004, Human reproduction.

[22]  C. Roehrborn,et al.  Efficacy and safety of dutasteride in the four-year treatment of men with benign prostatic hyperplasia. , 2004, Urology.

[23]  E. Nieschlag,et al.  Age‐related disease pattern in infertile men: increasing incidence of infections in older patients , 2002, Andrologia.

[24]  D. Lamb,et al.  World Health Organization Laboratory Manual for the Examination of Human Semen and Sperm‐Cervical Mucus Interaction, 4th ed. , 2000, Journal of Andrology.

[25]  R. Meacham,et al.  Fertility and the aging male. , 2011, Reviews in urology.

[26]  E. Nieschlag,et al.  Paternal age and reproduction. , 2010, Human reproduction update.

[27]  E. Nieschlag,et al.  Andrology : male reproductive health and dysfunction , 2001 .

[28]  C. Roehrborn,et al.  Management of benign prostatic hyperplasia. , 1997, Annual review of medicine.