Physical analysis of ejaculate to evaluate the secretory activity of the seminal vesicles and prostate.

The purpose of this study was to ascertain whether analysis of the physical properties of ejaculate also has any diagnostic potential for evaluating the function of these accessory sex glands. Diverse normal and abnormal states of coagulation, liquefaction, volume, viscosity and pH were studied with regard to the levels of biochemical markers of the seminal vesicles (fructose and inorganic phosphorus) and prostate (calcium, zinc and acid phosphatase). Fructose and inorganic phosphorus were significantly decreased in samples with absent or poor coagulation (p<0.001), volume < 2.0 mL (p=0.009 and p<0.001, respectively), hypoviscosity (p=0.013 and p<0.001), hyperviscosity (p=0.006 and p<0.001) and pH < or = 7.1 (p=0.018 and p<0.001). Also, fructose and inorganic phosphorus were significantly decreased in samples with liquefaction > 120 min (p=0.003) and pH > 8.0 (p<0.001), respectively. Calcium, zinc and acid phosphatase activity were significantly increased in samples with absent or poor coagulation (p<0.001), and significantly decreased in samples with volume > 5.0 mL (p=0.007, p=0.034 and p=0.011) and pH > 8.0 (p<0.001). Also, calcium and zinc were significantly increased in hypoviscous samples (p=0.012 and p=0.003), whereas the zinc concentration was significantly lower in hyperviscous samples (p=0.026). Using receiver operating characteristic (ROC) curve analysis, pH showed the highest predictive power to identify prostate dysfunction (83.6%) and simultaneous prostate and seminal vesicle dysfunction (98.8%). Physical analysis of ejaculate was also found to be clinically useful for evaluating the secretory activity of the seminal vesicles and prostate. Abnormal coagulation, liquefaction, volume, viscosity and pH strongly suggest gland dysfunction.