Diagnosis of accessory gland infection and its possible role in male infertility.

The diagnosis of male adnexitis is difficult and the influence of this condition on fertility is still a matter of debate. With the intention to define diagnostic criteria a comprehensive study of biochemical and morphological features of semen, plus culture for microorganisms, was performed in patients who were assessed for infertility during a four year period. The following parameters were considered of diagnostic value: a) history of urogenital infection and/or abnormal rectal palpation. b) significant alterations in the expressed prostatic fluid and/or urinary sediment after prostatic massage. c) 1. Uniform growth of more than 10(3) pathogenic bacteria, or more than 10(4) non-pathogenic bacteria per ml, in culture of diluted seminal plasma. c) 2. Presence of more than 10(6) (peroxidase positive) leucocytes per ml of ejaculate. c) 3. Signs of disturbed secretory function of the prostate or seminal vesicles. The diagnosis of infection is accepted if either of the following combinations if found: a + b, a + c (1 or 2 or 3), b + c (1 or 2 or 3), c1 + c2, c1 + c3, c2 + c3.