Correction of infertility in patients with chronic abacterial prostatitis using hypercapniic hypoxia

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Abstract

Aim. To evaluate the effect of basic therapy for CPPS/chronic prostatitis of category IIIA in combination with hypercapnic hypoxia on ejaculate, as well as to describe changes in hemodynamic and microcirculatory properties of the prostate.

Materials and methods. A total of 30 men with a lack of conception in marriage due to chronic abacterial prostatitis of category IIIA were included in the study. Depending on the treatment, patients were divided into 2 groups. In the group 1, patients received basic drug therapy, while in the group 2, an additional breathing training was carried out, which is based on the effect of hypercapnic hypoxia. The main parameters of the ejaculate (concentration, progressive sperm motility, morphology, DNA fragmentation index) and microcirculatory features in the prostate were analyzed using a LAKK-2 laser analyzer. In addition, hemodynamic parameters of the prostate were studied using Doppler ultrasound. All diagnostic studies were carried out at baseline and 90 days after the end of therapy, followed by statistical processing of the results.

Results. There were changes in a median of ejaculate, microcirculation and hemodynamic parameters after treatment compared to baseline in groups 1 and 2, including sperm concentration (3 million/ml vs. 12 million/ml; p=0.021), progressive motility (3 % vs. 15%; p=0.03), normal morphology (0.5% vs. 2%; p=0.04), sperm DNA fragmentation (0.5% vs. 13%; p=0.001), average blood flow (1.16 perf. units vs. 3.44 perf. units; p<0.001), microcirculation efficiency index (0.17 units vs. 0.64 units; p<0.001), bypass index (0.25 units vs. 0.52 units; p<0.001), peak systolic blood flow velocity (0.8 cm/s vs. 3.62 cm/s; p<0.001), resistance index (0.08 vs. 0.12 cm/s; p<0.001).

Conclusion. Basic drug treatment of CPPS/chronic prostatitis of category IIIA in combination with hypercapnic hypoxia have a positive effect on the clinical course manifestations, and also significantly improve the fertile properties through the correction of microcirculatory and hemodynamic insufficiency.

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About the authors

B. A. Neymark

Altai State Medical University of the Ministry of Health of Russia; NUZ KB “RJD-Medicine”

Email: neimark.b@mail.ru

Ph.D., MD, Professor of the Department of Urology and Andrology with a course of Specialized Surgery

Russian Federation, Barnaul; Barnaul

D. V. Borisenko

NUZ KB “RJD-Medicine”

Author for correspondence.
Email: borisenkodmitry093@gmail.com

urologist at the Department of Urology 

Russian Federation, Barnaul

А. I. Neymark

Altai State Medical University of the Ministry of Health of Russia

Email: urologagmu@mail.ru

Ph.D., MD, professor, Head of the Department of Urology and Andrology with a course of Specialized Surgery 

Russian Federation, Barnaul

N. A. Nozdrachev

Altai State Medical University of the Ministry of Health of Russia; NUZ KB “RJD-Medicine”

Email: Nozdrachevuro@mail.ru

Ph.D., associate professor at the Department of Urology and Andrology with a course of Specialized Surgery

Russian Federation, Barnaul; Barnaul

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Supplementary files

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2. Fig. 1. Laser flowmetry of the prostate projection zone of a healthy man A-LDF-gram. B-amplitude-frequency histogram.

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3. Fig. 2. Laser flowmetry of the projection zone of the prostate gland of a patient with CAP A-LDF-gram. B-amplitude-frequency histogram.

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