Ejaculate (semen) abnormalities in CPPS

Ejaculate is comprised of sperm, prostatic fluid (watery, 15-30%), urethral (Littre’s) and bulbourethral (Cowper’s) gland fluids (viscous, clear) and seminal vesicle fluid (gelatinous, 50-70% of volume). About 1.5-5 milliliters is the average. Anecdotal evidence indicates that semen gets yellowish and thicker or too watery and having a non-homogenous appearance in CPPS, especially during flares. Is this because of abnormal proportions of the various fluids or other causes ?

Ejaculate is slightly alkaline: pH 7.3-8.5 (variation is due to methodology and values as low as about 6.5 can be found in the literature). Higher pH is indicative of infection and too low pH impairs sperm motility. Some CPPS sufferers have high pH.

A small study has found that ejaculate citrate levels are depressed in NIH-II, IIIa and IIIb patients compared to controls. Interestingly NIH-II and IIIa sufferers had very similar levels 3.32 +/- 0.79 mg/ml and 3.41 +/- 0.88 (controls 8.55 +/- 1.20) indicating commonality. IIIb sufferers have intermediate values (4.37 +/- 0.77).(1)

Analyses have also shown decreased levels of magnesium, zinc, fructose(2), spermine, prostate anti-microbial factor (PAF) and other substances. There are also conflicting studies on seminal microflora. There is a case report of CPPS in conjunction with the presence of uric acid in the ejaculate.(3)

Ejaculate main composition: Zinc 0.352 ± 0.048 g/liter; Magnesium 0.120 ± 0.060 g/liter; Calcium 1.200 ± 0.080 g/liter; Citric acid 4.80 ± 26.9 g/liter; Cholesterol 0.078 ± 0.013 g/liter; Spermine 0.243 ± 0.025 g/liter; Lysozyme 0.021 ± 0.006 g/liter; Acid phosphatase 2.56 million IU per liter.(4)

Andra bloggar om CPPS, kroniskt bäckenbottensmärtsyndrom, prostata, ejakulat, sperma
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(1) Chen J, Xu Z, Zhao H, Jiang X. Citrate in expressed prostatic secretions has the feasibility to be used as a useful indicator of category IIIB prostatitis. Urol Int 78(3):230-234, 2007. The essentially same article was also published as Chen J, Zhao HF, Xu ZS, The prostate has secretory dysfunction for category IIIA and IIIB prostatitis in J Urol 177(6):2166-2169, 2007.
(2) Engeler DS, Hauri D, John H. Impact of prostatitis NIH IIIB (prostatodynia) on ejaculate parameters. Eur Urol 44(5):546-548, 2003.
(3) Motrich RD, Olmedo JJ, Molina R, Tissera A, Minuzzi G, Rivero VE. Fertility and Sterility 85(3):751, 2006.
(4) Sexually transmitted diseases, Holmes KK, Mårdh P-A, Sparling PF, Weisner PJ, Cates W Jr, Lemon SM, et al., eds.