Persistence of ultrasound alterations after antibiotic treatment with levofloxacin in patients with male accessory gland infection

No studies have evaluated the ultrasound features of the male sex accessory glands in infertile patients with bacterial male accessory gland infection （MAGI） according to the microbiological outcomes of bacterial cultures （absent, partial or complete） following antibiotic therapy administration. Therefore, the aim of this study was to evaluate the ultrasound characteristics of the prostate, seminal vesicles, and epididymal tracts after treatment with levofloxacin （a common quinolone antibiotic）, in patients with infections caused by Escherichia coil （a Gram-negative bacterium） according to the Naber＇s classification, which includes the following categories： eradication, eradication with superinfection, persistence and persistence with superinfection. The study was conducted in 100 patients aged 25±8 years （range： 20-40 years） with bacterial MAGI and bacterial cultures positive only for E. coil（colony forming units ≥ 106 per ml）. Retrospective analysis was conducted only on patients treated with oral levofloxacin （500 mg） administered once daily for 28 days who were recruited over the last 5 years. Following antibiotic treatment, patients with microbiological persistence or persistence with superinfection had a significantly higher percentage of ultrasound abnormalities suggestive of prostato-vesiculitis （PV） （30.2% and 36.0%, respectively） or prostato-vesiculo-epididymitis （PVE） （60.2% and 70.0%, respectively） compared with patients with microbiological eradication （PV= 10.2% and PVE=8.2%, respectively） or eradication with superinfection （PV= 18.8% and PVE=21.2%, respectively）. In conclusion, patients with microbiological persistence or persistence plus superinfection showed the highest prevalence of complicated forms of MAGI （PV and PVE）, compared with patients with microbiological eradication or eradication with superinfection.

Acquired premature ejaculation and male accessory gland infection： relevance of ultrasound examination

We have previously demonstrated a high frequency of premature ejaculation （PE） among patients with male accessory gland infection （MAGI）. The aim of this study was to evaluate the ultrasound （US） features of patients with MAGI and acquired premature ejaculation （APE） associated （MAGI-APEpos）. US evaluation of 50 MAGI-APEpos patients compared to 50 patients with MAGI without PE （MAGI-PEneg） which represent the control group. The diagnosis of APE was made through the evaluation of Intravaginal ejaculation latency time （IELT） and confirmed with the questionnaire PEDT （Premature Ejaculation Diagnostic Tool）. The main outcome measure was represented by the frequency of US criteria suggestive of P （prostatitis）, V （vesiculitis）, and E （epididymitis） in MAGI-APEpos and MAGI-PEneg patients. MAGI-APEpos patients showed a total number of US criteria significantly higher compared to MAGI-PEneg patients. MAGI-APEpos showed a higher frequency of US criteria of V and E （complicated forms of MAGI）. Finally, in MAGI-APEpos group, it was found a positive relationship between the anteroposterior diameter （APD） of the caudal tract of the epididymis and the APD of the seminal vesicles, as well as between both diameters and the PEDT score. MAGI-APEpos patients have a peculiar US characterization compared to MAGI-PEneg patients. According to these results, US evaluation of the epididymal and of the prostato vesicular tract should be considered in the practical clinical approach of patients with MAGI and APE. In particular, it could be a SUDDort for a possible Dathoahysiological interpretation of this clinical problem in these patients.

Male accessory gland inflammation prevalence in type 2 diabetic patients With symptoms possibly reflecting autonomic neuropathy

Male accessory gland inflammation or infection （MAGI） is a potentially underdiagnosed complication of type 2 diabetes （DM2）; specifically, we reported in a recent study that the frequency of MAGI was 43% among DM2 patients. In previous studies, we have demonstrated that diabetic autonomic neuropathy （DAN） is associated with a peculiar ultrasound characterization of the seminal vesicles （SVs） in DM2 patients. The aim of the present study was to evaluate the frequency of MAGI in two different categories of DM2 patients （i.e. patients with and without symptoms that possibly reflect DAN） and the respective ultrasound characterizations. Sixty DM2 patients with a mean （± s.e.m.） age of 42.0 ± 6.0 years （range： 34-47 years） were classified according to the presence or the absence of symptoms that could possibly reflect DAN （group A： DM2 with symptoms possibly reflecting DAN, n = 28 patients and group B： DM2 without symptoms possibly reflecting DAN, n = 32 patients）. The patients in Group A exhibited a significantly higher frequency of MAGI compared with those in group B patients （P 〈 0.05）; moreover, the Group A patients exhibited a significantly higher frequency of ultrasound signs suggestive of vesiculitis （P 〈 0.05）. Finally, the concentrations of lymphocytes but not the concentrations of the leukocytes in the semen were significantly higher （P 〈 0.05） in group A compared with group B.