Prostatitis and its link to male infertility

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I am a 21-year-old male.  I was diagnosed with some form of prostatitis two and a half years ago.  My symptoms include a tendency to have to urinate many times throughout the day, though the urination is never painful.  I also experience one “prostate attack” about every other month or so.  I have moderate pain in my perennial and rectal areas when these 30 to 45 minute attacks occur, but very little pain in my testicles.  When I went to my urologist two and a half years ago, he gave me some Bactrim that prevented the attacks from occurring as long as I was on the medication.  Once I came off the medication, I had prostate attacks only occasionally.  After having two attacks this past November, I returned to my urologist who, after giving me what turned out to be a very painful rectal exam, gave me more Bactrim to take for about six weeks.  Again, I experienced no attacks as long as I was on the medication.  However, this past week I had an attack.  I am writing you not because I am concerned that I will not be able to live with an occasional attack every now and then.  Rather- I am very concerned about the chances of my prostatitis affecting my fertility.  I am getting married next year and want to ensure that I am doing everything in my power to remain fertile.  I am a virgin, so I am not engaging in sexual intercourse at this time.   However, under my urologist’s orders, I have been ejaculating at least 3 times a week for the past two and a half years.  My urologist told me that although I would have to live my life with occasional prostatitis attacks, prostatitis would not affect my fertility.  However, I have seen several sources on the internet that say it may do so, although I know several men who have prostatitis who have fathered several children.  Please tell me if I should discuss with my urologist the possibility of me taking antibiotics permanently to prevent my prostatitis from interfering with my fertility.  Also, please tell me what I can do to increase my chances of fertility if they are, in deed, at stake.  Can the fertility problems associated with prostatitis be treated?  Thank you very much.

[Kevin Pho, MD]

In general, I am not aware of chronic prostatitis affecting fertility.  There are some specialized cases, such as tuberculous prostatitis and prostatitis before puberty, where fertility may be affected.  However, to obtain a more definitive answer, you may want to seek another urological opinion.

Regarding the prostatitis, you may want to consider some imaging studies - such as a transrectal ultrasound - to ensure that there isn't an abscess present.  If so, then drainage, not antibiotics, would be the optimal treatment.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
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