children
Rocco Gianni
The symptoms are mild and tolerable but I am very concerned about its
impact on my ability to have kids. What's the word on CP and Kids.
Please advise. THANKS
Dr. A. N. Feliciano
> From: Rocco Gianni <rgi...@MATHWORKS.COM>
> To:
> Subject: children
> Date: Friday, April 16, 1999 2:50 AM
I have answered similar question in previous postings but I don't mind
posting my answer again.
There are certain organisms infecting the vagina and/or semen that are
associated with low sperm density and motility. Chronic prostatitis,
uncomplicated is not usually associated with infertility
The following organisms has been implicated;
E. coli, T. vaginalis, Proteus spp., Ureaplasma urealyticum and C.
albicans.
Have a semen analysis.
Antonio Novak Feliciano, M.D., F.P.C.S.
Visit my website
http://web.idirect.com/~ino
http://www.qinet.net.user/dr.anf/chronic.htm
bud
>
> I am 27 and I have had prostatititis on and off for a couple years now.
> The symptoms are mild and tolerable but I am very concerned about its
> impact on my ability to have kids. What's the word on CP and Kids.
> Please advise. THANKS
Int J Androl 1993 Feb;16(1):1-13
Infection in the male reproductive tract. Impact, diagnosis and
treatment in relation to male infertility.
Purvis K, Christiansen E
Andrology Laboratory, National Hospital, Oslo, Norway.
The following are the conclusions that can be derived from a review of
the literature regarding the role of infection in
the aetiology of male infertility. (i) Temporary inflammatory episodes
in the male reproductive tract which are
self-limiting are probably common. (ii) Caution should be exercised in
the use of leukospermia or bacteriospermia as
parameters for glandular infection. (iii) There is a need for
alternative techniques for detecting non-symptomatic deep
pelvic infections in the male; one technique of great promise is rectal
ultrasound. (iv) Rectal ultrasound indicates that a
large number of men with poor sperm quality have a non-symptomatic,
chronic prostatovesiculitis. (v) Increasing
evidence implicates Chlamydia trachomatis as being a major cause of
chronic non-bacterial prostatitis. (vi) An
important aspect of chlamydial infections in men may be that the male
accessory sex glands may function as
reservoirs for the organism, increasing the probability of infection in
the female. (vii) Ureaplasma urealyticum may
also play an important aetiological role in male infertility but its
significance is confounded by its acknowledged
function as a commensal in the reproductive tract. (viii) One of the
manifestations of male reproductive tract infection
is the induction of sperm autoantibodies. (ix) There is a need for more
systematic controlled studies of the effects of
antibiotic treatment on sperm quality with different preparations for
extended periods using patient groups in which a
glandular infection has been verified, e.g. by rectal ultrasonography.
Publication Types:
Review
Review, academic
PMID: 8468091, UI: 93224191
CalTrucker
>I am 27 and I have had prostatititis on and off for a couple years now.
>The symptoms are mild and tolerable but I am very concerned about its
>impact on my ability to have kids. What's the word on CP and Kids.
>Please advise. THANKS
>
>
The answer to your problem is JUST KEEP TRYING...
My Story:
I am 37 and have had cp for 11 years. I had two children prior to the
onset of the cp. 10 years ago my wife and I decided we wanted a third child. We
tried and tried with very little luck. We both visited our docs and mine (a
uro) said I had a low sperm count. I didn't know it then but probably because
of the cp. He said it was not impossible for me to father another child but it
might take some time. After much trying we had success. Our third child came
along. Then a years or so later, my wife didn't take her birth control pill and
we decided to have sex one night thinking no way she could get pregnant after
all the time it took for me to get her pregnant with our third child. So we had
sex and GUESS WHAT? Our fourth was born 9 months later.
Conclusion:
We can still father children, it might just take awhile. Also, my above
story happened early on in my prostatitis. Today it has gotten much worse, so I
don't know if I could get her pregnant again now or not.
Hope all goes well with you...
Jeff
David L. Casey, MD
Assisted reproductive techniques have changed how infertility is practiced.
These days (though it's not exactly cheap or available everywhere) a
pregnancy can sometimes be obtained even if there are NO sperm in the
ejaculate...sperm obtained directly from the testis may even be able to
fertilize an egg with these specialized techniques. If a patient has CP and
is infertile (this isn't universal, and the most common causes of infertility
are NOT related to CP in my experience), and that patient and his spouse want
to have children, then they should seek the care of an infertility specialist
with assisted reproductive technique skill. Probably in the future the only
reason that a couple cannot have a child is if there is some female factor
that totally prohibits it (in which case a surrogate mother may carry the
couple's fertilized egg) or if the testicles of the man simply do not make
sperm as in germinal failure, germinal aplasia, or "Sertoli cell only
syndrome". I hope this helps.
BTW I think the "keep trying" advice is still the best thing for now...
David L. Casey, MD
Denton Urology
Denton, Texas USA
http://www.dentonurology.com/
This communication is intended to provide general information, and in no way
is a substitute for face-to-face medical care. No implication of a
doctor-patient relationship should be assumed by the reader.
Sorry, but no questions or requests answered by private email.
-----------== Posted via Deja News, The Discussion Network ==----------
http://www.dejanews.com/ Search, Read, Discuss, or Start Your Own
bud
>
> In article <19990417163421...@ng105.aol.com>,
> caltr...@aol.com (CalTrucker) wrote:
> > >
> > >I am 27 and I have had prostatititis on and off for a couple years now.
> > >The symptoms are mild and tolerable but I am very concerned about its
> > >impact on my ability to have kids. What's the word on CP and Kids.
> > >Please advise. THANKS
> > >
> > >
>
Dr. Casey, Wasn't there a recent report citing an unusually high genetic
defect rate with high-tech sperm injection techniques? Something about
interfering with the normal molecular process during fertilization.
Also, wouldn't you advise someone with CP to be checked for infection
before starting to try for a baby? Isn't infection a major cause of
tubal blockage and cillia damage in women?
Do you really trust an RE with tens of thousands of dollars on the line
to find a simple, inexpensive solution to infertility?
Maybe not in your experience, but there seems to be a statsitically
significant correlation between infertility and semen infection:
Arch Androl 1998 Nov-Dec;41(3):203-8
Chlamydial infection in asymptomatic infertile men attending an
andrology clinic.
Bornman MS, Ramuthaga TN, Mahomed MF, Greeff AS, Crewe-Brown HH, Reif S
Department of Urology, Medical University of Southern Africa, Medunsa,
South Africa. mbor...@medic.up.ac.sa
Urethral swabs, first-catch urine or urine collected at least 2 h after
the previous micturition, and semen swabs were
collected from 131 asymptomatic men during the routine workup for
infertility at the andrology clinic at Ga-Rankuwa
Hospital, Medunsa. The urethral and seminal swabs were used for enzyme
immunoassay (EIA) (IDEIA III), tissue
culture, and direct immunofluorescent antibody (DFA) test (IMAGEN) to
detect Chlamydia trachomatis, and similarly
the urine was tested by EIA. In 82/131 (62.6%) cases all tests for
chlamydiae were negative and in 49/131 (37.4%)
cases at least one test was positive. Tissue culture detected 24/131
(18.3%) as positive for C. trachomatis. Urethral
swab EIA detected 33/131 (25.2%) and DFA 34/131 (26%) positive patients.
Urine EIA was positive in 33/131 cases
(25.2%). Semen EIA was positive in 35/131 (26.7%) of cases of whom 7/131
(5.3%) were positive in semen EIA
only (all samples were conformed by PCR). It would seem, therefore, that
testing for the presence of chlamydia was
incomplete if semen samples were not included. The positivity in only
semen samples raises the possibility that the
organisms are harbored in the epididymis, seminal vesicles, or the
prostate.
PMID: 9805149, UI: 99021965
David L. Casey, MD
I was not implying that someone with proven infectious CP shouldn't have it
treated to eradicate whatever microorganisms may be causative. Many men with
CP are fully capable of fathering children, and most never have wives with
tubal damage from whatever process they have...I guess my point is that if
you've been diagnosed with an infection as the cause of your CP syndrome, and
have been treated appropriately, and are still infertile, then your next step
is assisted reproduction. As far as the increased risk for genetic birth
defects, that is always an issue, but I honestly am not up on the latest in
this arena as I do not do these techniques...I do see infertility patients
from time to time, and rarely if ever do they have symptoms or signs of
chronic pelvic pain syndrome, and often go through empirical trials of this
or that, and some have gotten varicocelectomies for "subclinical"
varicoceles, and still they are infertile...
As far as a statistically significant connection between infertility and
semen infection, I'm not sure how to interpret your citations...if there's
bacterial growth in the semen, then I suppose there could be a higher rate of
infertility in those men, but I don't see these men for whatever reason. Now
if you're trying to say that the majority of infertile men presenting to
their physician are infertile because of semen infection, then I think you're
wrong...we have to understand how these studies are done...
I hope this helps, and best of luck.
David L. Casey, MD
> Dr. Casey, Wasn't there a recent report citing an unusually high genetic
> defect rate with high-tech sperm injection techniques? Something about
> interfering with the normal molecular process during fertilization.
Maybe...like my previous statement said I don't follow these areas closely,
but I know assisted techniques are still quite widely practiced...
>
> Also, wouldn't you advise someone with CP to be checked for infection
> before starting to try for a baby? Isn't infection a major cause of
> tubal blockage and cillia damage in women?
I think I covered this in my last post...
>
> Do you really trust an RE with tens of thousands of dollars on the line
> to find a simple, inexpensive solution to infertility?
>
> Maybe not in your experience, but there seems to be a statsitically
> significant correlation between infertility and semen infection:
Your reference below is interesting...it is in ASYMPTOMATIC men...meaning they
do not have "chronic prostatitis" as it is usually thought of...
Secondly, as I'm sure you know it is impossible to conclude anything from an
abstract alone.
Thirdly, where's the control? They should have looked at a similar
population of FERTILE men to see what their rate of chlamydial colonization
is...maybe in South Africa that is a common commensal. Ureaplasma (first
cousin to chlamydia) is often considered a commensal in many urinary
tracts...
I think it's a wonderfully interesting topic, and I appreciate you bringing it
to the forum.
I think the problems with your reference are:
There isn't a control group.
Only the abstract is presented, and the abstracts often do not represent the
whole story.
These aren't men with "CP" as I or most people would define it.
Thanks again!
bud
Dr. Casey, As you know, many cases of infertility are "unexplained,"
where both partners check out O.K. Normal semen, etc. And, as I am sure
you are also aware, accurate detection of chlamydia or ureaplasma
requires sophisticated PCR tests. I am not implying that everyone with
CP will have a wife with damaged tubes, but simply the following:
1) If you have signs of CP you MAY have a chlamydia infection.
2) If you have a chlamydia infection, your wife MAY have a chlamydia
infection.
3) If your wife has a chlamydia infection, it will affect fertility.
I don't think that you will argue any one of these three points. But,
when you put them together, I think it makes sense for someone with CP
to have a PCR test for Chlamydia (and maybe ureaplasma and mycoplasma)
before spending tens or hundresd of thousands of dollars on fertility
treatments. Yet, this is not typically done. Doctors seem to be
satisfied shrugging and declaring unexplained infertility.
Here is another citation:
Scott I. Zeitlin, MD
>Rocco Gianni wrote:
>>
>> I am 27 and I have had prostatititis on and off for a couple years now.
>> The symptoms are mild and tolerable but I am very concerned about its
>> impact on my ability to have kids. What's the word on CP and Kids.
>> Please advise. THANKS
>
The simplest way to determine the fertility potential of any patient
is to have a semen analysis. Concerns regarding male infertility
should be addressed to a urologist that specializes in male
infertility. However, the most important factor in achieving a
pregnancy is often maternal age and this is important to remember.
Scott I. Zeitlin, MD
Institute for Male Urology
http://www.urol.com
David L. Casey, MD
> where both partners check out O.K. Normal semen, etc. And, as I am sure
> you are also aware, accurate detection of chlamydia or ureaplasma
> requires sophisticated PCR tests. I am not implying that everyone with
> CP will have a wife with damaged tubes, but simply the following:
>
> 1) If you have signs of CP you MAY have a chlamydia infection.
> 2) If you have a chlamydia infection, your wife MAY have a chlamydia
> infection.
> 3) If your wife has a chlamydia infection, it will affect fertility.
>
> I don't think that you will argue any one of these three points. But,
> when you put them together, I think it makes sense for someone with CP
> to have a PCR test for Chlamydia (and maybe ureaplasma and mycoplasma)
> before spending tens or hundresd of thousands of dollars on fertility
> treatments. Yet, this is not typically done. Doctors seem to be
> satisfied shrugging and declaring unexplained infertility.
citation snipped.
I guess I don't argue your points because of the all cap "MAYS" appropriately
thrown in there. If you wish to have these tests done, then by all means do
it. My question is this: If you do test positive for chlamydia (or
Mycoplasma or Ureaplasma) then how do you treat that? I mean most men with
CP have already undergone therapy with (usually) appropriately chosen type
and duration of antibiotics that should have been effective in eradicating
these organisms if they were present...so knowing you have something that
hasn't responded to the appropriate treatment would likely lead to additional
antibiotic therapy and testing (which is not without expense or risk) that
probably would not alter the fertility of the patient so treated in my humble
opinion...I'll admit I'm not an infertility expert, and so could be way off,
but I just thought I'd put in my 2 cents worth...Thanks, and I wish you the
best of luck.
David L. Casey, MD
Denton Urology
Denton, Texas USA
This communication is intended to provide general information, and in no way
is a substitute for face-to-face medical care. No implication of a
doctor-patient relationship should be assumed by the reader.
Sorry, but no questions or requests answered by private email (These E-mails
will be deleted).
Dr. A. N. Feliciano
Regards. I wonder what you think of our protocol. Certain bacteria (E.
coli) and fungus (C. albicans), has been found to be correlated with low
sperm count and low motility. In some patients that initially have a low
count (below 40 million) and low motility (below 70% fresh), will show an
improvement of both density and motility.
Thank you,
Antonio Novak Feliciano, M.D., F.P.C.S.
Visit my website
http://web.idirect.com/~ino
http://www.qinet.net.user/dr.anf/chronic.htm
----------
> From: Scott I. Zeitlin, MD <szei...@UCLA.EDU>
> To:
> Subject: Re: children
> Date: Thursday, April 22, 1999 12:30 PM
bud
>
> thrown in there. If you wish to have these tests done, then by all means do
> it. My question is this: If you do test positive for chlamydia (or
> Mycoplasma or Ureaplasma) then how do you treat that? I mean most men with
> CP have already undergone therapy with (usually) appropriately chosen type
> and duration of antibiotics that should have been effective in eradicating
> these organisms if they were present...so knowing you have something that
> hasn't responded to the appropriate treatment would likely lead to additional
> antibiotic therapy and testing (which is not without expense or risk) that
> probably would not alter the fertility of the patient so treated in my humble
> opinion...I'll admit I'm not an infertility expert, and so could be way off,
> but I just thought I'd put in my 2 cents worth...Thanks, and I wish you the
>
> David L. Casey, MD
> Denton Urology
> Denton, Texas USA
>
> http://www.dentonurology.com
>
> is a substitute for face-to-face medical care. No implication of a
> doctor-patient relationship should be assumed by the reader.
>
> will be deleted).
>
> http://www.dejanews.com/ Search, Read, Discuss, or Start Your Own
Dr. Casey, You are assuming that I am one of the many who have tried
multiple courses of antibiotics, but this is not the case. Thanks for
your interest and I will let you know if I have any success.
In the mean time, my uro put me on doxycycline, and the damndest thing
happened: it cured my indigestion! I was tested for H. Pylori in the
past, but it was negative. I was not treated, even though there are
aparently 18 other organisms that can cause gastrointestinal trouble.
Doxy seems to have killed whatever it was. So, unlike some folks, I
can't say I didn't get anything from abx.
Scott I. Zeitlin, MD
wrote:
>Dear Dr. Zeitlin,
>
>Regards. I wonder what you think of our protocol. Certain bacteria (E.
>coli) and fungus (C. albicans), has been found to be correlated with low
>sperm count and low motility. In some patients that initially have a low
>count (below 40 million) and low motility (below 70% fresh), will show an
>improvement of both density and motility.
>
>Thank you,
>
>Antonio Novak Feliciano, M.D., F.P.C.S.
>Visit my website
>http://web.idirect.com/~ino
>http://www.qinet.net.user/dr.anf/chronic.htm
Low sperm counts are defined as less than 20million/ml. Normal
motility should be 50%. While infections can have an impact on the
parameters of the semen analysis, I believe that this is not limited
to the organisms you mentioned.
Abrjack
>> Mycoplasma or Ureaplasma) then how do you treat that?
Does a standard culture of EPS detect the above critters? Is Leviquin effective
against them?
Dr. A. N. Feliciano
Just to clarify, I did not limit the cause of infertility to the organisms
I mentioned and did not categorically state that the organism mentioned
causes infertility. They were implicated as "maybe causal" in infertility.
Thank your,
----------
> From: Scott I. Zeitlin, MD <szei...@UCLA.EDU>
> To:
> Subject: Re: children
> Date: Saturday, April 24, 1999 12:26 PM
bud
--- quoting in part McGraw-Hill Encyc. Sci & Tech, 1997 ---
Chlamydia
A unique genus of bacteria with a growth cycle differing from those
of
all other microorganisms: Chlamydia grow only in living cells and
cannot
be cultured on artificial media. Although capable of synthesizing
macromolecules, they have no system for generating energy; the host
cell's energy system fuels the chlamydial metabolic processes.
Infectious particle. The chlamydial infectious particle, called the
elementary body, is round and small (about 350-450 nanometers in
diameter). It enters a susceptible host cell and changes to a
metabolically active and larger (approximately 800-1000 nm in diameter)
reticulate body that divides by binary fission. The entire growth cycle
occurs within a vacuole that segregates the Chlamydia from the
cytoplasm
of the host cell. The reticulate bodies change back to elementary
bodies, and then the cell lyses and the infectious particles are
released. The growth cycle takes about 48h.
Chlamydial diseases. Diseases are caused by three species of
Chlamydia. Chlamydia trachomatis, occurring in humans, ... contain
glycogen. Chlamydia psittaci, occurring in birds, lower
animals, and humans, ... The TWAR strains have been given their own
species
category, C. pneumoniae. The TWAR elementary body is pear shaped rather
than round, and there is little deoxyribonucleic acid (DNA)
relatedness.
Chlamydia trachomatis. Chlamydia trachomatis is almost exclusively a
human pathogen, and one of the most common. Those strains infecting
humans have no known animal reservoir. Infections occur in two distinct
epidemiologic patterns. In many developing countries, C. trachomatis
causes trachoma, a chronic follicular keratoconjunctivitis. It is the
world's leading cause of preventable blindness, affecting approximately
500 million people, with millions losing their sight. In areas where
this condition is highly endemic, virtually the entire population is
infected within the first few years of life. Most active infections are
found in childhood.
Scarring can develop as a result of severe inflammation of the
conjunctiva. Over a period of years, the scars shrink and distort the
upper eyelid, causing an in-turning of the eyelashes which damages the
cornea and causes blindness. By age 60, more than 20% of a population
can be blinded as a result of trachoma.
Chlamydia trachomatis can be spread sexually. In the United States,
it
is the most common sexually transmitted bacterial pathogen; an
estimated 4.5 million cases occur each year. The most common
manifestation of this infection is nongonococcal urethritis in males.
The cervix is the most commonly infected site in women. Ascending
infections can occur in either sex, resulting in epididymitis in males
or endometritis and salpingitis in females. Chlamydial infection of the
fallopian tube can cause late consequences such as infertility and
ectopic pregnancy, even though the earlier infection is asymptomatic.
For
some women, their first knowledge of having had a chlamydial infection
occurs when they are being evaluated for infertility or are
hospitalized
with an ectopic pregnancy. Thus chlamydial infection in the female can
be particularly insidious and dangerous.
The infant passing through the infected birth canal can acquire the
infection and may develop either conjunctivitis (called inclusion
conjunctivitis of the newborn, or inclusion blennorrhea) or pneumonia.
In the United States, C. trachomatis is the leading cause of
conjunctivitis in the first month of life, and of pneumonia in the
first
6 months.
All of the diseases mentioned above involve mucous membranes. There
is a more invasive form of C. trachomatis that causes a systemic
sexually transmitted disease called lymphogranuloma venereum.
Lymphogranuloma venereum has a worldwide distribution, although it is
more common in some tropical countries. This disease has a predilection
for lymphoid tissue involvement. It occurs in stages: the primary stage
involves small, superficial, usually painless genital lesions; in the
secondary stage, inguinal buboes (infected lymph nodes) are the common
finding. If untreated, the disease may progress to stages involving
widespread tissue destruction of genital and intestinal tracts.
Chlamydia psittaci. ... as a cause of abortion in
sheep, cattle, and goats. ... Chlamydia psittaci can
infect humans, causing the disease psittacosis. Psittacosis can occur
as
pneumonia or a febrile toxic disease without respiratory symptoms.
...
Chlamydia pneumoniae (TWAR). Chlamydia pneumoniae appears to be a
human pathogen with no animal reservoir. It is of worldwide
distribution
and may be the most common human chlamydial infection. It appears to be
an important cause of respiratory disease, being found in association
with sporadic cases of community-acquired pneumonia and epidemics of
mild pneumonia. In addition, C. pneumoniae infection has been linked to
coronary artery disease.
...
--- end quoting in part McGraw-Hill Encyc. Sci & Tech, 1997 ---
jdimi...@my-dejanews.com
Culture is not the current gold standard. Besides, it cannot detect Chlamydia
in the EPS due to inhibitory substances.The best test presently available is
PCR or LCR.
Concerning mycoplasma and ureaplasma, they, too are not routinely tested and
cannot be cultured on simple media. Here, the colony-forming unit is
important and it has to be interpreted very carefully because ureaplasma can
be found in up to 50 % of asymptomatic (healthy) men and the diagnosis
depends on the colony count.
Chlamydia can sometimes be resistant to levaquin (levofloxacin) and so is
ureaplasma. So, the CDC currently recommends azithromycin (Zithromax) or
Doxycycline for the treatment of chlamydial infections. No recommendations
have been published for Ureaplasma and my lab employs antibiotic
susceptibility testing for ureaplsma.
Regards,
Jordan Dimitrakov, MD
In article <19990424113239...@ng-fu1.aol.com>,
abr...@aol.com (Abrjack) wrote:
> >My question is this: If you do test positive for chlamydia (or
> >> Mycoplasma or Ureaplasma) then how do you treat that?
>
> Does a standard culture of EPS detect the above critters? Is Leviquin
effective
> against them?
>
-----------== Posted via Deja News, The Discussion Network ==----------
Anonymous
> the CDC currently recommends azithromycin (Zithromax) or
> Doxycycline for the treatment of chlamydial infections.
Many men on this group have had multiple courses of these
ABx, with no improvement. Indeed, I and others find our
symptoms worsen with tetracyclines and macrolides. The idea
that chlamydia or -plasmas underlie chronic male pelvic pain
syndrome is therefore extremely unlikely. To me, it
represents the last refuge for the believers in bacterial
etiology.
> No recommendations have been published for Ureaplasma and
> my lab employs antibiotic susceptibility testing for ureaplsma.
> Jordan Dimitrakov, MD
I think statements like these, which could serve to attract
patients to your clinic, should be made with extreme caution
if you wish to maintain credibility here.
bud
>
> jdimi...@my-dejanews.com wrote:
>
> > the CDC currently recommends azithromycin (Zithromax) or
> > Doxycycline for the treatment of chlamydial infections.
>
> Many men on this group have had multiple courses of these
> ABx, with no improvement. Indeed, I and others find our
> symptoms worsen with tetracyclines and macrolides. The idea
> that chlamydia or -plasmas underlie chronic male pelvic pain
> syndrome is therefore extremely unlikely. To me, it
> represents the last refuge for the believers in bacterial
> etiology.
>
Considering the thread was on CP and children, it is appropriate to
consider possible infection and its potential effect on fertility (male,
female and unexplained infertility). The original poster is 27 with
"mild and tolerable" CP so he probably hasn't been through the abx
thing. Not everyone who follows this group is here because of
unbearable chronic pain.
Dr. A. N. Feliciano
> From: bud <b...@NOSPAM.COM>
> To:
> Subject: Re: Can Chlamydia be cultured: No! (was: children )
> Date: Monday, April 26, 1999 12:07 AM
>
> Abrjack wrote:
> >
> > >My question is this: If you do test positive for chlamydia (or
> > >> Mycoplasma or Ureaplasma) then how do you treat that?
> >
> > Does a standard culture of EPS detect the above critters? Is Leviquin
effective
> > against them?
>
>
> Chlamydia
>
> A unique genus of bacteria with a growth cycle differing from those
> of
> cannot
> be cultured on artificial media. Although capable of synthesizing
> macromolecules, they have no system for generating energy; the host
> cell's energy system fuels the chlamydial metabolic processes.
Very informative Bud, in addition;
Four species from the order Mycoplasmatales are found in the human genital
tract: Mycoplasma hominis, Mycoplasma fermentans, Mycoplasma genitalium and
Ureaplasma urealyticum. These organisms are the smallest free-living
organisms known. Their genome is also small which greatly limits their
synthetic abilities. Having no cell wall, they are bounded only by a
membrane which contains cholesterol, a component not found in classical
bacteria. Since mycoplasmas do not synthesize cholesterol, animal serum is
required for their growth, On agar, the organisms form microscopic colonies
which show the appearance of a "fried egg" (a dark center surrounded by a
peripheral sometimes lacy area). The organisms show little evidence of
growth in broth, producing only a faint haze.
Because the properties of the four species are so diverse, no single medium
suffices to isolate all organism. Therefore, culture is directed at the two
organisms which can be readily isolated, M. hominis and U. urealyticum.
Both species can be recovered on a single medium of pH 6.0-6.6, U agar
without lincomycin.
Two isolation system are recommended: U agar and U broth for ureaplasmas;
and for M. hominis, H agar and H broth. Isolation of ureplasmas is
difficult, not because the organisms are hard to grow but because they have
a very short stationary phase and have a very steep death phase. Isolation
of M. hominis is considerably easier since medium of pH 5.5 to 8.0 will
provide growth of these organism.
Specimens are collected on swabs and place directly into transport medium
unless isolation media can be inoculated immediately. If not inoculated
immediately, transport specimens to the laboratory on ice or frozen at 70
degree C.
Dr. A. N. Feliciano
> Date: Monday, April 26, 1999 6:44 AM
CDC is currently recommending the following drugs in the treatment of
Chlamydia.
Azithromycin 1 g orally in a single dose is now a recommended regimen for
the treatment of chlamydial infection, along with the previously
recommended regimen of doxycycline 100 mg orally 2 times a day for 7 days.
Azithromycin has been shown in several randomized controlled trials to have
efficacy similar to that of doxycycline.
Ofloxacin 300 mg orally 2 times a day for 7 days is now included an
alternative regimen, alone with the older erythromycin and sulfisoxazole
regimens. Clindamycin is another option.
None of these antibiotics have a 100% cure rate.
(Ref. STD Journal of the American Venereal Disease Association, Vol. 21
Number 2, 1994)
Abrjack
possible bacterial causes before pursuing other remedies such as anti
inflamatories and muscle relaxants?
Ken Smith
jdimi...@my-dejanews.com
stimulate the discussion in the group I hereby present the following data on
Ureaplasma urealyticum. It must be stressed that some of the data presented
here are based on results obtained with insensitive techniques and are
therefore inconclusive:
David Taylor-Robinson. Mycoplasma and Ureaplasma Infections: An Update.
Clinical Infectious Diseases 1996;23: 671-84. "The results of human and
animal (see below) inoculation studies and observations on immunocompromised
patients provide good evidence that ureaplasmas are a cause of nonchlamydial
(nongonococcal urethritis NGU) in men, and controlled antibiotic and
serological studies lend support to this contention. (Taylor-Robinson D.
Mycoplasmal and mixed infections of the human male urogenital tract and their
possible complications. In: The mycoplasmas. Vol. 4 - Mycoplasma
pathogenicity. New York: Academic Press, 1985: 27-63). However, the
proportion of patients who have ureaplasma-induced diseases is unknown; the
occurrence of urethral ureaplasmas in healthy men suggests that the organisms
may persist after causing asymptomatic untreated disease and/or that only
certain serovars are pathogenic or that predisposing factors such as lack of
mucosal immunity exist in those who develop disease. Overall, it is the
frequent finding of ureaplasmas in the urethra of healthy men that ranks them
behind Chlamydia trachomatis and Mycoplasma genitalium as a cause of NGU
(Table 3).
It is plausible but unproven that ureaplasmas could be responsible for some
cases of the acute urethral syndrome in women.
It is likely that ureaplasmas can gain access to the prostate during an acute
ureaplasmal infection of the urethra. However, it is debatable whether the
fact that they are isolated more frequently and in greater numbers from
patients with acute urethroprostatitis whose specimens were obtained via the
Stamey procedure than they are from controls indicates that they cause
inflammation of the prostate gland, even though patients with less than 10[3]
organisms in expressed prostatic fluid have been reported to respond to
tetracycline therapy (Brunner H, Weidner W, Schiefer HG. Quantitative studies
on the role of Ureaplasma urealyticum in non-gonococcal urethritis and
chronic prostatitis. Yale J Biol Med 1983;56:545-50). Ureaplasmas have not
been isolated from prostatic biopsy specimensobtained from patients with
chronic abacterial prostatitis, a finding that is in keeping with the absence
of other miroorganisms (Doble A, Thomas BJ, Furr PM, et al. A search for
infectious agents in chronic abacterial prostatitis using ultrasound guided
biopsy. Br J Urol 1989;64:297-301).
In contrast, ureaplasmas were recovered directly from the epididymis of a
patient with nonchlamydial, nongonococcal avute epididymo-orchitis who
developed specific antibodies and responded to tetracycline therapy (Jalil N,
Doble A, Taylor-Robinson D. Infection of the epididymis by Ureaplasma
urealyticum. Genitourinary Med 1988;64:367-8). It seems unwise to place too
much emphasis on a single case, but it is at least worth remembering that the
organisms have the potential for causing this disease."
Researchers from Spain (Nunez-Calonge R; Caballero P; Redondo C; Baquero F;
Martinez-Ferrer M; Meseguer MA) studied the in-vitro effects of several
concentrations of Ureaplasma urealyticum on the motility, membrane integrity
and morphology of washed spermatozoa from healthy donors (Ureaplasma
urealyticum reduces motility and induces membrane alterations in human
spermatozoa.Hum Reprod 1998 Oct;13(1O):2756-61.) A significant reduction in
sperm motility and signs of membrane alteration, directly related to
U.urealyticum concentration and contact time were observed. Scanning
electron microscopy examination showed masses of U. urealyticum attached to
the head and middle piece of some of deformed spermatozoa. They suggested
that U.urealyticum is involved in sperm changes leading to male infertility,
particularly when there is heavy U. urealyticum colonization or specific
infections with this microorganism. Kjaergaard N; Kristensen B; Hansen ES;
Farholt S; Schonheyder HC; Uldbjerg N; Madsen H from Denmark found U.
urealyticum in 11.8 % of men attending an infertility clinic. (Microbiology
of semen specimens from males attending a fertility clinic. APMIS 1997
Jul;105(7):566-70). Rose BI and Scott B from Pennsylvania found that
overnight incubation with mycoplasma species resulted in small but highly
statistically significant differences in motility, morphology,
hyperactivation after overnight capacitation, and proportion acrosome reacted
after incubation with calcium ionophore compared with controls and concluded
that incubation with mycoplasma species impairs sperm physiology. In their
opinion, identification and treatment of mycoplasma may augment a
physiology-based infertility evaluation. (Sperm motility, morphology,
hyperactivation, and ionophore-induced acrosome reactions after overnight
incubation with mycoplasmas. Fertil Steril 1994 Feb;61(2):341-8)
Another comment from Domingue and Hellstrom "Prostatitis." Published in
Clinical Microbiology Reviews 1998;11(4):604-613: "Although U. urealyticum
has long been implicated as sometimes causing ningonococcal urethritis, its
role as an etiologic agent of prostatitis is controversial. Ina study by Teng
et al (Teng K; Li M; Yu W; Li H; Shen D; Liu D. Comparison of PCR with
culture for detection of Ureaplasma urealyticum in clinical samples from
patients with urogenital infections. J Clin Microbiol 1994
Sep;32(9):2232-4)in 50 specimens including sperm, urine, and prostate
secretions from hospitalized patients (n=50) with urogenital infections. Five
positive diagnoses and an additional four doubtful diagnoses were made by
culture, whereas PCR detected U. urealyticum in 12 samples. Eight specimens
were derived from prostatic secretions, one was positive by culture and two
were positive by PCR. Of 14 specimensfrom infertile subjects, 2 were positive
by culture, 4 were doubtful, and 6 were positive by PCR. In addition to its
greater sensitivity and lesser dependence on careful specimen handling
between collection and testing, PCR had aq further advantage of yielding
faster results. PCR may show considerable promise for the rapid and specific
diagnosis of U. urealyticum from an appropriately obtained specimen
localising the infection to the prostate, provided that there is sufficient
demand to justify the cost of a thermal cycler and the requirements for more
costly reagents than are needed for culture. It will also be of value to use
PCR primers that distingusih between serovars when considering the biological
significance of ureaplasma in clinical specimens, since specific biovars may
be associated with different diseases of the genitourinary system (i.e. is
there a prostate-specific biovar?)"
To sum it all up: - the role of ureaplasma in prostatitis has not been fully
elucidated because the diagnosis has been hindered by its - presence (up to
50 %) in the urethra of asymptomatic men; - lack of specific diagnostic
techniques; - relying too much on serologic (antibody) responses to confirm a
ureaplasma infection which, as it has been shown, are of no value; PCR has
disclosed the existence of specific kinds of ureaplasmas which had previously
been classified as "serovars" and has correlated the different types with
different disases-causing (pathogenic) potential. We have done the following
study:
UREAPLASMA UREALYTICUM MOLECULAR SUBTYPES AND CYTOKINE REPERTOIRE IN PATIENTS
WITH CHRONIC PROSTATITIS
JORDAN D. DIMITRAKOV, HIGHER MEDICAL INSTITUTE, PLOVDIV, BULGARIA AND GEORGES
RAWADI, INSTITUT PASTEUR, PARIS, FRANCE
INTRODUCTION AND OBJECTIVES: A number of studies examining the role of
Ureaplasma urealyticum (UU) in the pathogenesis of chronic nonbacterial
prostatitis/pelvic pain syndrome (CPPS) have yielded conflicting results. We
therefore decided to study its role in CPPS patients and correlate it with
the number of leukocytes and the level of expression of proinflammatory
cytokines. METHODS: We studied sixty EPS and/or post-prostatic massage urine
samples obtained at the time of diagnosis of patients with CPPS using a PCR
assay with three primer pairs for the detection of Ureaplasma urealyticum,
parvo biovar, mba types 1,3,and 6, and in cultured clinical specimens with
primer pairs designed by using the polymorphic base positions within a 310-
to 311-bp fragment of the 5' end and upstream control region of the mba gene.
The specificity of the assay was confirmed with reference serovars 1,3, 6,
and 14 and by the amplified-fragment sizes (81 bp for mba 1, 262 bp for mba
3, and 193 bp for mba 6). Second, a more sensitive nested PCR involving a
first-step PCR, using the primers UMS-125 and UMA226, followed by the nested
mba-type PCR described above was performed after the protocol of Knox and
Timms. Random amplified polymorphic DNA (RAPD) PCR with seven arbitrary
primers was also performed and cytokine levels were measured by using RT-PCR.
RESULTS: Forty-five patients (75 %) had serovar 8 UU and thirty patients (50
%) had more than one serovar, most frequently 4 and 8. By RAPD-PCR with seven
arbitrary primers we were also able to differentiate the two biovars of UU
and to identify10 RAPD-PCR subtypes. None of the patients had the same
subtype detected in the urine or the urethral swab. Changes in the serovar
correlated with an increase in the number of leukocytes in the EPS and an
elevated level of tumor-necrosis factor-alpha (TNF-alpha), IL-2, IL-6, IL-8,
and IL-10. CONCLUSIONS: UU should be considered as a possible etiologic agent
in CPPS patients and fluctuations in leukocyte count should be correlated
with the changes in UU serovars. Molecular subtyping techniques could
contribute to the unraveling of its role in CPPS.
Thanks for reading!
Respectfully,
Jordan Dimitrakov, MD
In article <B0000...@mail.qinet.net>,
-----------== Posted via Deja News, The Discussion Network ==----------
Dr. A. N. Feliciano
> From: Abrjack <abr...@AOL.COM>
> To:
> Subject: Re: children (Questions for Dr. Casey)
>
> I'm no Doctor, however isn't it just plain common sense to eliminate all
> possible bacterial causes before pursuing other remedies such as anti
> inflamatories and muscle relaxants?
>
resorting to expensive cultures, and administer a combination of
antibiotics and antifungal drug empirically for a period of no more than 2
to 3 weeks. Without massage or once or twice a week massage, our statistics
indicate that the cure rate is less than if we do the massage daily for the
first four days and every other day thereafter.
In the first edition of my book, published in 1982 - I reported - The
incidence and cure rate of chronic prostatitis in 803 patient treated in
our clinic from June 1, 1979 to Dec. 31, 1981. Our protocol involve once a
week massage and the use of single or dual antibiotics.
We divided our patients according to age group
440 patients - below 29, and 363 -30 yr.. or above.
Results; Below 29 years - 287 were declared cure after 1 month, 83 after 2
months, and 35 cure after 3 months. 35 remained infected at the end of this
period, giving a 92% cure.
Above 30 yr.. 177 cure within one month, 86 within 2 months and 36 within 3
months. Cure rate 82%.
Our cure was based on disappearance of pus cells or stabilization to less
than 5, and disappearance of symptoms.
Our present protocol evolved from this initial observation. We have doctors
from other countries, who observed our protocol and has adapted it. We have
published these facts in my book and accepted by most doctors.
Dr. A. N. Feliciano
antibiotic, but whose pus cells did not go to 0. We will stop antibiotics
and will advised these patients to return after a few weeks or if symptoms
recurred. We would repeat the basic test (Gram's stain of AU and EPS,
urinalysis and semen analysis. If all are negative, then there is no
further need for re-treatment.
Antonio Novak Feliciano, M.D., F.P.C.S.
Visit my website
http://web.idirect.com/~ino
http://www.qinet.net.user/dr.anf/chronic.htm
----------
> From: Alex Parisotti <apari...@COMPUSERVE.COM>
> To:
> Subject: Re: children (Questions for Dr. Casey)
> Date: Wednesday, April 28, 1999 7:50 AM
>
> Dr Feliciano, what do you mean "after 2 months", "after 3 months"? Do
you mean
> that the people concerned were receiving antibiotics for that time? You
say
> earlier in your reply that antibiotics are given for 2-3 weeks at most.
>
> dr....@QINET.NET (Dr. A. N. Feliciano) wrote:
>