The Status of Microvascular Reactivity in Infertile and Fertile Patients with Chronic Prostatitis
The study covered 280 patients with chronic prostatitis (CP) on the background of sexually transmitted infections. Patients with chronic prostatitis were divided into 2 patient groups: infertile males (140) and fertile males (140). The control group consisted of 50 somatically healthy males of a reproductive age. To assess the functional state of skin microvessels in the projection of the prostate gland, the authors used the method of laser Doppler flowmetry supplemented by iontophoretic probes with sodium nitroprusside and acetylcholine. It has been proved that the development of infertility in patients with chronic prostatitis is associated with a number of microvascular disorders. In the infertile male group with chronic prostatitis the authors observed a marked inflammatory hyperemia and a decrease in the microvascular response to a sympathetic and tonic stimulation. Not only was the direct microvascular vasodilation under the influence of sodium nitroprusside reduced, but the production of their own vasodilators under the influence of acetylcholine as well, indicating the development of endothelial dysfunction. The peculiarity of the microvascular endothelial reaction to iontophoresis of endothelium‐dependent vasodilator (acetylcholine) in the infertile patients with chronic prostatitis was the slowdown of the development of vasodilation with its quicker cessation, unlike the fertile patients who, on the contrary, developed vasodilation faster than the control group.