Influence of hypercapnic hypoxia on the reproductive and copulative functions of men in the complex treatment of chronic abacterial prostatitis.
Authors:   Department of Urology and Andrology, Altai State Medical University of the Ministry of Health of Russia, Neymark A.I. ,   Barnaul, Russia, Neymark B.A. ,   Department of Urology and Andrology, Altai State Medical University of the Ministry of Health of Russia; Barnaul, Russia, Borisenko D.V. ,   urological department of the Private healthcare institution Clinical Hospital «RZD-Medicine» in Barnaul; Barnaul, Russia
Published: January 2023

Introduction. The relationship between chronic abacterial prostatitis/chronic pelvic pain syndrome (CP/CPPS) and male infertility is the subject of numerous studies, and therefore various methods for correcting pathospermia have been proposed. The main concept is that in one way or another it is necessary to create conditions for a more perfect penetration of drugs into the zone of the prostate-vesicular complex. In this regard, the search for new and pathogenetically substantiated methods of therapy for such a patient seems to be very relevant Aim of study. To evaluate the effect of hypercapnic hypoxia on reproductive and copulatory functions of men in the complex treatment of CP/CPPS. Materials and methods. The study involved 24 patients who applied to a urologist with complaints about the absence of conception in marriage for 1 year or more. The examination revealed pathospermia and symptoms of CP/CPPS in these patients. Assessment of the severity of symptoms of CP/CPPS was assessed using a questionnaire on the symptoms of chronic prostatitis using the NIH-CPSI questionnaire. In order to identify and monitor violations of the male copulatory function, ICF questionnaires created by O.B. Loran and A.S. Segal and the International Index of Erectile Function (MIEF-5). Reproductive function analysis was monitored using a semen analysis and sperm DNA fragmentation index test. The patients were divided into 2 groups of 12 people. Both groups received phenotypically directed pathogenetic and symptomatic therapy. For patients of the 2nd group, the complex treatment included breathing training procedures using the carbonic simulator, which ensures blood saturation with CO2, leading to the effect of hypercapnic hypoxia. This phenomenon contributes to angiogenesis and improvement of blood circulation in organs and systems. The effectiveness of the treatment was evaluated after 1 and 3 months. Results. According to the results of the NIH-CPSI questionnaire, 3 months after treatment, therapy in patients of group number 2 was more effective. According to the results of the MIEF 5 and ICF questionnaires in patients with CP/CPPS, a violation of erectile and ejaculatory function was revealed, and according to the results of the spermogram and the sperm DNA fragmentation test (IFD), pathospermia was noted, which was expressed in a decrease in the concentration of spermatozoa (group number 1 – 15.3 ± 1.6 million / ml, group number 2 – 16.8±2.2 million/ml), their progressive mobility (group number 1 – 24 ± 2.6%, and in group number 2 23.25 ± 2.9%.), normal morphology (group number 1 – 2.1 ± 0.17%, group number 2 – 2.5 ± 0.29%) and an increase in IFD (group number 1 – 17.9 ± 2.06%, group number 2 – 19.75± 1.9%). 3 months after treatment, the concentration of spermatozoa was 21.1±2.16 million/ml in group number 1, and 31.8±2.5 million/ml in group number 2. Progressive mobility in group number 1 – 31.4±2.2%, in group number 2 – 38.4±1.9%. Normal morphology in group number 1 is 3.1 ± 0.32%, in group number 2 – 4.6 ± 0.6%. IFD in group number 1 – 12.25 ± 0.6%, in group number 2 – 7.8 ± 1.3%. Conclusion. Patients of the group number 2, who trained on the breathing device «carbonic», achieved a more significant clinical effect from the therapy. Hypercapnic hypoxia, in the complex treatment of CP/CPPS, can contribute not only to the relief of pain and dysuric symptoms, but also to improve both the copulative and reproductive functions of men.