Urethral stricture and semen quality.

OBJECTIVE

To study the relationship between urethral stricture and infertility, which has not been well studied in the past.

PATIENTS AND

METHODS

In this study in West Africa, the mean semen values from 90 fertile controls and 32 infertile controls were compared to 40 men with incomplete urethral strictures (IUS) and 56 men with complete urethral strictures after treatment. Testicular biopsies were performed on 30 patients. Sexually transmitted urethritis accounted for 79% of the strictures within this group of patients. Repair of the strictures restored ejaculate in 39 men, and 22 men had normospermia (20 million/mL); however, the remainder had either azoospermia or oligospermia. The biopsies revealed normal spermatogenesis in 5 men, which suggested ductal obstruction, but 14 patients had destruction of seminiferous tubules suggesting end organ failure. Eleven other men had hypospermatogenesis, maturation arrest, or premature sloughing of cells, which may be amenable to treatment.

CONCLUSIONS

These data suggest that early medical treatment and repair of urethral stricture may improve fertility for men with urethral strictures, especially strictures following infectious urethritis. Testicular biopsies may aid in the diagnosis of persistent infertility among these men, and should be considered as part of the work-up.