What are the benefits of semen cultures in the workup of chronic bacterial prostatitis (CBP)?

Updated: May 25, 2021
  • Author: Samantha D Kraemer, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Budia et al retrospectively studied 895 patients with chronic prostatitis/CPPS who all had EPS and/or VB3 specimens as well as semen cultures done. They reported that semen cultures had higher sensitivity than EPS samples for gram-negative organisms (97% versus 82.4%) and for gram-positive cultures (100% versus 16.1%). [33]

Magri et al conducted a retrospective study of 696 patients with prostatitis symptoms who had a four-glass test and semen culture analyzed for bacteriological work-up. They found that semen cultures are a useful adjunctive diagnostic tool and there were no differences in eradication rates (using combination treatment with a fluoroquinolone and a macrolide) between patients diagnosed with different tests. [34]  

Zegarra Montes et al conducted a prospective comparison of diagnosis with a semen culture versus diagnosis with the four-glass test, in 70 men with symptoms consistent with chronic prostatitis along with 17 asymptomatic controls. Semen culture had a sensitivity of 45% and specificity of 94%.These authors concluded that a positive semen culture in a symptomatic patient may be sufficient to justify starting treatment with antibiotics but a negative culture does not rule out CBP. [32]

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