Male accessory gland infection

Male accessory gland infection is a condition with signs of inflammation involving one or more sites in the male genital tract. Diagnosis is made according to parameters defined by the World Health Organization, and it is particularly made in relation to infectious or inflammatory causes of male infertility.
MAGI is typically the result of infections that spread from the urethra, although non-infectious causes can also contribute to the condition.

Definition

Along with testicles, MAGI includes infections involving one or more of the following male genital organs or tracts:

Diagnosis

As infection has a negative impact on the secretory function of the accessory glands, findings that could indicate the presence of MAGI include:

signs of inflammation in a semen analysis
low semen volume
elevated semen pH
low levels of alpha-glucosidase, fructose and zinc

WHO criteria

MAGI can be diagnosed when there are two or more factors present that meet criteria defined by the World Health Organization :

Factors	Description	For positive diagnosis
A	History of: urinary tract infection epididymitis sexually transmitted infection Physical signs: thickened or tender epididymis tender vas deferens abnormal digital rectal examination	Any one Factor A feature plus one feature from either Factor B or Factor C
B	Prostatic fluid: abnormal expressed prostatic secretion abnormal voided urine after prostate massage	Either one of the Factor B features plus one feature from either Factor A or Factor C
C	Semen: leukocytes ≥ 1 million/mL semen culture with significant growth of pathogenic bacteria abnormal semen appearance increased semen viscosity increased pH abnormal biochemistry of the seminal plasma	Any two Factor C features or any one Factor C feature plus one feature from either Factor A or Factor B

Biomarkers

One study has proposed that elevated levels of soluble urokinase-type plasminogen activator receptor in seminal plasma might be useful as a marker for MAGI.

Causes

The main infectious agents are Enterobacteriaceae, Neisseria gonorrhoeae, and Chlamydia trachomatis.
One study has shown that men with MAGI who have lower serum levels of total testosterone tend to have a more complicated form of MAGI, such as involving more than one site, than those with normal levels.

Complications

Potential complications include:

obstruction of the epididymis
impairment of spermatogenesis
impairmentment of sperm function
induction of sperm auto-antibodies
dysfunctions of the male accessory glands

These complications can result in
sexual dysfunction and male subfertility.