Infections or inflammation of the testicles, epididymis or prostate are common. Infections can occur due to sexually transmitted diseases or from a urinary tract infection not related to sexual activity.
These infections may or may not cause symptoms. Symptoms usually include pain, tenderness and possibly fever. Prostate infections can cause urinary urgency and burning with urination or pain with ejaculation. In many cases, when men have such symptoms, including pain in the genitals, no infection is actually found. In these cases, which are the majority of cases, the symptoms are due to an inflammatory condition which may or may not be identifiable. The inflammation may be longstanding or acute.
A semen culture is the best test to evaluate for the presence of an infection versus inflammation. If an infection is present, it can interfere with the function of the sperm. The bacteria, as well as the white blood cells that are released to fight the infection, release free radicals. In the case of inflammation, white blood cells are activated even though bacteria is not present and their free radicals do damage as well. These free radicals degrade the membrane as well as the nucleus of the sperm and can reduce its ability to fertilize an egg. For acute inflammation, a prolonged course of anti-inflammatory pills (ibuprofen) can be an effective treatment. In addition to anti-inflammatory medication, antioxidant rich foods or supplements which scavenge the free radicals help improve the quality of the semen and improve fertility.