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Pyospermia is the presence of abnormally high amounts of white blood cells (WBC) in semen. This medical condition is also referred to as leukocytospermia and is confirmed when a semen analysis reveals over one million WBC per milliliter (.033 ounces) of semen.

It is normal for men to have a small amount of white bloods cells in their semen. However, when unusually high numbers are present, this can be pointing to an underlying health condition or contributing behavior. Therefore, further evaluation and treatment is recommended.

What causes pyospermia?

There are several factors that may lead to pyospermia. It is important to undergo a thorough examination by a trained medical professional to determine its origin. Possible causes include:

  • A urogenital infection – As with any infection, it is natural for white blood cells to increase in numbers when targeting and fighting an infection.
  • Genital infections associated with some sexually transmitted diseases
  • Autoimmune diseases – The nature of autoimmune diseases is that they attack healthy tissue. This attack can increase the production of WBC.
  • Varicocele
  • Inflammation or swelling of the genitals
  • Urethral stricture
  • Personal behaviors such as using tobacco, marijuana or abusing alcohol
  • Infrequent ejaculation

Male infertility

Male infertility can be negatively affected by genital inflammation or a urogenital infection. Problems can also increase if large numbers of white blood cells in semen attack and damage sperm. Damage can include sperm deformity, a negative impact of sperm integrity, and damage to the sperm acrosome.

Diagnosis and treatment

It’s important to identify the underlying cause of leukocytospermia in order to treat it properly. When visiting a Urologist, the patient should expect a thorough analysis of their current and past medical history, a physical examination, a urinalysis, and a discussion about their social habits and sexual health. Additional diagnostic tools can be ordered to gain more information about the condition. These include: imaging of the genitourinary tract, a semen culture and a urine flow test. Depending on the patient’s results, the provider may prescribe a regimen of broad spectrum antibiotics, over-the-counter antioxidants and the surgical correction of a varicocele or stricture. They may also recommend that the patient alter their use of tobacco, marijuana and alcohol.