A randomized controlled trial on the impact of bovhyaluronidase azoximer on ejaculate biofilms in patients with chronic prostatitis.
Morozov Andrey, Vovdenko Stanislav, Bragina Elizaveta et al.
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In 30 seconds
This randomized controlled trial evaluated antibiotics plus bovhyaluronidase azoximer versus antibiotics alone in patients with chronic bacterial prostatitis and infertility. Outcomes included symptoms, microbiological findings, ejaculate microscopy, and recurrence. The combination group had greater improvement in NIH-CPSI scores (MD -3.04, 95%CI: -3.77 to -2.3, p < 0.001), more frequent ejaculate clearance from neutrophils and bacteria, and lower recurrence rates at 6 and 12 months. Electron microscopy showed disappearance of the intercellular matrix of bacterial microcolonies only in the combination group.
Key findings
- NIH-CPSI improvement was greater with combination treatment (MD -3.04, 95%CI: -3.77 to -2.3, p < 0.001).
- Ejaculate clearance from neutrophils occurred in 41% vs 7.2% (p = 0.01), and bacterial clearance in 41.7% vs 12.1% (p = 0.043).
- Bacterial colony counts and neutrophil levels fell significantly in the combination group; microscopy showed biofilm-matrix disappearance only in that group.
- Recurrence rates were lower with combination treatment at both 6 months and 12 months.
Why it matters
The findings suggest that targeting biofilm structures alongside antibiotics may improve symptom scores and microbial clearance in chronic bacterial prostatitis, a condition associated with infection recurrence. The microscopy results provide a biological correlate for the observed clinical and microbiological differences, although the abstract does not quantify the recurrence reduction.