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Overview

Male reproductive tract disorders
are amongst the most common diseases and include infertility and prostate disease as the most prevalent. Whilst infertility is of major importance in younger men of ‘reproductive age’, prostate disease, such as benign prostate hyperplasia (BPH), prostate cancer (PCa), lower urinary tract symptoms (LUTS), and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) occur most frequently in older men.


Infertility affects
approximately one in six couples. Male infertility is thought to be a sole or contributing factor to half of all infertility cases, and is estimated to affect ~30 million men globally (Agarwal et al, 2015), however, in 30-50% of men the aetiology is unknown. The incidence of male factor infertility in the general population is about 7%, making it as prevalent as Type I and II diabetes mellitus combined (9%, US Natl. Diabetes Statistics). About 50% of infertile men are able to father a child through the use of assisted reproduction techniques (ART), however such procedures are costly, have a high failure rate per cycle (up to 75%) and are particularly invasive for the female partner. The remaining 50% of men have limited prospects of fathering a child. Importantly, male infertility is associated with significant co-morbidities and poorer health outcomes (Eisenberg et al, 2014). The relationship between male infertility and other diseases is complex, and can include chronic diseases such as inflammatory disorders that impact on male fertility (Schuppe et al., 2008; Weidner et al., 2013) as well as underlying genetic causes of infertility that could impact on other aspects of a man’s health.

Therefore, it is essential
to develop new strategies to better diagnose, treat and manage infertile men.
Also of major concern to men is the high frequency of prostate disease. Conditions such as PCa, BPH and CP/CPPS affect up to 90% of men at some point during their lifetime. Patients can live for many years with these prostate disorders however both the disorder itself, and the treatment, can negatively impact on their quality of life. For example, pharmacological therapy of BPH often results in a high percentage of sexual dysfunction in patients, especially loss of erections and ejaculatory dysfunction and CP/CPPS causes in erectile dysfunction and premature ejaculation in many younger men (Wagenlehner et al., 2013). New treatments for PCa, BPH and CP/CPPS would improve both health and quality of life outcomes for millions of men.