Hello XXXXXXX XXXXXXX

Thanks for writing to us.

Pyospermia is defined as presence of more than 5 pus cells per high power field .

Repeated pyospermia might lead to abnormal semen count as well as motility, hence it is imperative to treat it completely and as soon as possible. Infection, autoimmune disease, inflammation of accessory sex glands and lower male urogenital tract, smoking, drug abuse like marijuana (social causes), alcohol, exposure to irritants and toxins, use of vaginal products by partner during sexual activities, abstinence, vasovasostomy, clomiphene citrate therapy, and urethroplasty, Chlamydia Trachomatis, Gardnerella vaginalis and Ureaplasma urealyticum, in patients' sexual partners (genital infection), lower CD4+ cell counts in HIV patients.

You should consult an expert XXXXXXX / Male infertility Specialist at the earliest.

A thorough bodily check up as well as local examination of genitals should be done for penile discharge, local infection, infection of prostate etc. An expressed prostatic secretion is examined for leukocytes, and urethral cultures are obtained for chlamydia and mycoplasma. Ultrasound or other imaging tests might be necessary. Your sexual history ,medical, genetic, social and drug history should be known.

Laboratory testings include differential sperm separation method, endocrine evaluation, semen analysis, and if indicated, culture of the ejaculates, quantitation of leukocytes in semen, antisperm antibodies and immature germ cells in semen.
The use of broad-spectrum antibiotics such as doxycycline and trimethoprim-sulfamethoxazole has been shown to reduce seminal leukocyte concentrations, improve sperm function, and increase conception.

Antibiotics should be given based on the report of your semen culture.Generally, the female partner is also completely evaluated and treated. There is increasing evidence that the antioxidant vitamins (A, C, and E) as well as glutathione etc are beneficial. Other alternative treatments include Chinese herbs (Magnolol), natural product antioxidants, and the practice of frequent ejaculation. Surgical correction for any anatomical reason maybe done.

You also mentioned Redness and swelling ( indicating infection ) of your penis - the condition is called balanitis.
Balanitis is usually caused by poor hygiene in uncircumcised men. Other possible causes include:

Uncontrolled local skin disease
Infection -bacteria, virus, sexually transmitted diseases, fungus
Harsh soaps, fabrics, friction.
Uncontrolled diabetes
Abnormal shape or condition of the penis/ foreskin which predisposes to infection.

This is one more reason to consult your XXXXXXX He could help in the following ways :
Thorough examination of the affected area
A swab/ culture to look for exact cause of infection.
A test to check for diabetes if this is suspected.
Referral to a skin specialist if a skin condition or allergy is thought to be the cause. Allergy testing may be advised if an allergy is suspected.
Rarely, if the inflammation persists, a biopsy (small sample) of inflamed skin may be taken to look at under the microscope. This can help to find the cause.

Treatment depends on the cause of the balanitis. For example, balanitis that is caused by bacteria may be treated with antibiotic pills or creams. Balanitis that occurs with skin diseases may respond to steroid creams. Anti-fungal creams will be prescribed if it is due to a fungus.

In severe cases, circumcision may be the best option. If you cannot pull back (retract) the foreskin to clean it, you may need to be circumcised.

Meanwhile, Avoid soaps when inflammation is present. Avoid using medicated/ perfumed products, cleansers , detergents. Use XXXXXXX warm water to clean your penis and then dry gently. Wash the glans each day. Pull the foreskin back gently whilst in the bath or shower. Then gently clean the glans using just water, or water and a bland soap. Make sure the penis and glans are dry before you put on underpants. Do not rub vigorously. If symptoms are related to condom use, try using a condom which is designed for sensitive skin. Wash your hands before going to the toilet if you work with chemicals which can irritate delicate skin. Use a condom each and every time you have sex with a new sexual partner.

I hope I have succeeded in clarifying all your doubts . Please feel free to ask for any further clarifications.

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Hi,
Since your sperm count is okay, right now you just need to be treated for the infection.
But repeated infections might lead to a problem in the sperm count also in the future.
In my previous answer, I have written down in detail various tests, both for the pus cells and for the inflammation of the penis.
You need to consult an XXXXXXX who would suggest the specific or additional tests after examining you.
Take care.

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Hi again,
Please do not worry about asking questions. You can ask as many as you wish ! I would be glad to answer them.
I will once again enumerate the tests and check ups. But please understand that you cannot directly go to a laboratory and get them done. You will have to consult a certified XXXXXXX ( Male Infertility Specialist ) who can order them and refer you for them.

1. Complete physical check up, including genital area check up.
2. Smear/culture of any penile discharge, prostatic secretion
3. Urethral cultures for chlamydia and mycoplasma.
4. Ultrasound of the scrotum, testes, prostate and ejaculatory ducts.
5. Sperm culture, quantitation of leukocytes in semen, antisperm antibodies and immature germ cells in semen.
6. Tests to look for diabetes
7. Complete blood count to look for signs of infection
8. Consultation with a skin specialist if any skin condition/allergy is suspected.

For these, you have to consult an XXXXXXX as I have repeatedly mentioned.
Certain natural products are available which act as anti infective agents. They too are available on prescription from Andrologists.

Frequent ejaculation means avoiding prolonged periods of abstinence, as that increases chances of infection.

Feel free to clear your doubts.

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