Posterior Urethral Valves and Fertility: Insight on Paternity Rates and Seminal Parameters

Background: Posterior urethral valves (PUVs) represent the most common cause of male congenital lower urinary tract obstruction, often responsible for renal dysplasia and chronic renal failure. Despite recent improvements in patients’ outcomes thanks to prenatal ultrasound early diagnosis, PUVs can...

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Main Authors: Marcello Della Corte, Simona Gerocarni Nappo, Antonio Aversa, Sandro La Vignera, Francesco Porpiglia, Cristian Fiori, Nicola Mondaini
Format: Article
Language:English
Published: MDPI AG 2025-01-01
Series:Diseases
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Online Access:https://www.mdpi.com/2079-9721/13/1/21
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author Marcello Della Corte
Simona Gerocarni Nappo
Antonio Aversa
Sandro La Vignera
Francesco Porpiglia
Cristian Fiori
Nicola Mondaini
author_facet Marcello Della Corte
Simona Gerocarni Nappo
Antonio Aversa
Sandro La Vignera
Francesco Porpiglia
Cristian Fiori
Nicola Mondaini
author_sort Marcello Della Corte
collection DOAJ
description Background: Posterior urethral valves (PUVs) represent the most common cause of male congenital lower urinary tract obstruction, often responsible for renal dysplasia and chronic renal failure. Despite recent improvements in patients’ outcomes thanks to prenatal ultrasound early diagnosis, PUVs can still impact sexual function and fertility. This study aims to review the available evidence on fertility in PUV patients, examining paternity rates and semen parameters. Methods: A review was conducted of the PubMed, Cochrane, Scopus, and Embase databases. Studies focusing on fertility and paternity outcomes in PUV patients were selected, including case reports, case series, and retrospective and prospective studies. Results: A total of 15 studies met the inclusion criteria. The review revealed that PUV patients often exhibit compromised semen parameters, including low sperm count, reduced motility, and abnormal morphology, as well as alterations in seminal plasma. PUV diagnoses are common in adults exhibiting infertility and ejaculation disorders, suggesting PUVs cannot be considered only a pediatric disease. Paternity rates among PUV patients were rarely reported in extenso, hampering the correct assessment of the overall medium paternity rate and its comparison with that of healthy individuals. Lastly, seminal parameters were assessed in a minimal cohort of patients, therefore, they could not be considered representative. Conclusions: Fertility and seminal parameters in PUV patients represent an under-investigated area. PUVs can variably and non-univocally affect fatherhood, and they may be associated with compromised semen quality. Early intervention and long-term follow-up are essential to address potential fertility issues. Future research should focus on developing targeted strategies to preserve and enhance fertility in this patient population.
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spelling doaj-art-8a4fc4635f034bd5bf93884726d138f92025-01-24T13:29:17ZengMDPI AGDiseases2079-97212025-01-011312110.3390/diseases13010021Posterior Urethral Valves and Fertility: Insight on Paternity Rates and Seminal ParametersMarcello Della Corte0Simona Gerocarni Nappo1Antonio Aversa2Sandro La Vignera3Francesco Porpiglia4Cristian Fiori5Nicola Mondaini6Division of Urology, Department of Oncology, School of Medicine, San Luigi Gonzaga Hospital, University of Turin, Regione Gonzole 10, 10043 Orbassano, ItalyDivision of Pediatric Urology, Regina Margherita Hospital, 10043 Turin, ItalyDepartment of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, 88100 Catanzaro, ItalyDepartment of Clinical and Experimental Medicine, University of Catania, 95123 Catania, ItalyDivision of Urology, Department of Oncology, School of Medicine, San Luigi Gonzaga Hospital, University of Turin, Regione Gonzole 10, 10043 Orbassano, ItalyDivision of Urology, Department of Oncology, School of Medicine, San Luigi Gonzaga Hospital, University of Turin, Regione Gonzole 10, 10043 Orbassano, ItalyDepartment of Urology, Magna Graecia University of Catanzaro, Viale Europa, 88100 Catanzaro, ItalyBackground: Posterior urethral valves (PUVs) represent the most common cause of male congenital lower urinary tract obstruction, often responsible for renal dysplasia and chronic renal failure. Despite recent improvements in patients’ outcomes thanks to prenatal ultrasound early diagnosis, PUVs can still impact sexual function and fertility. This study aims to review the available evidence on fertility in PUV patients, examining paternity rates and semen parameters. Methods: A review was conducted of the PubMed, Cochrane, Scopus, and Embase databases. Studies focusing on fertility and paternity outcomes in PUV patients were selected, including case reports, case series, and retrospective and prospective studies. Results: A total of 15 studies met the inclusion criteria. The review revealed that PUV patients often exhibit compromised semen parameters, including low sperm count, reduced motility, and abnormal morphology, as well as alterations in seminal plasma. PUV diagnoses are common in adults exhibiting infertility and ejaculation disorders, suggesting PUVs cannot be considered only a pediatric disease. Paternity rates among PUV patients were rarely reported in extenso, hampering the correct assessment of the overall medium paternity rate and its comparison with that of healthy individuals. Lastly, seminal parameters were assessed in a minimal cohort of patients, therefore, they could not be considered representative. Conclusions: Fertility and seminal parameters in PUV patients represent an under-investigated area. PUVs can variably and non-univocally affect fatherhood, and they may be associated with compromised semen quality. Early intervention and long-term follow-up are essential to address potential fertility issues. Future research should focus on developing targeted strategies to preserve and enhance fertility in this patient population.https://www.mdpi.com/2079-9721/13/1/21posterior urethral valvesfertilitypaternitylower urinary tract obstructionmegacystisrenal dysplasia
spellingShingle Marcello Della Corte
Simona Gerocarni Nappo
Antonio Aversa
Sandro La Vignera
Francesco Porpiglia
Cristian Fiori
Nicola Mondaini
Posterior Urethral Valves and Fertility: Insight on Paternity Rates and Seminal Parameters
Diseases
posterior urethral valves
fertility
paternity
lower urinary tract obstruction
megacystis
renal dysplasia
title Posterior Urethral Valves and Fertility: Insight on Paternity Rates and Seminal Parameters
title_full Posterior Urethral Valves and Fertility: Insight on Paternity Rates and Seminal Parameters
title_fullStr Posterior Urethral Valves and Fertility: Insight on Paternity Rates and Seminal Parameters
title_full_unstemmed Posterior Urethral Valves and Fertility: Insight on Paternity Rates and Seminal Parameters
title_short Posterior Urethral Valves and Fertility: Insight on Paternity Rates and Seminal Parameters
title_sort posterior urethral valves and fertility insight on paternity rates and seminal parameters
topic posterior urethral valves
fertility
paternity
lower urinary tract obstruction
megacystis
renal dysplasia
url https://www.mdpi.com/2079-9721/13/1/21
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