MALE ACCESSORY GLAND INFECTION (MAGI)

• Male accessory gland infection (MAGI) also known as Male accessory gland inflammation has been identified among those diagnostic categories which have a negative impact on the reproductive function and fertility in males
• MAGI is a hypernym that groups the following different clinical categories viz. prostatitis, prostate‐vesiculitis, and prostate‐vesiculo‐epididymitis
• It is a condition with signs of inflammation involving one or more site in the male genital tract

Classification

• Uncomplicated form - including prostatitis
• Complicated forms, which encounter the inflammatory involvement of both prostate and seminal vesicles (prostate‐vesiculitis)
• The involvement of all three glands (PVE)

Several pathophysiological mechanisms may impair sperm function during MAGI, including reduction of the accessory gland function, obstruction of sperm transport, and dysregulation of spermatogenesis

• Microorganisms, - Escherichia coli, Neisseria gonorrhoeae, Chlamydia trachomatis, Ureaplasma urealyticum, Candida albicans, Trichomonas vaginalis
• Viruses – Hep B &C viruses, Papilloma virus
• Oxidative stress
• Pro‐inflammatory cytokines
• Epididymal macrophages and dendritic cells
• Post‐infective secretory alterations

• Urinary disorders - particularly nocturia, decreased urinary strength, and incomplete bladder emptying
• Chronic pelvic pain- which can manifest itself as pain in the scrotal, penile, inguinal, suprapubic, and anal region
• Sexual dysfunctions -including erectile dysfunction, premature ejaculation, and decreased libido, are present in approximately 50% of patients
• Rarely cause obstruction of the seminal pathways
• Can have an unpredictable intracanicular spread to one or more sexual accessory glands of the reproductive tract, as well as to one or both sides

COMPLICATIONS

• Altered secretory function of the epididymis, seminal vesicles, and prostate
• Obstruction of epididymis
• Impaired spermatogenesis

• History - positive for urinary infection, epididymitis, and/or sexually transmitted disease
• Physical signs - Thickened or tender epididymis, tender vas deferens, and/or abnormal digital rectal examination
• Prostatic fluid - Abnormal prostate fluid expression and/or abnormal urine after prostatic massage
• Ejaculate signs - Leucocyte >1 mil/mL, culture with significant growth of pathogenic bacteria, abnormal appearance, increased viscosity, increased pH, and/or abnormal biochemistry of the seminal plasma
• Scrotal and transrectal prostate‐vesicular ultrasound scans

• Antibiotics play an important therapeutic role in bacterial prostatitis, while in non‐microbial forms, the treatment of choice is based on the use of anti‐inflammatory compounds

Ayurvedic Treatment

Internal Medicines

• Guduchyadi Kashaya
• Saptasara kashaya
• Nirgundyadi kashaya (in infections)
• Punarnavadi kashaya
• Guggulu panchapala choorna
• Vilwadi gutika
• Chandraprabha vati
• Chandanasava
• Punarnavasava
• Guduchi satva
• Gokshura pana
• Abhraka bhasma

Procedures

• Virechana – kalyana guda