EFFICIENCY OF ENDOLYMPHATIC ANTIBIOTIC THERAPY IN CHRONIC PYELONEPHRITIS WITH TERATOZOOSPERMIA: A CASE REPORT

Introduction: Nowadays, endolymphatic antibiotic therapy is widely used in the prevention and treatment of complications of urogenital diseases. We report a case of chronic pyelonephritis with concomitant chronic prostatitis and astheno teratozoospermia refractory to conventional antimicrobial therapy. Aim: To evaluate the efficiency of endolymphatic antibiotic therapy in patients with chronic pyelonephritis with teratozoospermia. Case Presentation: A 32 year old male presented with exacerbation of chronic pyelonephritis and prostatitis, confirmed by positive urine cultures and semen analysis demonstrating astheno teratozoospermia. After 10 days of systemic antibiotic therapy without improvement, endolymphatic gentamicin (80 mg twice daily) was administered via catheter inserted in lymphatic vessel on the dorsum of the left foot for 8 days. Results: Post treatment, normalization of body temperature, urinary function, and prostate morphology were reported. Semen analysis 90 days after therapy revealed normospermia, normozoospermia, and a negative MAR (Mixed Antiglobulin Reaction) test, indicating restored spermatogenesis and immune status. Conclusion: In this case, endolymphatic antibiotic administration was more effective than standard systemic therapy for chronic pyelonephritis with astheno teratozoospermia, underscoring its potential in treating urogenital inflammatory conditions. Large-scale studies are warranted to explore endolymphatic therapeutic route and its immunomodulatory effects.