[Microplastic and male urogenital health: current evidence and clinical implications]

Microplastic particles (MPs; <5 mm) are ubiquitous environmental contaminants now detected in human tissues, including testicular tissue, semen, and prostate.

This narrative review synthesizes current evidence on MPs and male urogenital health and derives precautionary counselling points for urologists.

Narrative review with a structured PubMed/MEDLINE search using three thematic blocks (andrology and fertility, uro-oncology, urinary tract, and exposure) covering 1/2020 to 8/2026, supplemented by reference-list hand searching and regulatory primary documents. Human studies as well as animal and in vitro models with urologically relevant endpoints were included. No formal risk-of-bias assessment was performed.

MPs have been detected in human testicular tissue, semen, and prostate tissue. Animal and in vitro work describes impaired spermatogenesis, oxidative stress in Leydig cells, and testosterone suppression. Transferability to human exposure conditions is not established. The available human data derive exclusively from small cross-sectional studies and show polymer-specific, mutually inconsistent associations with semen parameters. Prostate tumor tissue showed higher MP concentrations than adjacent reference tissue. In vitro data suggest pro-proliferative effects. For bladder cancer, cytotoxic in vitro data and one ecological correlation analysis are available.

MPs are regularly detectable in the male urogenital tract. A causal link with impaired fertility or urological carcinogenesis has not been established in humans. The evidence is of low to very low quality. It justifies clinical vigilance, extended environmental history-taking, and precautionary, low-risk counselling, but no change to guideline-based diagnostic or therapeutic algorithms.