-
Compicated Urinary Tract Infection due to Urologic Diseases: European Urology Association Guideline
-
Seung Bae Lee, Hwancheol Son
-
Korean J Urogenit Tract Infect Inflamm 2012;7(1):81-87. Published online April 30, 2012
-
-
-
 Abstract
 PDF
- A complicated urinary tract infection (UTI) is an infection associated with a condition, such as a structural or functional abnormality of the genitourinary tract, or the presence of an underlying disease that interferes with host defence mechanisms, which increase the risks of acquiring infection or of failing therapy. A broad range of bacteria can cause a complicated UTI. The spectrum is much larger than in uncomplicated UTIs and bacteria are more likely to be resistant to antimicrobials, especially in a treatment related complicated UTI. Enterobacteriaceae are the predominant pathogens, with Escherichia coli being the most common pathogen. However, non-fermenters (e.g. Pseudomonas aeruginosa) and Gram-positive cocci (e.g. Staphylococci and Enterococci) may also play an important role, depending on the underlying conditions. Treatment strategy depends on the severity of the illness. Treatment encompasses three goals: management of the urological abnormality, antimicrobial therapy, and supportive care when needed. Hospitalization is often required. To avoid the emergence of resistant strains, therapy should be guided by urine culture whenever possible. If empirical therapy is necessary, the antibacterial spectrum of the antibiotic agent should include the most relevant pathogens. A fluoroquinolone with mainly renal excretion, an aminopenicillin plus a β-lactam inhibitor (BLI), a Group 2 or 3a cephalosporin or, in the case of parenteral therapy, an aminoglycoside, are recommended alternatives (LE: 1b, GR: B). In case of failure of initial therapy, or in case of clinically severe infection, a broader-spectrum antibiotic should be chosen that is also active against Pseudomonas, e.g. a fluoroquinolone (if not used for initial therapy), an acylaminopenicillin (piperacillin) plus a BLI, a Group 3b cephalosporin, or a carbapenem, with or without combination with an aminoglycoside. The duration of therapy is usually 7-14 days (LE: 1b, GR: A), but has sometimes to be prolonged for up to 21 days. Until predisposing factors are completely removed, true cure without recurrent infection is usually not possible. Therefore, a urine culture should be carried out 5-9 days after the completion of therapy and also 4-6 weeks later.
-
Update of Acute Bacterial Prostatitis
-
Woosuk Choi, Hwancheol Son
-
Korean J Urogenit Tract Infect Inflamm 2011;6(1):8-17. Published online April 30, 2011
-
-
-
Abstract
PDF
- Acute bacterial prostatitis is defined as acute infection of prostate. It is classified into category I according to the National Institutes of Health (NIH) consensus classification. Patients with acute bacterial prostatitis present with acute symptoms of urinary tract infection, including urinary frequency, dysuria and symptoms suggestive of systemic infection, such as malaise, fever and myalgia. The prostate may be swollen and tender on digital rectal examination, butprostatic massage is contraindicated. The most common pathogen is Escherichia coli. For initial therapy, high doses of bactericidal antibiotics, such as abroad-spectrum penicillin, a third-generation cephalosporin or a fluoroquinolone may be administered parentally and these regimens may be combined with an aminoglycoside. After defeverescence and normalization of infection parameters, oral antibiotic therapy can be continued for 2 to 4weeks. We should bear in mind that acute bacterial prostatitis secondary to manipulation of the lower urinary tract, such as transrectal prostatic needle biopsy,has more aggressive clinical course.
-
Clinical Guideline for the Management of Urinary Tract Infections and Urolithiasis in Pregnant Women
-
Yun Kwan Ro, Hwancheol Son
-
Korean J Urogenit Tract Infect Inflamm 2010;5(2):220-224. Published online October 31, 2010
-
-
-
Abstract
PDF
- Urinary tract infection (UTI) is common in pregnant women. Urine culture is the gold standard for diagnosis of UTI, and E. coli is the most common pathogen. Antibiotic treatment of symptomatic or asymptomatic bacteriuria reduces the rate of pyelonephritis and low weight birth, although there is still no consensus on the optimal antibiotic regimen. Urolithiasis in pregnant women is the most common non-obstetrical cause of renal colic pain. Diagnosis and treatment are difficult. Special consideration should be taken in choosing the correct tool for diagnosis. Expectant therapy with pain medication and hydration should be considered first, although ureteroscopic stone removal has been shown to be safe and effective.
-
The Effects of Human Acellular Dermal Matrix Injected into Mouse Dermis
-
Jin Suk Chang, Dong Woo Ko, Hahn-Ey Lee, Yun Kyu Oh, Hwancheol Son
-
Korean J Urogenit Tract Infect Inflamm 2010;5(1):76-81. Published online April 30, 2010
-
-
-
Abstract
PDF
- "Purpose: Soft tissue augmentation using the injectable human acellular dermal matrix is widely used in Opthamology and Otorhinolaryngology. We performed this study to determine the efficacy and safety of injectable human acellular dermal matrix as a bulking agent, which may be applied to vesicoureteral reflux (VUR) or urinary incontinence later on. Materials and Methods: 0.2ml of normal saline and 0.05, 0.1 and 0.2ml of human acellular dermal matrix were injected into the dermis of the back skin of mouse. At 1, 2, 4, 8 and 12weeks after injection, the volume changes, the histologic changes and the adverse effects were evaluated. Results: In the mouse receiving injections, over 64% of the volume was maintained at 12weeks. The volume change was proportionate to the injected volume of injectable human acellular dermal matrix (p<0.05). After 8weeks, the volume change was stabilized. No inflammatory reaction was noticed in the mouse. Conclusions: The injectable human acellular dermal matrix is effective and safe for augmentation of soft connective tissue. Long term follow-up experiment should be required to prove its usefulness in the treatment of urinary incontinence or VUR as a bulking agent."
-
The Analysis of Urinary Tract Infection and Voiding Dysfunction of Patients Who Were Consulted from Neurosurgery Department to Urology Department
-
Hwancheol Son, Minyong Kang, Jungbum Bae, Sang Hyung Lee
-
Korean J Urogenit Tract Infect Inflamm 2008;3(1):99-103. Published online April 30, 2008
-
-
-
Abstract
PDF
- "Introduction: In general hospital, a lot of patients are consulted to one department from another. We analysed the patients who consulted from the Neurosurgery (NS) department to Urology department for various reasons. Material and methods: The clinical data of patients who consulted from the NS department to Urology department was analysed. And we analysed the results of urinalysis and urine culture data, and antibiotics resistance data. Results: Only 8.4% of neurosurgical patients were consulted to Urology department. In 40 patients, voiding difficulty was most common in 13 post-operative and 8 peri-operative patients. In nineteen cases who had no urinary tract infection (UTI), 5 showed UTI after neurosurgical procedure. Conclusions: Considering of high prevalence of voiding dysfunction and benign prostatic hyperplasia, very small proportion of neurosurgical patients were consulted to Urology department and the most of them had voiding failure during post-operative care. The education for neurosurgical surgeon about voiding dysfunction is needed for higher quality of patients care."
|
KAUTII
