Urogenital Tract Infection

Seung Ki Min

32 Articles

Xanthogranulomatous Epididymitis Unresponsive to Antibiotic Treatment: Yeasol Kwon, Jun Baek Park, Sang Hwa Lee, Seung Ki Min; Urogenit Tract Infect 2023;18(2):70-73. Published online August 31, 2023; DOI: https://doi.org/10.14777/uti.2023.18.2.70

Abstract PDF PubReader ePub: Xanthogranulomatous epididymitis is very rare, and there are few case reports worldwide. Clinically, it is necessary to differentiate between chronic scrotal inflammatory diseases, such as tuberculous epididymitis and testicular tumors. Proteus and Escherichia coli are the pathogens that generally cause xanthogranulomatous pyelonephritis, but the pathogens of xanthogranulomatous epididymitis are unclear. This paper reports a case of a 66-year-old male with epididymitis on scrotal ultrasonography and had Pseudomonas aeruginosa detected in a culture test. An orchiectomy was performed because he did not respond to antibiotic treatment.

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Korean Multicenter Study of Infectious Complications after Transurethral Prostate Surgery in Patients with Preoperative Sterile Urine: Seong Hyeon Yu, Seung Il Jung, Eu Chang Hwang, Tae-Hyoung Kim, Jae Duck Choi, Koo Han Yoo, Jeong Woo Lee, Dong Hoon Koh, Sangrak Bae, Seung Ok Yang, Joongwon Choi, Seung Ki Min, Hoon Choi; Urogenit Tract Infect 2022;17(3):81-88. Published online December 31, 2022; DOI: https://doi.org/10.14777/uti.2022.17.3.81

Abstract PDF PubReader ePub: Purpose: To evaluate the efficacy of antibiotic prophylaxis and determine the risk factors of infectious complications after transurethral surgery of the prostate.
Materials and Methods: Seven hundred and seventy-two patients who underwent transurethral resection of the prostate (TURP) or holmium laser enucleation of the prostate (HOLEP) were reviewed. Of these, this study enrolled 643 patients without bacteriuria who had not received antibiotics for urinary tract infections for two weeks before surgery. The patients were divided into two groups according to the duration of the antibiotics (Group 1: less than one day, n=396 vs. Group 2: more than one day, n=247).
Results: The overall incidence of postoperative infectious complications in 643 patients was 5.0% (32/643). When postoperative infectious complications were compared according to the duration of the antibiotics (Group 1 vs. Group 2), the infectious complications rates were 5.6% (22/396) vs. 4.0% (10/247), respectively (p=0.393). When postoperative infectious complications were compared according to the duration of antibiotics (Group 1 vs. Group 2) in the TURP and HOLEP groups, the infectious complications rates were 6.3% (12/192) vs. 1.0% (1/103) (p=0.035) and 4.9% (10/203) vs. 6.0% (8/134) (p=0.677), respectively. The duration of Foley catheterization was independently associated with infectious complications (p=0.003).
Conclusions: The results showed that prolonged postoperative catheterization affects postoperative infectious complications associated with transurethral prostate surgery. Although antibiotics administered for less than one day are effective for antibiotic prophylaxis of transurethral prostate surgery, a longer antibiotic therapy is recommended for TURP.

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Clinical Course of the Benign Prostate Hyplasia Patients during the Intermittent Use of 5-Alpha Reductase Inhibitors: Kwibok Choi, Byounghoon Kim, In-Chang Cho, Seung Ki Min; Urogenit Tract Infect 2019;14(3):93-98. Published online December 31, 2019; DOI: https://doi.org/10.14777/uti.2019.14.3.93

Abstract PDF: Purpose: 5-Alpha reductase inhibitors (5ARI), inhibit the conversion of testosterone to dihydrotestosterone, which is essential in prostate hyperplasia, and decreases the prostate volume directly. On the other hand, 5ARI have a range of side effects, such as sexual dysfunction. After the discontinuation of 5ARI, prostate regrowth occurs rapidly until it reaches the baseline size. This study examined the effects of 5ARI when used intermittently.
Materials and Methods: Between March 2009 and May 2017, patients who visited one physician’s outpatient clinic and were diagnosed with BPH underwent transrectal ultrasonography. The selected patients began to take 5ARI until the prostate size decreased at least 10% of the baseline (the first medication). After confirming adequate prostate shrinkage, the patients stopped medication until prostate regrowth reached 50% of the decreased size. After regrowth, they restarted medication for one year (second medication). The prostate size, serum prostate specific antigen (PSA) levels, international prostate symptom score (IPSS) scores, and maximum flow rate (Qmax) in uroflowmetry were collected after the first and second medication and compared using paired t-tests.
Results: Sixty patients with a mean age of 65.1 years were included in the study. The prostate size and serum PSA level increased after the second medication compared to the first, and the prostate reduction and Qmax in uroflowmetry decreased significantly. On the other hand, the symptoms felt by the patients surveyed by the IPSS scores showed no significant difference.
Conclusions: 5ARI appear to be less effective in reducing the prostate volume and improving uroflowmetry after discontinuation.

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Changes in Antibiotic Resistance of Acute Bacterial Prostatitis in a Korean Single Center: Byoung Hoon Kim, Kwibok Choi, In-Chang Cho, Seung Ki Min; Urogenit Tract Infect 2019;14(1):14-19. Published online April 30, 2019; DOI: https://doi.org/10.14777/uti.2019.14.1.14

Abstract PDF: Purpose: Acute bacterial prostatitis (ABP) is one of main infective disease in urology with various symptoms. Occurrence of complications can be minimized by appropriate treatment. We studied whether any changes in antimicrobial resistance of hospitalized ABP patients as time passed.
Materials and Methods: The study was based on retrospective study. From 2004 to 2007 as past period and 2014 to 2017 as recent period defined. Patient’s ages, length of admission days, intensive care, urinalysis, strains, and resistance to antibiotics were investigated in hospitalized patients with ABP and compared between the two periods.
Results: Fifty patients of past period and 72 patients of recent period with ABP were admitted. The mean age was increased 55.5±13.2 years to 62.0±15.3 years. The infection route was mostly community-acquired. Prostate biopsy-related was decreased 7 to 1. The mean of hospital days were 7.9±4.2 days to 6.9±3.4 days. Intensive care were 5 to 7. Average length of stay intensive care was 4.2±1.3 days to 4.1±1.4 days. Urine cultures showed no significant difference from the previous studies in strains. Extended spectrum beta-lactamases producing bacteria increased 4.3% to 25.0%, and third generation cephalosporin resistance was increased 13.0% to 40.9%. Fluoroquinolone was no significant change 26.1% to 27.3%. Aminoglycosides were identified in 4.3% to 6.8% and carbapenem in 4.3% to 2.3%.
Conclusions: The mean age of hospitalized patients with ABP increased. Antimicrobial resistance did not change to fluoroquinolone, but extended spectrum beta-lactamases producing bacteria showed increased resistance to third-generation cephalosporin. Therefore, attention should be paid to the use of empirical antibiotics.

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Patient’s Factors Correlated with Prostate Volume Recovery after 5 Alpha Reductase Inhibitor Discontinuation: Kwibok Choi, Byounghoon Kim, In-Chang Cho, Seung Ki Min; Urogenit Tract Infect 2018;13(3):79-83. Published online December 31, 2018; DOI: https://doi.org/10.14777/uti.2018.13.3.79

Abstract PDF: Purpose: The 5 alpha reductase inhibitor (5ARI) reduces the size of the prostate and alleviates lower urinary tract symptoms. After stopping 5ARI, the prostate quickly recovers to its pre-medication size. The purpose of this study was to investigate the factors affecting the restoration of prostate size after 5ARI discontinuation.
Materials and Methods: Between March 2009 and May 2017, patients who visited an outpatient clinic and were diagnosed with benign prostatic hyperplasia were selected and start 5ARI medication. After 6 months of medication, the patients stopped medication for 1 year. Meanwhile, we measured the prostate volumes of patients 3 times (before and after medication, after discontinuation) and divide the patients into 3 groups (maintained, intermediate, and restored) with recovered prostate volume ratio. After classification, we investigated the relationship between the variable factors (age, serum prostate-specific antigen, initial volume, reduced volume after medication) between groups.
Results: Among the 147 selected patients, the mean age and plasma PSA level were 61.6±7.9 and 0.8±0.6, respectively. The mean initial prostate volume was 32.3±4.2 ml, which reduced to 23.2±3.2 ml after medication. After one year of discontinuation, the mean volume was 31.4±6.4 ml, with restoration to 101.5% of the reduced size. We noticed a tendency that patients with faster prostate volume recovery were generally older than those with slower recovery; however, this was not statistically significant. Other factors showed no relationship with prostate recovery.
Conclusions: When using 5ARI in elderly patients, continuous treatment seems better than intermittent treatment. If discontinuation is needed, short term follow-up is recommended.

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Hyperuricemia and Urologic Disease: In-Chang Cho, Seung Ki Min; Urogenit Tract Infect 2017;12(3):103-109. Published online December 31, 2017

Abstract PDF: Gout is a disease that causes painful inflammatory arthritis related to hyperuricemia, due to the incorrect metabolism of uric acid. Decreased renal excretion of urate is thought to be the major hyperuricemic mechanism. Most genes responsible for the serum uric acid (SUA) level encode uric acid transporters or related regulatory proteins. The acquired effects can also modulate SUA level and uric acid excretion, which can result in acute gout. Interestingly, kidney related comorbidities in gout, such as hypertension, chronic kidney disease (CKD), and urolithiasis, all have a fairly high prevalence. Recent advancements in genetics and molecular physiology have greatly improved our understanding of renal reabsorption and secretion of filtered uric acid. Furthermore, the baseline SUA level appears to be established by a net balance between absorption and secretion through the epithelium of the kidneys and intestines. There have also been considerable progress in the management of gout patients with CKD. Increased prevalence of gout with CKD can be balanced by an expanded spectrum of treatment options for this important disease. Another issue is that lowering of the uric acid level can reduce the incidence of cardiovascular disease, renal disease, and urological complications. Basic research and clinical studies on these mechanisms might be helpful in determining the appropriate treatment for hyperuricemic patients. Based on currently existing literature, there have been improvements associated with medications that lower uric acid, particularly xanthine oxidase inhibitors. Here, we review the pathogenesis and epidemiology of hyperuricemia, specific diseases related to uric acid, and up-to-date perspectives on their management.

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Intraurethral Lidocaine Usage in Office-Based Rigid Cystoscopy on Pain Experience: Kwi Bok Choi, In-Chang Cho, Seung Ki Min; Urogenit Tract Infect 2017;12(3):117-121. Published online December 31, 2017

Abstract PDF: Purpose: Cystoscopy is one of the most reliable urological examinations. However, it also a painful one. Intraurethral lidocaine gel injection is widely used to relieve pain during cystoscopy. The purpose of this study is to compare between the use of lidocaine gel and lidocaine solution as a pretreatment for cystoscopy.
Materials and Methods: Between March 2016 and May 2017, we studied 147 patients who had undergone cystoscopy at our institution. Patients were divided into four groups. Lidocaine gel and solution were administered just 10 minutes before each test. For randomization, the patient groups were divided into either odd or even number for the test day and as the patient number, irrespective of medical condition. The amount of lidocaine gel and solution of 10 ml each was uniformly injected. After the procedure, patients were asked to rate their pain on a 10-point visual analogue scale.
Results: The average degree of pain relief was in the order of solution/10 minutes, gel/immediately, gel/10 minutes, and solution/immediately. The gel was associated with significantly less pain in the immediate group than in 10-minute before group, whereas the solution was associated with significantly better pain relief in the 10-minute before group than in the immediate group. There were no complications to report in all groups.
Conclusions: Lidocaine gel and solution showed different changes of pain relief over time. Further prospective studies with a larger population is necessary to better develop a less painful method of cystoscopy in the future.

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The Antibiotic Susceptibility of Escherichia coli from Community-Acquired Uncomplicated Urinary Tract Infection: A Focused on Fosfomycin: Hyun-Sop Choe, Seung-Ju Lee, In Ho Chang, Tae-Hyoung Kim, Hong Chung, Jae Min Chung, Sang Don Lee, Jae Hung Jung, Ki Ho Kim, Seung Ki Min, Yong Gil Na, Hana Yoon, Ho Song Yu, Mi-Kyung Lee, Sun-Ju Lee; Urogenit Tract Infect 2017;12(2):77-81. Published online August 31, 2017

Abstract PDF: Purpose: To assess the antibiotic susceptibility of Escherichia coli from community-acquired uncomplicated urinary tract infection (UTI).
Materials and Methods: Between August and December of 2015, confirmed cases of E. coli as a pathogen of community-acquired uncomplicated UTI were collected and assessed for antibiotic susceptibility in 10 designated hospitals. Additional fosfomycin susceptibility test was performed by a central laboratory using the disk diffusion method.
Results: A total of 347 E. coli isolates were collected from urine samples of community-acquired uncomplicated UTIs patients. The susceptibility rates of antibiotics were as follows: amikacin 100.0% (347), imipenem 100.0% (347), ciprofloxacin 57.1% (198), cefotaxime 74.9% (260), ampicillin 30.0% (104), trimethoprim/sulfamethoxazole 66.9% (232), and fosfomycin 98.0% (340). All fosfomycin-resistant E. coli isolates were extended-spectrum β-lactamase (ESBL)-producing. In 85 cases of ESBL-producing E. coli, the fosfomycin susceptibility rate was 91.8% (78/85).
Conclusions: Fosfomycin may be a useful option for the treatment of community-acquired uncomplicated UTIs. Further studies evaluating the role of fosfomycin in the treatment of UTIs and its clinical efficacy are necessary.

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The Effect of Intrarectal Lidocaine Gel Instillation before Transrectal Ultrasound Guided Prostate Biopsy: Yoo Seok Kim, Soon Ki Kim, Kwibok Choi, In-Chang Cho, Seung Ki Min; Urogenit Tract Infect 2016;11(3):97-102. Published online December 31, 2016

Abstract PDF: Purpose: To compare pain induced by a transrectal ultrasound (TRUS)-guided prostate biopsy in men between using local lidocaine gel or plain lubricant.
Materials and Methods: Between January and October of 2014, a total of 63 consecutive patients undergoing TRUS-guided prostate biopsy for elevated prostate-specific antigen (PSA) levels and/or a suspicious digital rectal examination were randomized to two groups: lidocaine group and control group. In the lidocaine group (n=31), patients received 20 ml of 2% lidocaine gel and betadine solution soaked gauze was administered via a transrectal route 10 minutes before the procedure. In the control group (n=32), 20 ml plain lubricant and betadine solution soaked gauze was administrated under the same condition. After the biopsy procedure, patients were asked to rate their pain perception on a 10-point visual analog scale (VAS) score.
Results: There was no statistically significant difference with the mean patient age, PSA, prostate volume, biopsy duration time between lidocaine group and control group. The mean pain score and number of patients with VAS ≥5 in the lidocaine group (4.14±2.0, 10) were significantly lower than those in the control group (5.78±2.3, 19). In younger men (≤65 years), pain was reported significantly less in the lidocaine group than in the control group. Complication rates were not different between the two groups.
Conclusions: Intrarectal lidocaine gel is a simple, safe, and efficacious for reducing pain and discomfort during the TRUS-guided prostate biopsy procedure. It appears to have an enhanced effect, especially in younger than in older men.

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Infectious Complications after Prostate Biopsy: A Prospective Multicenter Prostate Biopsy Study: Eu Chang Hwang, Ho Song Yu, Seung Il Jung, Dong Deuk Kwon, Sun Ju Lee, Tae-Hyoung Kim, In Ho Chang, Hana Yoon, Bongsuk Shim, Kwang Hyun Kim, Donghyun Lee, Jung-Sik Huh, Dong Hoon Lim, Won Jin Jo, Seung Ki Min, Gilho Lee, Ki Ho Kim, Tae Hwan Kim, Seo Yeon Lee, Seung Ok Yang, Jae Min Chung, Sang Don Lee, Chang Hee Han, Sang Rak Bae, Hyun Sop Choe, Seung-Ju Lee, Hong Chung, Yong Gil Na, Seung Woo Yang, Sung Woon Park, Young Ho Kim, Tae Hyo Kim, Won Yeol Cho, June Hyun Han, Yong-Hyun Cho, U-Syn Ha, Heung Jae Park, The Korean Association of Urogenital Tract Infection and Inflammation (KAUTII); Urogenit Tract Infect 2016;11(1):17-24. Published online April 30, 2016

Abstract PDF: Purpose: Recent studies have highlighted an increasing trend of infectious complications due to fluoroquinolone-resistant organisms among men undergoing transrectal prostate biopsy. This study evaluated the current incidence of infective complications after trans-rectal prostate biopsy for identification of risk factors in Korean men who received fluoroquinolone prophylaxis.
Materials and Methods: A prospective, multicenter study was conducted in Korea from January to December 2015. Prostate biopsies performed with fluoroquinolone prophylaxis during 3 months in each center were included. A pre-biopsy questionnaire was used for identification of patient characteristics. Clinical variables including underlying disease, antibiotic prophylaxis, enema, povidoneiodine cleansing of the rectum, and infectious complications were evaluated. The primary outcome was the post-biopsy infection rate after fluoroquinolone prophylaxis. Univariable and multivariable analyses were used for identification of risk factors for infectious complications.
Results: The study included 827 patients, of whom 93 patients (11.2%) reported receiving antibiotics in the previous 6 months and 2.5% had a history of prostatitis. The infectious complication rate was 2.2%. Post-biopsy sepsis was reported in 2 patients (0.2%). In multivariable analysis predictors of post-biopsy sepsis included person performing biopsy (adjusted odds ratio [OR], 4.05; 95% confidence interval [CI], 1.31-12.5; p=0.015) and operation history within 6 months (adjusted OR, 5.65; 95% CI, 1.74-18.2; p=0.004).
Conclusions: The post-prostate biopsy infectious complication rate in this study was 2.2%. Person performing biopsy (non-urologists) and recent operation history were independent risk factors for infectious complications after trans-rectal prostate biopsy.

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Proposed New Pathophysiology of Chronic Prostatitis/Chronic Pelvic Pain Syndrome: In-Chang Cho, Seung Ki Min; Urogenit Tract Infect 2015;10(2):92-101. Published online October 31, 2015

Abstract PDF: The most common type of prostatitis is category III, also known as chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). The current National Institutes of Health definition of CP/CPPS includes genitourinary pain with or without voiding symptoms in the absence of uropathogenic bacteria, as detected by standard microbiological methods, or other identifiable causes such as malignancy. Many different etiologies and mechanisms of pathogenesis of CP/CPPS have been proposed with a suggested role for immunological, neurological, endocrine, and psychological factors. We examined the data supporting the role of each of these areas and also examined the possible interrelationship of these factors in producing the symptoms of CP/CPPS. Prostatitis types IIIa and IIIb are classified according to the presence of pain without concurrent presence of bacteria; however, it is becoming more evident that, although levels of bacteria are not directly associated with levels of pain, the presence of bacteria might act as the initiating factor that drives primary activation of mast-cell-mediated inflammation in the prostate. The gate control theory provides a neurologic basis for the influence of both somatic and psychological factors on pain. Acceptance of chronic pain as a diagnosis may be difficult for the clinician and patient, however it is an important concept in the care of CP/CPPS, which enables the use of pain-directed therapies. Management of CP/CPPS will remain challenging; however, this review provides a better understanding of the condition and improved management strategies based on the newest evidence and concepts available.

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Change of Antibiotic Resistance to the Causative Organisms of Pelvic Wound Infection for Recent 5 Years: Yoo Seok Kim, Soon Ki Kim, In-Chang Cho, Jin Soo Ko, Gyeong In Lee, Seung Ki Min; Urogenit Tract Infect 2015;10(2):112-119. Published online October 31, 2015

Abstract PDF: Purpose: We researched microbial profiles and the antimicrobial resistance profile of wound infection of the pelvic area in Korea for the recent 5 years in order to provide useful information on the choice of adequate drugs in the treatment of pelvic wound infection.

Materials and Methods: We retrospectively analyzed 211 pelvic wound culture samples and their antimicrobial resistance in 198 in- or out-patients of the Urology and Plastic surgery department from January 2010 to December 2014.

Results: Of the total samples, Staphylococcus aureus was isolated most frequently (35.3%), followed by Escherichia coli (15.1%), Staphylococcus epidermidis (12.6%), Staphylococcus haemolyticus (12.6%), Staphylococcus lugdunensis (8.4%), Pseudomonas aeruginosa (6.7%), Enterococcus spp. (4.2%), and Streptococcus spp. (3.3%). There were no notable changes of bacterial distribution for 5 years. For Gram-positive isolates, the oxacillin resistance rate for Gram-positive bacteria was 42.6% and showed an increasing tendency for the recent 5 years. Piperacillin, rifampicin, and vancomycin had low resistance for Gram-positive bacteria. Carbapenems, piperacillin/tazobactam had low resistance for Gram-negative bacteria. The Gram-positive organisms were more sensitive to many antibiotics in contrast to the Gram-negative organisms.

Conclusions: Of varied causative organisms and susceptibility of the pelvic wound site, the most frequently infected organisms of the pelvic area were S. aureus, followed by E. coli. The methicillin resistive S. aureus (MRSA) incidence showed a tendency to increase yearly, thus selection or early change of antibiotics considering MRSA is recommended if the antibiotic response is poor. Gram-negative bacteria has a higher resistance rate compared with Gram-positive bacteria and had carbapenems and piperacillin/tazobactam.

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Inflammation of Prostate and Prostate-Specific Antigen: In-Chang Cho, Seung Ki Min; Korean J Urogenit Tract Infect Inflamm 2015;10(1):7-11. Published online April 30, 2015

Abstract PDF: Noncancerous conditions (e.g., benign prostatic hyperplasia and prostatitis) can elevate serum prostate-specific antigen (PSA) levels, limiting the specificity of PSA screening for prostate cancer. In recent years, several studies have also demonstrated a relationship between chronic prostatitis/chronic pelvic pain syndrome and increased PSA levels. However, in asymptomatic patients, routine screening for this diagnosis is not performed before transrectal biopsy to rule out prostate cancer. These asymptomatic men with elevated PSA levels frequently show evidence of inflammation when their expressed prostatic secretions are examined, or on their prostate biopsy specimens. This raises the problem of appropriate evaluation in the presence of chronic prostatitis and elevated PSA levels not only in prostate cancer screening programs, but also in cancer-negative biopsy findings. Thus, there has been investigation into ways to decrease the confounding from inflammation, including repeat PSA measurements after a period of observation or a course of empiric antibiotics. This article reviews the evidence regarding elevations in PSA due to prostatitis and describes the controversy over the optimal approach to reduce its confounding impact on prostate cancer screening. Nowadays, it appears that in patients with prostatic inflammation and increased PSA, an antimicrobial regimen may provide more acceptable initial treatment than proceeding directly to prostate biopsy. Additional evidence is necessary in the form of a randomized clinical trial in which all patients undergo biopsy, regardless of the PSA response to antibiotic or placebo.

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Effectiveness of Topical Ofloxacin Ointment for Genitourinary Post-Operative Patients with Urinary Catheterization: Yoo Seok Kim, Soon Ki Kim, Gyeong In Lee, Seung Ki Min; Korean J Urogenit Tract Infect Inflamm 2015;10(1):25-30. Published online April 30, 2015

Abstract PDF: Purpose: Catheter associated urinary tract infection and discomfort is common in patients with an indwelling urinary catheter. We investigated the effectiveness of prophylactic topical antibiotic ointment for genitourinary post-operative patients with a urinary catheter. Materials and Methods: We investigated 112 inpatients between March 2013 and October 2013, who had an indwelling urinary catheter ≥24 hours after a genitourinary operation in our institution from medical records. Among 112 patients, 59 patients applied ofloxacin ointment to urethral meatus around the indwelling catheter twice a day (ointment group: 52.7%) and 53 patients did not (non-ointment group: 47.3%). All patients were examined by urine analysis and urine culture before the operation, urethral sweep culture after catheter removal, and severity of pain was recorded as visual analogue scale (VAS) score while having an indwelling urinary catheter. Results: Mean duration of urinary catheter of both groups did not differ statistically (3.08±2.19 day, 2.91±2.25 day). Patients with pyuria detected at pre-operative urinalysis were 22.1% vs. 15.1%, pre-operative urine culture positive were 6.8% vs. 9.4%, urethra meatal culture positive after urethral catheter removal were 16.9% vs. 13.2%, respectively, and all results showed no significant differences between two groups. VAS scores of the ointment group (3.52±1.66) while having an indwelling urinary catheter were significantly lower than those of the non-ointment group (5.61±1.75) (p＜0.001). Conclusions: Application of topical antibiotic ointment for genitourinary post-operative patients with urinary catheter had no benefit in reducing growth of urethral microorganisms, but it may decrease pain from an indwelling urinary catheter.

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Evaluation of Clinical Sample for Accupower UU Real-Time PCR Kit: Seung Ki Min, Soon Ki Kim, Yoo Seok Kim, In-Chang Cho, Gyeong In Lee; Korean J Urogenit Tract Infect Inflamm 2014;9(2):99-103. Published online October 31, 2014

Abstract PDF: Purpose
In recent years, various diagnostic methods, including culture, immunological detection, conventional polymerase chain reaction (PCR) based methods, and microarray experiment have been applied for detection of Mycoplasma genitalium and Ureaplasma urealyticum infection. We assayed results of real time PCR and culture of variable clinical samples and evaluated various diagnostic indexes for assessing the clinical usefulness of the Accupower UU Real-Time PCR Kit (Bioneer Corp.) for detection of U. urealyticum/parvum. Materials and Methods: We surveyed 111 results of culture test and antibiotic sensitivity test of Ureaplasma spp. that were requested to the department of laboratory medicine, National Police Hospital from January to April 2011. The specimens of Ureaplasma spp. were collected from 97 uterine cervical swab samples, 13 urine samples, and one expressed prostate secretion sample. Real-time PCR and culture methods were performed using the Accupower UU Real-Time PCR Kit (Bioneer Corp.) and Mycoplasma IST2 Kit (BioMérieux). Results: The real-time PCR results showed that 80 clinical specimens were infected with U. urealyticum/parvum. These results were compared with those confirmed by microbiological culture. Compared with the culture, the diagnostic indexes (sensitivity, specificity, positive predictive value, and negative predictive value) of Accupower UU Real-Time PCR were 88.6%, 38.8%, 48.8%, and 83.9%, and the concordance between the Accupower UU Real-Time PCR Kit and the microbiological culture method was 58.5%. Conclusions: Accupower UU Real-Time PCR is a very valuable technique which can process analysis of a massive number of samples with high speed, high sensitivity and specificity, and a high detection rate, particularly for Ureaplasma spp.

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Recurrent Urinary Tract Infection from Urethral Stricture and Urethral Hair Growing after Hypospadias Repair Surgery: Yoo Seok Kim, Sung Bin Kim, Soon Ki Kim, In-Chang Cho, Seung Ki Min; Korean J Urogenit Tract Infect Inflamm 2014;9(2):122-125. Published online October 31, 2014

Abstract PDF: Despite successful hypospadias repair surgery, complications may occur. We report on a case of recurrent urinary tract infection from urethral stricture and urethral hair growth after hypospadias repair surgery. A 33-year-old man who first underwent hypospadias repair surgery at the age of seven underwent two more visual internal urethrotomy operations afterward. He was referred to our hospital because of voiding difficulty, dysuria, and residual urine sense. His urethral meatus was located at 1 cm proximal ventral sulcus from the glans. We found the urethral stricture and one hair in the urethra at the 2 cm proximal portion from the urethral meatus by retrograde urethrography and urethroscopy. Bacteriuria was found on urine culture, thus, we resolved the problems with soundation, epilation, and antibiotic therapy. However, the patient kept experiencing these problems recurrently; therefore, we managed his problems by recurrent urethral soundation, hair epilation, and antibiotic treatment with three years of regular follow-up.

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Prevalence of Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasmagenitalium, Ureaplasma urealyticum in Chronic Prostatitis Category IIIa andIIIb Patients Using Polymerase Chain Reaction: In-Chang Cho, Yoo Seok Kim, Sung Bin Kim, Soon Ki Kim, Gyeong In Lee, Seung Ki Min; Korean J Urogenit Tract Infect Inflamm 2013;8(2):102-108. Published online October 31, 2013

Abstract PDF

Purpose: The aim of this study was to report on the prevalence of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Mycoplasma genitalium (MG), and Ureaplasma urealyticum (UU) in patients with chronic prostatitis (CP) IIIa and CP IIIb using PCR and correlations between four microorganisms and other clinical parameters.

Materials and Methods: The medical charts of 206 Patients who visited National Police Hospital and were diagnosed with CP IIIa and CP IIIb between January 2011 and December 2012 were reviewed. We investigated white blood cell (WBC) counts on expressed prostatic secretion (EPS) samples and the frequency of four possible causative microorganisms of prostatitis, CT, NG, MG, and UU, using PCR techniques on first voided urine samples (VB1).

Results: Of 206 patients, 88 patients were CP IIIa and 118 were CP IIIb, with a mean age of 33.8±12.9 and 34.6±11.3, respectively. CT, NG, MG, and UU were detected in 13.6%, 0%, 4.5%, and 14.8% of CP IIIa patients and in 0.8%, 0%, 3.4%, and 11.9% of CP IIIb patients, respectively. Among men aged 19-30, detection of CT was significantly greater in the CP IIIa group than in the CP IIIb group (p=0.002). CT showed a positive association with EPS or the third voided urine (VB3) WBC count grade (p＜0.01), however, MG and UU did not. The relationship between numbers of detected microorganisms and WBC counts was statistically insignificant.

Conclusions: In subgroup analyses, microorganisms were detected in by PCR in 29 CP IIIa patients (32.9%) and 19 CP IIIb patients (16.1%). Young aged men in the CP IIIa group showed high prevalence of CT, and patients in whom CT was detected in urine PCR had high EPS WBC counts.

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Asymptomatic Prostatitis: Clinical Significances and Management: In-Chang Cho, Seung Ki Min; Korean J Urogenit Tract Infect Inflamm 2013;8(1):13-19. Published online April 30, 2013

Abstract PDF: Asymptomatic inflammatory prostatitis (National Institutes of Health, category IV) has been introduced as a separate clinical entity among other prostatitis syndromes. Asymptomatic inflammatory prostatitis is characterized by the presence of significant amount of leukocytes (white blood cells) in prostate-specific samples (post-prostatic massage urine, expressed prostatic secretion, semen, and prostate biopsy) but no subjective symptoms are found, and is therefore diagnosed solely in the laboratory. There have been many questions regarding the clinical role of asymptomatic inflammatory prostatitis and its impact on the management of prostate disease and sterility. This review presents the current definition of asymptomatic inflammatory prostatitis, summarizes the clinical evidence on the two important issues prostate specific antigen and pyospermia, and discusses the optimal approaches to reduce its confounding impact on prostate cancer screening and indiscriminate use of antibiotics.

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Effect of the Severity of Chronic Prostatitis Symptoms on Premature Ejaculation among Korean Males in Their 40-50s: Sung Bin Kim, Yoo Seok Kim, In-Chang Cho, Seung Ki Min; Korean J Urogenit Tract Infect Inflamm 2013;8(1):32-37. Published online April 30, 2013

Abstract PDF: Purpose: The purpose of this study was to analyze the effect of the severity of chronic prostatitis symptoms on premature ejaculation among Korean males in their 40-50s.
Materials and Methods: From September 2011 to December 2012, we conducted a survey targeting 319 Koreans who had undergone medical examinations in our institution, using National Institute of Health chronic prostatitis symptom index (NIH-CPSI) and premature ejaculation diagnostic tool (PEDT).
Results: The average age of 319 volunteers was 50.8 years (40-59), the average total NIH-CPSI score was 8.6±6.2. And total PEDT score was 7.7±5.0. Twenty eight persons had chronic prostatitis-like symptoms (8.8%). Statistically significant differences in the prevalence of premature ejaculation were observed between persons with chronic prostatitis-like symptoms (82%) and those without (37.5%). In the same manner, the prevalence of premature ejaculation was higher in the moderate and severe symptom groups than in the mild symptom groups according to the symptom scale score (pain plus voiding score) and total score of NIH-CPSI (mild: 38.2%, moderate/severe: 59.6% by symptom scale score and mild: 36.7%, moderate/severe: 65.4% by total score). In univariate and multivariate analyses, presence or absence of chronic prostatitis-like symptoms and classification according to total NIH-CPSI score were independent predictive factors for the prevalence of premature ejaculation on PEDT.
Conclusions: Significant statistical relationships were observed between NIH-CPSI and PEDT in Korean males in their 40-50s who have chronic prostatitis-like symptoms or were classified into moderate and severe symptom groups according to total NIH-CPSI score.

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Outbreaks and Seasonal Variation of Mumps Orchitis: Report of Multicenter Data in Korea: Hoon Choi, Jae Hyun Bae, Seung Il Jung, Seung Ki Min, Tae Hyung Kim, Yong Gil Na, Gil Ho Lee; Korean J Urogenit Tract Infect Inflamm 2013;8(1):43-46. Published online April 30, 2013

Abstract PDF: Purpose: Mumps is an infectious viral disease that often results in painful swelling of testis preceded by parotitis. We report multicenter data on mumps orchitis from five community hospitals.
Materials and Methods: From January 2011 to December 2012, 98 patients diagnosed with acute mumps orchitis were treated at five community hospitals in different districts of Korea. As a report on an outbreak of mumps orchitis, age, bilaterality, monthly occurrence frequency, and vaccination status were recorded retrospectively.
Results: The mean age of the 98 patients was 19.7 (range from 10 to 38) years old. Age distribution of patients included 60 teens (61.2%), 31 in their twenties (31.6%), and seven in their thirties (7.2%). No evidence of a previous mumps vaccination was found in medical records from six patients (6.1%), and the vaccination status of one patient was unknown. Bilateral orchitis was noted in eight patients (8.2%), and 90 patients (91.8%) had unilateral orchitis. Right-sided orchitis was noted in 50 patients (51.0%), and left-sided orchitis was noted in 40 patients (40.8%). Autumn (September to November) was the most prevalent season, with 35 outbreaks (35.7%). Seasonal outbreaks occurred in 13 patients (13.2%) in spring (3rd- 5th), 24 patients (24.7%) in summer (6th-8th), and 26 patients (26.4%) in winter (12th-2nd).
Conclusions: In spite of continued vaccination, mumps orchitis is still a prevalent disease. Therefore, due to a large number of outbreaks, mumps orchitis should still be considered, especially in teenagers and during autumn season. Conduct of additional long-term follow-up and large prospective studies is needed in Korea.

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Analysis of Correlation between The National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and International Index of Erectile Function (IIEF-5) among Korean Males Aged 40-50s: In Chang Cho, Sung Bin Kim, Yoo Seok Kim, Jae Young Choi, Seung Ki Min; Korean J Urogenit Tract Infect Inflamm 2012;7(2):164-171. Published online October 31, 2012

Abstract PDF: Purpose
Analyzed the correlation between the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and International Index of Erectile Function (IIEF-5) from questionnaires among Korean 40-50s male.
Materials and Methods: From September 1, 2011 to December 31 2012, we conducted a survey targeting 1032 Korean males who were had medical examinations in National Police Hospital, Using NIH-CPSI and IIEF-5. After explaining the content of the NIH-CPSI and IIEF-5, the paper was checked by volunteers in person, and the results were then collected. The subjects were limited to Korean males in their 40-50s. We analyzed the collected questionnaires.
Results: The average age of 1032 volunteers was 50 years old (42-59), and the average of NIH-CPSI total scores was 7.1±5.5. The average of IIEF-5 total scores was 17.4±6.5. IIEF-5 category was divided into Normal 385 (37.3%), Mild 296 (38.7%), Mild-Moderate 215 (20.8%), Moderate 98 (9.5%), and Severe 38 persons (3.7%). Among total volunteers, 72 persons were Chronic prostatitis like symptom patients (6.9%), and whose NIH-CPSI average of pain score (total 21), voiding score (total 10), quality of life score (total 12) and total scores were 7.6±3.1, 4.3±2.5, 5.8±2.3, and 17.8±6.7, respectively. There were moderate correlations of pain score, voiding score, quality of life score, but not significant (Pearson's coefficient of correlations <0.501). An average of total IIEF-5 scores in chronic prostatitis - like symptoms in the present group was 14.0±6.8. It was significantly lower than in the in the absent group. Prostatitis-like symptoms in the present group had more severe degrees of erectile dysfunction than absent group (p=0.002). Assessing each NIH-CPSI category score and total score affected to total IIEF-5 score, we analyzed the correlation between NIH-CPSI and IIEF-5 using regression analysis. There were all negative correlations between IIEF-5 and Pain score(t=-6.199, r2=0.036, p=0.000), voiding score (t=-0.157, r2=0.025, p=0.000), QOL score (t=-7.845, r2=0.056,p=0.000), and total score (t=-9.366, r2=0.078, p=0.000). Having analyzed correlations between each score of NIH-CPSI groups and IIEF-5 score by using multiple regression analysis, there were statistically significant difference negative correlations between pain score and IIEF-5 (t=-2.646, p=0.008), QOLscore (t=-4.219, p=0.000), and age (t=-3.135, p=0.002), but not to voiding score (t=0.628, p=0.530).
Conclusions: The higher the NIH-CPSI score, especially for pain and QOL scores play a larger role, and adversely affects erectile function of chronic prostatitis like symptom patients in Korean males aged 40-50s. (Korean J UTII 2012;7:164-171)

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The Efficacy of Extracorporeal Shock Wave Therapy in Genitourinary Disease: Present and Future: Seung Ki Min; Korean J Urogenit Tract Infect Inflamm 2012;7(1):20-28. Published online April 30, 2012

Abstract PDF: Extracorporeal shock wave therapy (ESWT) is an effective, safe, and non-invasive modality for pain relief and tissue regeneration. Because, ESWT is used on various medical areas and many diseases, but its use is limited on genitourinary disease, except urinary stone. However, many studies about efficacy of ESWT in chronic prostatitis, Peyronie's disease, and erectile dysfunction are published recently. Many people are suffering from these diseases all over the world, but these diseases are difficult to treat effectively by previous therapy, so ESWT will be able to be an alternative treatment for them. Of course, the physiology of ESWT is not confirmed to be a standard treatment scientifically, therefore it is necessary to make a greater effort to investigate it.

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Tuberculosis Infected Multiple Genitourinary System: Jae Young Choi, Sung Bin Kim, Yu Seok Kim, Ji Yun Pae, Seung Ki Min; Korean J Urogenit Tract Infect Inflamm 2012;7(1):68-72. Published online April 30, 2012

Abstract PDF: Genitourinary tuberculosis is the most common manifestation of an extrapulmonary tuberculous infection. A 54 year old patient was presented with a painful & swelling right testicular mass and left flank pain. Under the clinical diagnosis of right testicular tuberculosis along with left kidney, ureter, bladder tuberculosis, a right orchiectomy and left double J stenting, as well as endoscopic bladder biopsy were performed. The radiological and pathological diagnosis revealed testicular tuberculosis, with involvement of the left kidney, ureter and bladder.

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Clinical Outcome of Acute Bacterial Prostatitis; A Multicenter Study: Seong Ju Lee, Jin Mo Koo, Bong Suk Shim, Yong Hyun Cho, Chang Hee Han, Seung Ki Min, Sung Joo Lee, Hwan Cheol Son, Jun Mo Kim, Jong Bo Choi, Tae Hyoung Kim, Sang Kuk Yang, Kil Ho Lee, Yong Kil Na, Sung Ho Lee, Hee Jong Jung, Seung Il Jung, Chul Sung Kim, Jae Min Chung, Young Jin Seo, Won Yeol Cho, Kweon Sik Min, Sang Don Lee; Korean J Urogenit Tract Infect Inflamm 2011;6(2):165-170. Published online October 31, 2011

Abstract PDF: "Purpose: Proper guidelines concerning antibiotic administration for acute bacterial prostatitis (ABP) are unclear. We retrospectively analyzed treatment status and clinical outcomes to establish a proper treatment guideline. Materials and Methods: The clinical records of 669 patients from 21 hospitals diagnosed with ABP were reviewed. Prior manipulation, antibiotics administration, mean length of treatment, complication and procedure were analyzed. Results: The mean age of 538 patients (80.4%) without manipulation (group 1) and 131 patients (19.6%) with manipulation (group 2) was 58.3 years (range 19-88 years). Transrectal prostate biopsy was the most common cause of acute bacterial prostatitis (n=66; 50.4%). Of the clinical symptoms in the non-manipulation and manipulation groups, fever was most common (88.2% and 86.3%, respectively). Acute urinary retention (14.3% and 28.1%, respectively) was significantly increased in the manipulation group (p<0.05). Escherichia coli was the most frequently isolated bacterium from urine (72.0% and 66.7% of cases, respectively). Mean length of treatment was 6.5days and 7.9days, respectively; the difference was significant (p<0.05). Combination antibiotic therapy with third generation cephalosporin+aminoglycoside was used in 49.3% and 55.5% of cases, respectively. For single antibiotic therapy, second generation quinolones were used the most (35.5% and 34.3%, respectively). Sequale occurred in 29 group 1 patients (5.4%) and 20 group 2 patients (15.3%); the difference was significant (p<0.05). Conclusions: Prior manipulation was associated with 20% of ABP patients. Regardless of manipulation, clinical outcome was similar after treating with appropriate antibiotics."

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Prevalence of Chronic Prostatitis Symptoms in Korean Young Adult Male using the National Institutes of Health Chronic Prostatitis Symptom Index: Sung Bin Kim, Jae Young Choi, Seung Hoon Cho, Seung Tae Lee, Seung Ki Min; Korean J Urogenit Tract Infect Inflamm 2011;6(2):192-198. Published online October 31, 2011

Abstract PDF: "Purpose: The National Institutes of Health chronic prostatitis symptom index (NIH-CPSI) was used to determine the prevalence of prostatitis-like symptoms among young adult Korean males. Materials and Methods: From February 1, 2009 to February 1 2011, we conducted a survey targeting 1095 Korean young men who were enrolled at an educational institution. After explaining about NIH-CPSI, subject completed a questionnaire. Respondents were fairly evenly distributed. We analyzed the collected questionnaires, and considered men who reported perineal and/or ejaculatory pain or discomfort and a total NIH-CPSI pain score of ≥4 as having prostatitis-like symptoms. We also analyzed the correlations of pain, urinary symptom and quality of life scores in the prevalence group. Results: The average age of 1095 volunteers was 30.1 years (range 25-35 years). Among these men, 90 (8.2%) indicated feeling pain. Of these men, 27 experienced perineal and/or ejaculatory pain or discomfort, and their total NIH-CPSI pain score exceeded 4. The estimated prevalence of prostatitis-like symptoms was approximately 2.5%. The mean pain score of men who indicated experiencing pain was 7.0, but the mean pain score of all respondents was 0.7; the difference was statistically significant. Positive correlations were evident between pain score and quality of life score (Pearson's correlation coefficient=0.965), and urinary symptom score and quality of life score (Pearson's correlation coefficient=0.891). Also, using mean score of quality of life domain of ≤6 and >6 revealed statistically significant differences of mean score of pain (8.1/5.4) and urinary symptoms (2.6/0.3). Conclusions: The estimated prevalence of prostatitis-like symptom in the examined population of young adult Korean males was 2.5%. And there were closed relationships between pain, urinary symptome, and quality of life score in prevalence group."

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Comparison of Clinical Symptoms Scored According to NIH-CPSI in Patients with Chronic Prostatitis Syndrome Category IIIa and IIIb: Jae Young Choi, Moung Jin Lee, Seung Hoon Cho, Sung Bin Kim, Seung Tae Lee, Seung Ki Min; Korean J Urogenit Tract Infect Inflamm 2011;6(1):42-47. Published online April 30, 2011

Abstract PDF: "Purpose: With little evidence, the causes of inflammatory and non-inflammatory chronic pelvic pain syndrome (CPPS), which cover a majority of cases of prostatitis syndromes, have not been fully explicated. The mechanisms of these two CPPS may be different. Although the clinical symptoms are expected to be disparate, we compared the clinical symptoms between the two using National Institutes of Health chronic prostatitis symptoms index (NIH-CPSI) over several parameters. Materials and Methods: The chronic pelvic pain syndrome patients (n=256) at our institution between April 2009 and March 2010 were included. After classifying these patients into two groups, the inflammatory CPPS and the non-inflammatory CPPS groups, we compared the two groups in terms of pain or discomfort, urinary symptom, quality of life, prostate volume measured by transrectal ultrasonography (TRUS), prostate specific antigen (PSA) and maximum flow rate (Qmax) difference. Result: There was no statistically significant difference between the two groups in pain or discomfort, urinary symptom, quality of life, prostate volume measured by TRUS, and Qmax difference. However, inflammatory CPPS patients showed meaningfully higher PSA scores than non-inflammatory CPPS patients. No significant difference was observed between patient age and compared among the age groups. Pain or discomfort, urinary symptom, quality of life, prostate volume measured by TRUS, and Qmax difference within each age group were not significantly different between the inflammatory CPPS & non-inflammatory groups. Conclusions: There was no statistically significant difference between the two groups except PSA. It remains unreliable to distinguish inflammatory CPPS from non-inflammatory CPPS based solely on clinical symptoms."

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Urinary Candidiasis Caused by Fluconazole-Resistant Candida glabrata: Moung Jin Lee, Seung Hoon Cho, Jae Young Choi, Seung Tae Lee, Seung Ki Min; Korean J Urogenit Tract Infect Inflamm 2010;5(1):97-101. Published online April 30, 2010

Abstract PDF: Urinary tract infection caused by Candida glabrata is an uncommon fungal infection. Risk factors for candiduria include diabetes mellitus, antimicrobial use, immunosuppressive therapy and urinary tract defect. We recently experienced a case of urinary tract infection caused by fluconazole-resistant Candida glabrata in a 57-year old woman with diabetes. The diagnosis and management are discussed, and the literature is reviewed

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Significance of Pyospermia in the Patients with Varicocele: Moung Jin Lee, Seung Hoon Cho, Jong Wan Lim, Seung Tae Lee, Seung Ki Min; Korean J Urogenit Tract Infect Inflamm 2009;4(2):196-201. Published online October 31, 2009

Abstract PDF: "Purpose: Pain is one of the indications to treat varococele at any age. The purpose of this study is to find the significance of pyospermia in the patients surgically treated for scrotal pain associated with varicocele. Material and Methods: From January 2002 to December 2008, a total of 365 men underwent varicocelectomy. As the preoperative semen analysis, we classified patients of scrotal pain into two groups as pyospermia group I (N=136) and non-pyospermia group II (N=112). Preoperative and postoperative clinical symptoms were analyzed. The result was classified into completely resolved, partially resolved and unchanged based on the relief of pain. Results: Of 365 men, 248 (67.95%) patients were available for follow-up 3 months postoperatively. Among 119 patients with scrotal pain who have received the varicocelectomy, 42 (65.63%) and 5 (7.8%) patients in group I (64 patients) reported completely resolved and partially resolved respectively (mean response rate 73.44%). In group II (55 patients), 42 (76.36%) and 8 (14.55%) reported completely and partially resolved respectively (mean response rate 90.90%) (p<0.05). Seventeen and 5 patients in group I and II reported persistent pain, respectively. Conclusions: Patients with pyospermia surgically treated for scrotal pain associated with varicocele have tendency to have persistent pain after surgical treatment. This result may help the varicocele patients with persistent pain after receiving the surgery."

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Is the Prophylactic Intravenous Antibiotics before the Prostate Biopsy Effective?: Jong Wan Lim, Moung Jin Lee, Seung Hoon Cho, Seung Ki Min; Korean J Urogenit Tract Infect Inflamm 2009;4(1):56-61. Published online April 30, 2009

Abstract PDF: "Purpose: The blood serum prostate-specific antigen (PSA) and digital rectal examination (DRE) are being more commonly used for the early diagnosis of prostate cancer, such that more patients are going through prostate biopsies. The authors investigated the value of prophylactic intravenous antibiotics to prevent infective complication after the biopsy. Materials and Methods: The subjects were 356 patients aged 40-88 year who had a prostate biopsy from January 2004 to July 2008. Among them, 89 patients who had taken prophylactic intravenous antibiotics before the biopsy were designated as Group I, and the remaining 267 patients, as Group II who didn't had taken prophylactic intravenous antibiotics before the biopsy. The patients took then oral antibiotics (fluoroquinolone) for one week, from the morning after the biopsy, to prevent infection. The occurrence of complication was monitored based on such symptoms as gross hematuria, rectal bleeding, hemospermia, dysuria, voiding difficulty, fever. Results: 87 patients (24.4%) of the total 356 patients were diagnosed with prostate cancer. Infective complication occurred in 6 patients (1.7%), among whom 2 patients (2.2%) in Group I had taken prophylactic intravenous antibiotics, and 4 patients (1.6%) in Group II did not take intravenous antibiotics. Infective complication rates of the two groups did not have statistically differences (p>0.05). Conclusions: The intake of prophylactic intravenous antibiotics before the prostate biopsy did not have a special impact on the prevalence rate of infective complication after the biopsies."

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Condyloma Lata Mimicking as a Condyloma Accuminata with Syphilis: Seung Hoon Cho, Myung Jin Lee, Jong Wan Lim, Yun Won Park, Seung Ki Min; Korean J Urogenit Tract Infect Inflamm 2008;3(2):236-239. Published online October 31, 2008

Abstract PDF: Condyloma lata is white lesions associated with secondary syphilis. Considering the recent increased in the incidence of syphilis in the Republic of Korea, such lesions are likely to present frequently. Differential diagnosis between Condyloma lata and Condyloma accuminata is required because they have in common with veneral warts the fact that they are both raised lesions on the vulva (or penis) or anus. A 20-year-old man was referred for a chancre at penile glans and numerous perianal masses. Serologic test for syphilis (VDRL, TPHA) will be positive. We misconceived condyloma accuminata with primary syphilis, then circumcision and perianal masses excision were done with Benzathine Penicillin G 24-hundred thousand U IM injection. As a pathologic result, they were doubted strongly skin lesions of syphilis, and HPV detection test was negative.

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Idiopathic Retroperitoneal Fibrosis: Clinical Role of 18F-Fluorodeoxyglucose Positron Emission Tomography for Differential Diagnosis from Malignancy: Chang Seung Liu, Seung Hun Seol, Jong Wan Im, Moung Jin Lee, Yeon Won Park, Seung Ki Min; Korean J Urogenit Tract Infect Inflamm 2008;3(1):108-115. Published online April 30, 2008

Abstract PDF: Retroperitoneal fibrosis sometimes causes urological problem involving the ureter, but the mechanism is uncertain. The most common treatment of retroperitoneal fibrosis is often a surgical exploration followed by urologic intervention, but medical therapy has been advocated recently. For medical therapy, there is necessary to exclude malignancy and 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) scan may be an useful alternative tool to avoid invasive procedure including open biopsy. Here we report two patients who were undergone the FDG-PET scan to exclude malignancy and received successful treatment of retroperitoneal fibrosis with prednisolone.

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Clinical Aspects and Short-term Results of Bladder Hydrodistention for Interstitial Cystitis in Young Adult Men: Changseung Liu, Seung Ki Min; Korean J Urogenit Tract Infect Inflamm 2007;2(1):66-72. Published online May 31, 2007

Abstract PDF: "Purpose: Interstitial cystitis (IC) is prevalent in the mid age women, characterized by frequency, urgency, nocturia, suprapubic pain and dysuria. We estimated the clinical aspects and short-term results of hydrodistention for young male IC patients. Materials and Methods: A retrospective chart review was conducted of 8 patients who had treated for interstitial cystitis between March 2002 and June 2006. They were diagnosed with exclusive criteria from National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) group. All of them were normal in urine analysis, prostatic secretion and transrectal ultrasonography (TRUS), and were not improved with anti muscarinic agents. We performed urodynamic study (UDS), potassium chloride sensitivity test (PST) and cystoscopy with hydrodistention under spinal anesthesia. Results: Symptom durations were less than 5 years in 4 (50%) patients, between 5-10 years in 2 (25%) and more than 10 years in 2 (25%). PST was positive in 6 (75%) patients. On cystoscopy, glomerulations were noted in all patients and one (12.5%) had the Hunner's ulcer. On bladder mucosal biopsy, there were mast cells in 2 (25%) specimens. All patients had enlarged both the volume of first voiding sensation and the maximal capacity of bladder with statistical significance and improved symptoms at 1 month after hydrodistention. Conclusions: Symptoms of young male IC patients were not different with general IC symptoms. Even though the results show short-term effects, simple bladder hydrodistention would be the effective treatment modality for them."

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Author Index