Urogenital Tract Infection

Yong-Hyun Cho

22 Articles

2017 Guidelines of The Korean Association of Urogenital Tract Infection and Inflammation: Acute Uncomplicated Cystitis: Ki Ho Kim, Seung-Ju Lee, Yong-Hyun Cho, Hyun-Sop Choe, Yong Gil Na, Jae Heon Kim, Hong Chung, Jae Min Chung, Jae Hung Jung, Hoon Choi, Sun-Ju Lee; Urogenit Tract Infect 2017;12(1):3-6. Published online April 30, 2017

Abstract PDF: Acute uncomplicated cystitis is the most common urinary tract infection that mainly occurs in adult females, particularly sexually active young women and postmenopausal women. It is commonly observed in primary health care settings, including urology as well as obstetrics and gynecology; more than half of healthy adult women visit clinics and hospitals at least once in their lifetime due to acute uncomplicated cystitis. The most common bacterium causing this condition is Escherichia coli, followed by Staphylococcus saprophyticus, Klebsiella pneumoniae, Proteus mirabilis, and etc. Trimethoprim-sulfamethoxazole or fluoroquinolones have been used as an empirical antibiotic treatment. However, as fluoroquinolone-resistant organisms or extended spectrum beta-lactamase-producing organisms are becoming more prevalent worldwide, information on regional antibiotic resistance and guidelines on antibiotic use are becoming increasingly more desparate.

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2017 Guidelines of The Korean Association of Urogenital Tract Infection and Inflammation: Recurrent Urinary Tract Infection: Seung-Ju Lee, Hyun-Sop Choe, Yong Gil Na, Ki Ho Kim, Jae Heon Kim, Hong Chung, Jae Min Chung, Jae Hung Jung, Hoon Choi, Sun-Ju Lee, Yong-Hyun Cho; Urogenit Tract Infect 2017;12(1):7-14. Published online April 30, 2017

Abstract PDF: Recurrent infection after an acute urinary tract infection (UTI) episode is common in adult women. It is onerous to both the patient and the physician to treat frequent recurrent UTI. Every time when UTI recurs, patients experience lower urinary tract symptoms, fatigue, and limitation in everyday life, while the physician has difficulty in counseling patients with a disease entity whose pathophysiology is less known. Currently, prophylactic treatment for recurrent UTI is limited, is ineffective in most cases, and sometimes accompanies unexpected side effects. In this guideline, we aimed to establish feasible and effective recommendations for the treatment of recurrent UTI in healthy adult women.

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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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Anti-Inflammatory Effect of Phlorotannin on Chronic Nonbacterial Prostatitis in a Rat Model: Yun Seok Jung, Yong-Hyun Cho, Chang Hee Han; Korean J Urogenit Tract Infect Inflamm 2014;9(2):86-92. Published online October 31, 2014

Abstract PDF: Purpose
Chronic nonbacterial prostatitis and chronic pelvic pain syndrome account for 90-95% of all prostatitis. Little is known about its pathophysiology, thus, various treatments are used. Ecklonia cava, a seaweed, is a member of the brown algae family; many recent reports have demonstrated that its extract containing phlorotannin has anti-oxidative and anti-inflammatory properties. Using the hormone-induced prostatitis rat model, we investigated the anti-inflammatory effects of E. cava extracts via its anti-oxidative process on chronic nonbacterial prostatitis. Materials and Methods: Forty, 10-week-old male white Wistar rats were utilized, and divided equally into the following five groups: 1) control, 2) E. cava-fed, 3) hormone-induced prostatitis (HIP), 4) E. cava-treated HIP, and 5) nonsteroidal anti-inflammatory drug (NSAID)-treated HIP. Results: The results showed statistically-significant improvement in the tissue response to the hormone-induced inflammation among the E. cava-treated and NSAID-treated groups (p＜0.05). Lower malonedialdehyde levels were observed in the group with E. cava-treated HIP than with HIP alone, which was statistically significant. We believe that this supports the anti-oxidative properties of E. cava. Conclusions: This study demonstrates that phlorotannin has anti-inflammatory properties via its anti-oxidative process, which we expect to play an important role in prevention and as an adjuvant therapy for chronic nonbacterial prostatitis.

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Acute Bacterial Prostatitis: U-Syn Ha, Yong-Hyun Cho; Korean J Urogenit Tract Infect Inflamm 2011;6(2):115-128. Published online October 31, 2011

Abstract PDF: Bacterial prostatitis represents a small portion of the prostatitis spectrum, and acute bacterial prostatitis (ABP) is uncommon. But ABP is a urologic emergency. Even if there is a wide consensus for the diagnosis and treatment of ABP, many physicians need detailed guidelines with clear evidence. We suggest the diagnosis and treatment criteria of ABP with extensive review of the current literatures. The initial diagnosis of ABP is based on signs and symptoms like fever or voiding problem. Patients with symptoms should undergo urine analysis and culture of the urine. An imaging study of the prostate including transrectal ultrasound (TRUS) is suggested to exclude prostatic abscess (LoE 4). Elevated levels of prostate-specific antigen (PSA) are helpful to distinguish ABP from other febrile UTI. The predominant causative organisms are Gram-negative bacteria, mainly Escherichia coli. Appropriate management of ABP includes rapid initiation of broad-spectrum parenteral antibiotics and symptomatic support.

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Factors of Progression to Chronic Infections from Acute Bacterial Prostatitis: Byung Il Yoon, Seol Kim, Tae Seung Shin, U-Syn Ha, Dong Wan Sohn, Yong-Hyun Cho; Korean J Urogenit Tract Infect Inflamm 2011;6(2):178-185. Published online October 31, 2011

Abstract PDF: "Purpose: We conducted a retrospective analysis of acute bacterial prostatitis (ABP) to evaluate the factors of progressing to chronic bacterial prostatitis (CBP) and inflammatory chronic pelvic pain syndrome (CPPS) from ABP. Materials and Methods: The clinical records of 480 cases compatible with a confirmed diagnosis of ABP from five urological centers between 2001 and 2010 were reviewed. We defined chronic infection (CI) as a progression to CBP and inflammatory CPPS after treatment of ABP in admission periods when followed-up at 3 months or more. Results were analyzed according to two groups: recovered without CI (group A, n=428) and developed to CI (group B, n=52). Results: Of the 480 ABP patients, 1.3% (6/480) progressed to CBP and 9.6% (46/480) progressed to inflammatory CPPS. The progression rate of CI was 10.9% (52/480). The factors that affected progress to CI were diabetes, prior manipulation, prostate volume, absence of cystostomy and urethral catheterization (p<0.05). Conclusions: The identification and characterization of influential factors may accelerate the development of preventive, diagnostic and therapeutic strategies for the treatment of CI from ABP."

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The New Korean Guideline for Sexually Transmitted Infections: Dong-Hoon Lim, Seung-Ju Lee, Bongsuk Shim, Chul-Sung Kim, Min Eui Kim, Yong-Hyun Cho; Korean J Urogenit Tract Infect Inflamm 2011;6(1):96-113. Published online April 30, 2011

Abstract PDF: Sexually transmitted infections (STIs) are increasing worldwide. To have a well-designed localized guideline on STIs is crucial in controlling the condition. We reviewed the newly developed Korean STI guideline, 2011 that will provide comprehensive information regarding STI management.

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Asymptomatic Bacteriuria: Chang-Hee Han, Yong-Hyun Cho; Korean J Urogenit Tract Infect Inflamm 2010;5(2):119-128. Published online October 31, 2010

Abstract PDF: Asymptomatic bacteriuria is common. Among healthy adults, bacteriuria increases with age, and occurs more frequently in women than men. Individuals with underlying genitourinary abnormalities, such as spinal cord injuries or with indwelling catheters also have a very high prevalence of bacteriuria. Bacteriuria per se in most population is benign. It has been shown to have adverse outcomes in pregnant women, in whom it is associated with pyelonephritis, low-birth weight and premature birth, and in patients undergoing traumatic genitourinary procedures associated with mucosal bleeding, in whom there is a high risk of bacteremia and sepsis. In other populations, clinical trials have consistently shown no benefits of screen for or treatment of asymptomatic bacteriuria. For some immunocompromised persons, such as those with neutropenia or post-renal transplant, further evaluation to describe the natural history and impact of bacteriuria is required.

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Changes in Detection Rate of Causative Organisms in Patients with Urethritis Symptoms and Signs: Seung Hyuk Yim, Myung Sun Choi, U-Syn Ha, Dong Wan Sohn, Yong-Hyun Cho; Korean J Urogenit Tract Infect Inflamm 2010;5(2):176-181. Published online October 31, 2010

Abstract PDF: "Purpose: Male urethritis is one of the most common sexually transmitted infections (STIs), but the etiology is still unclear in many cases. We retrospectively studied and compared the detection rate of the causative organisms in patients with urethritis symptoms and signs between 2000 and 2009. Materials and Methods: We reviewed the medical records of 181 patients with urethritis symptoms and signs who had undergone a gram stain, urethral swab culture, multiplex polymerase chain reaction (mPCR) assay in 2000 and 2009 at a single hospital. Changes in detection rate of the causative organisms between 2000 and 2009 were analyzed. Results: The common pathogens in 2009/2000 were Ureaplasma urealyticum (27.40% vs. 13.89%, p=0.025), Mycoplasma species (12.33% vs. 5.56%, p=0.107), Chlamydia trachomatis (10.96% vs. 12.04%, p=0.827) and Neisseria gonorrhoeae (4.11% vs. 1.85%, p=0.367). Detection rate of Ureaplasma urealyticum significantly increased in 2009 compared to 2000 (p=0.025). Conclusions: Ureaplasma urealyticum was the most common pathogen of nongonococcal urethritis in our study. In particular, Ureaplasma urealyticum was found to have increased significantly in recent years."

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Aminoglycosides Resistance of Escherichia coli Isolates from Acute Uncomplicated Cystitis: Gilho Lee, Min Eui Kim, Yong-Hyun Cho, Chul Sung Kim, Young Ho Kim, Seung Ju Lee; Korean J Urogenit Tract Infect Inflamm 2010;5(1):51-56. Published online April 30, 2010

Abstract PDF: "Purpose: The aim of the study was to determine the aminoglycosides resistance of Escherichia coli (E. coli) strains isolated from acute uncomplicated cystitis. Materials and Methods: All 219 female patients who presented with symptoms of acute cystitis by E. coli infection were included in this study. We used gentamicin, tobramycin, and amikacin for detecting the resistance to aminoglycosides. The prevalence of gentamicin, tobramycin, and amikacin resistance of E. coli was 25.1%, 24%, and 0.4%, respectively. Results: The resistant isolates to tobramycin or gentamicin definitively showed an associated resistance to other antibiotics such as ciprofloxacin and trimethoprin-sulfamethoxazole, while the resistance to amikacin was not. In addition, 3 aminoglycosides resistant E. coli isolates did not associated with the history of recurrent cystitis. Conclusions: We recommend the clinical use of amikacin for the ciprofloxacin or trimethoprim- sulfamethoxazole resistant E. coli isolates from urinary tract infection, instead of gentamicin or tobramycin."

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The Correlation between Post-void Residual Urine Volume and Urinary Tract Infection in Asymptomatic Men Visited for Prostate Examination: Seung Hyuk Yim, U-Syn Ha, Dong Wan Sohn, Yong-Hyun Cho; Korean J Urogenit Tract Infect Inflamm 2010;5(1):63-67. Published online April 30, 2010

Abstract PDF: "Purpose: The large post-void residual urine (PVR) could be related to various complications, especially urinary tract infections (UTIs). Although numerous cut-off value of PVR related to UTIs have been proposed there is still debate on that. We investigated the correlation between PVR and UTIs. Materials and Methods: From January 2008 to December 2008, retrospective analysis was performed on 351 asymptomatic male patients who visited our clinic for prostate examination. The prostate specific antigen (PSA) level, peak urine flow rate, PVR, voided urine volume, International Prostatic Symptom Score (IPSS) and urine culture results were obtained. PVR was measured by portable bladder scanner. A positive result of urine culture was defined as growth of more than 100,000 bacteria per ml. We investigated the association between urine culture results and PVR, and estimated cut-off value of PVR predicting bacteriuria using ROC analysis. Results: The mean age of patients was 63.3±10.4years and 8.83% of the total patients (31 patients) showed positive in urine culture. Mean PVR volume was significantly higher in the group with positive urine culture compare to the group with negative urine culture (105.6mL vs 41.8mL, p<0.001), but we couldn't validate cut-off value of PVR for predicting UTIs. Conclusions: Significant bacteriuria was found in 8.83% of the asymptomatic male patients. Although the positive relationship between PVR and the risk of UTIs was found we couldn't validate cut-off value of PVR for predicting UTIs."

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Treatment and Prevention of Catheter-Associated Urinary Tract Infections: Seung Hyuk Yim, U-Syn Ha, Dong Wan Sohn, Seung-Ju Lee, Chang Hee Han, Choong Bum Lee, Yong-Hyun Cho; Korean J Urogenit Tract Infect Inflamm 2009;4(2):159-169. Published online October 31, 2009

Abstract PDF: Urinary tract infections (UTIs) represent the second most often observed infectious diseases in community, following the respiratory tract infections. Approximately 40% of nosocomial infections originate in the urinary tract; about 80% of urinary tract infections is related to urinary catheterization. The duration of catheterization is the most important risk factor for development of UTIs and additional risk factors include female sex, diabetes mellitus, renal function impairment, lack of antimicrobial therapy, and not maintaining a closed drainage system. There are many methods for preventing catheter-associated urinary tract infections (CAUTI); (i) an indwelling catheter should be introduced under antiseptic conditions; (ii) urethral trauma should be minimized by the use of adequate lubricant and the smallest possible catheter; (iii) the catheter system should remain closed; and (iv) the duration of catheterization should be minimal. Antimicrobial urinary catheters can prevent or delay the onset of CAUTI, but the effect on morbidity is not known. Antibiotic treatment is recommended only in symptomatic infection (bacteremia, pyelonephritis, epididymitis, prostatitis), but systemic antimicrobial treatment of asymptomatic CAUTI is only recommended in the following circumstances; (i) patients undergoing urological surgery or implantation of prosthesis; (ii) treatment may be part of a plan to control nosocomial infection due to a particularly virulent organism prevailing in a treatment unit; (iii) patients who have a high risk of serious infectious complications; and (iv) infections caused by strains causing a high incidence of bacteremia.

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Clinical Characteristics of Prostatic Abscess Treated with Transurethral Resection or Incision and Drainage: Yun Seok Jung, Jang Chun Woo, Yong Seok Lee, Sung Hak Kang, Chang Hee Han, Yong-Hyun Cho; Korean J Urogenit Tract Infect Inflamm 2009;4(1):67-71. Published online April 30, 2009

Abstract PDF: "Purpose: To evaluate the clinical presentations of prostatic abscess treated with transurethral resection or incision and drainage. Materials and Methods: We retrospectively assessed the charts of 5 patients with the diagnosis of prostatic abscess and treated with transurethral resection or incision and drainage from January 2008 to March 2009. Factors analyzed included presenting features, predisposing factors, radiologic imaging, bacteriological profile, and treatment. Results: The mean patients' age was 58.8 years. Diabetes mellitus was the most common predisposing factor (40%). Four patients presented lower urinary tract symptoms and fever, and three patients had chill. The mean size of prostatic abscess was 3.82cm and four patients had leukocytosis and pyuria. Abscess was drained by transurethral resection of prostate in three cases, and by transurethral incision and drainage in two cases. There were no postoperative complications with complete abscess resolution in all patients. Conclusions: Transurethral resection or incision and drainage should be considered in a patient with large prostatic abscess, which is not responsive to the appropriate antibiotic therapy."

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Septic Shock Caused by Pancreatic Injury after Radical Nephrectomy: Dong-Wan Sohn, Tae Seung Shin, Sung Dae Kim, U-shin Ha, Yong-Hyun Cho; Korean J Urogenit Tract Infect Inflamm 2009;4(1):93-95. Published online April 30, 2009

Abstract PDF: A 66-year-old female patient presented with right upper quadrant pain for 3months. Preoperative computed tomography, magnetic resonance imaging, and laboratory tests were not consistent with findings of pheochromocytoma, but rather tumor originating from renal cortex. Pathology revealed pheochromocytoma and pancreatic injury was suspected after the surgery. Septic condition persisted despite of proper antibiotics, drainage, and octreotide therapy. Patient died on 8th day after radical nephrectomy. We report a morbid complication of pancreatic injury leading to septic shock and to death.

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Jaundice and Acute Pyelonephritis due to a Giant Urinoma: Sung Dae Kim, Dong Sub Lee, Dong Wan Sohn, Sae Woong Kim, Yong-Hyun Cho; Korean J Urogenit Tract Infect Inflamm 2008;3(2):244-248. Published online October 31, 2008

Abstract PDF: Disruption of the urinary collecting system can produce internalized urine leaks that can be continous urine extravasation and form an encapsulated collection of urine, which is known as a urinoma. Urinoma is also called as pararenal pseudocyst and usually the result of renal injury and may be the result of obstructive uropathy from a ureteral stone or pelvic mass or even a urological procedure. Although urinoma may induce the urinary infection such as acute pyelonephritis, it may not give rise to jaundice due to biliary tract obstruction. We describe an unusual case of jaundice and acute pyelonephritis due to a giant urionoma after high grade renal injury.

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Experimental Animal Models of Prostatitis: Limitations and Potential: Yun Seok Jung, Chang Hee Han, Yong-Hyun Cho; Korean J Urogenit Tract Infect Inflamm 2008;3(1):10-23. Published online April 30, 2008

Abstract PDF: Prostatitis is a polyetiological inflammation of the prostate gland in men characterized by pelvic pain, irritative voiding symptoms, and sexual dysfunction. Histologically prostatitis is characterized by poly- and mononuclear cell infiltrates (neutrophils, lymphocytes, macrophages and plasma cells) in the stromal connective tissue around the acini or ducts. Prostatitis is an important worldwide health problem in men. The pathogenesis and diagnostic criteria for the condition are obscure, with the result that the development of management programs for this condition has been hindered. Animal model(s) might be useful in elucidating mechanisms involved in the molecular pathogenesis of chronic nonbacterial prostatitis and chronic pelvic pain syndrome. Given that prostatitis might have a multifactorial etiology, several animal models with unique features may prove helpful. This review examines a number of experimental animal models of prostatitis and evaluates their advantages and limitations.

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The Antimicrobial Effect of Antibiotics to Patients with Chronic Prostatitis of Positive Reaction on Chlamydial Antibody: Sung Dae Kim, Dong Wan Sohn, Sae Woong Kim, Yong-Hyun Cho; Korean J Urogenit Tract Infect Inflamm 2008;3(1):81-88. Published online April 30, 2008

Abstract PDF: "Purpose: Chronic bacterial prostatitis is the most common urological disease in adult males, with antibiotic therapy being the gold standard for its treatment. Recent studies suggest that Chlamydia may play a role in chronic prostatitis but was difficult to prove the pathogen to the prostate. We evaluated the effect of three antibiotics (azithromycin, doxycycline, levofloxacin) in patients with chronic prostatitis of positive reaction on Chlamydial antibody. Material and Methods: The study included 54 patients who had symptoms of chronic prostatitis and proven presence of Chlamydia. The presence of Chlamydia was confirmed in expressed prostatic secretion (EPS) immediately after prostatic massage by multiplex polymerase chain reaction (PCR). The patients were randomized to receive azithromycin 1.0g (n=16) once, or doxycycline 100mg b.i.d. (n=19) for 21 days or levofloxacin 100mg t.i.d. (n=19) for 21 days. Patients’ sexual partners were treated at the same time. Clinical and bacteriological efficacy (leukocyte count, pathogen eradication rate, NIH-CPSI) was evaluated after the end of therapy. Results: After treatment of antibiotics, the leukocytes counts in the EPS was significantly decreased in all groups (p<0.05), but there was no significant difference in three groups. Also, all of groups was superior to control Chlamydia (azithromycin:doxycycline:levofloxacin=93.75%:78.94%:89.47%) and there was no significant difference of the pathogen eradication rates in three groups. The total NIH-CPSI score was significantly decreased, especially pain domain and quality of life domain (p<0.05), and there was no significant difference in three groups. Conclusions: These data suggest that antibiotics of three groups was effective to the patient with chronic prostatitis of positive reaction on Chlamydia antibody."

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The Present Status and Counterplans of Nosocomial Infection: Sung Dae Kim, Dong Wan Sohn, Sae Woong Kim, Yong-Hyun Cho; Korean J Urogenit Tract Infect Inflamm 2007;2(2):1-11. Published online May 31, 2007

Abstract PDF: "Although of advances in medical environment we are faced with new pathogen in hospital according to increase of antimicrobial resistance, invasive procedure, population of old men, abuse of immune suppressants. Nosocomial infections are more common phenomena than other infection in clinical practice. Therefore, we should know about the exact definition, diagnostic principles, need of control of nosocomial infection. Especially, We need to understand about it in Korea. So the Korean Society for Nosocomial Infection Control (KOSNIC) organized the Korean Nosocomial Infectious Surveillance System (KONIS) to establish a nationwide database of nosocomial infection rate on the intensive care units of hospitals in Korea. This article focuses on the definition, background, principles of diagnosis, the current status and counterplans of nosocomial infection in Korea. We have full assurance that it should provide a theoretical strategy to enforce the infection control."

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The Relationship between Sexually Transmitted Diseases and HIV Transmission: Sung Dae Kim, Dong Wan Sohn, Seung-Ju Lee, Sae Woong Kim, Yong-Hyun Cho; Korean J Urogenit Tract Infect Inflamm 2007;2(2):157-166. Published online October 31, 2007

Abstract PDF: More than 42 million people worldwide are now infected with HIV, in spite of sustained prevention activities. Although the spread of HIV has been primarily sexual, epidemiological studies have indicated that the efficiency of the spread of HIV is poor, perhaps as infrequently as 1 in every 1,000 episodes of sexual intercourse. However, sexually transmitted diseases (STDs) that cause ulcers or inflammation greatly increase the efficiency of HIV transmission by increasing both the infectiousness of, and the susceptibility to HIV infection. STDs might be particularly important in the early stages of a localized HIV epidemic, when people with risky sexual behaviour are most likely to become infected. In China, eastern Europe and Russia, there has been a remarkable increase in the incidence of STDs in recent years, and this is reflected in the rapid increase in the spread of HIV in these areas. Targeted STDs detection and treatment should have a central role in HIV prevention in these emerging epidemics.

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Bilateral Vesicoureteral Reflux and Wilms' Tumor Combined with Urinary Tract Infection: Byung Il Yoon, Sung Dae Kim, Dong Wan Sohn, Sae Woong Kim, Yong-Hyun Cho; Korean J Urogenit Tract Infect Inflamm 2007;2(2):221-224. Published online October 31, 2007

Abstract PDF: Vesicoureteral reflux is a common condition in children. It may cause and maintain urinary tract infection, evaentually leading to progressive renal damage and end-stage renal disease. Wilms' tumor is the most common primary malignant renal tumor of childhood. There is no literature that vesicoureteral reflux combined with Wilms' tumor. We report rare case of bilateral vesicoureteral reflux combined with left Wilms' tumor.

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Multicenter Clinical Outcome of Gatifloxacin for Chronic Prostatitis (NIH Category II or IIIa) in Korea: Sang Don Lee, Seung Ju Lee, Tae Kon Hwang, Duck Ki Yoon, Kyu Sung Lee, Luck Hee Sung, Myung Soo Choo, Bong Suk Shim, In Rae Cho, Min Eui Kim, Soo Bang Ryu, Chul Sung Kim, Young Gon Kim, Chun Il Kim, Hyun Yul Rhew, Yong-Hyun Cho; Korean J Urogenit Tract Infect Inflamm 2007;2(1):53-60. Published online May 31, 2007

Abstract PDF: "Purpose: The objective of this study was to investigate the efficacy and safety of gatifloxacin for patients with chronic prostatitis (NIH category II or IIIa) in Korean urologic practice. Materials and Methods: A total of 16 outpatient urology clinics at tertiary care medical centers in Korea participated. Gatifloxacin (400 mg/day) treatment (S.D.) of 149 patients (20 patients with category II and 129 patients with category IIIa) with prostatitis (mean age 45.8±13.3 years) was carried out for 41.7 (33.1) days. A 4-glass test according to Meares and Stamey or two glass test was carried out at study entry and one month after the end of treatment. Clinical response, safety and bacteriological response were assessed before treatment (within 48 hours of initiation of the study medication) and at one month after treatment completion. Results: In a otal of 149 patients, the total NIH-CPSI score was significantly reduced from 20.5 to 10.0 (response rate 86.7%; 95% CI 80.2-93.2%) (p<0.05). Sub-scores of pain, urinary symptoms and impact on the quality of life were also significantly reduced from 8.9 to 3.8 (response rate 83.8%; 95% CI 76.8-90.9%), from 4.2 to 2.0 (response rate 73.3%; 95% CI 64.9-81.8%) and from 7.4 to 4.2 (response rate 79.0%; 95% CI 71.3-86.8%), respectively (p<0.05). In terms of the overall clinical efficacy assessment by investigators, out of 149 patients with prostatitis, 71.2% were assessed to be responders. Bacteriological studies in expressed prostatic secretion (EPS) or post prostate massage urine (VB3) at 1 month after treatment completion demonstrated that the overall eradication rates of pathogens was 85% and the pyuria (≥10 WBC/HPF) rates in the NIH category II and IIIa were 35% and 18.6%, respectively (overall rate 20.8%). There were 16.1% of patients that presented with some adverse events considered by investigators to be related to the drug. The majority of adverse events were considered to be of mild (87.5%) or moderate (8.3%) intensity. Conclusions: These results suggest that gatifloxacin in Korean urologic practice is well tolerated and improves the clinical outcomes in the patientswith chronic prostatitis (NIH category II or IIIa)."

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Present and Future Strategies in the Treatment of Bacterial Urinary Tract Infection: Yong-Hyun Cho; Korean J Urogenit Tract Infect Inflamm 2006;1(1):17-22. Published online October 31, 2006

Abstract PDF: Bacterial urinary tract infections (UTIs) are common infectious diseases that can be associated with substantial morbidity and significant expenditures. The mainstay of management of UTIs is almost exclusively antibiotic agent. There are two predominant aims in the antibacterial treatment of UTIs: (i) rapid and effective response to therapy and prevention of recurrence of the individual patient treated; (ii) prevention of emergence of resistance to antimicrobial chemotherapy in the microbial environment. The main drawback of current antibiotic therapies is the emergence and rapid increase of antibiotic resistance. To combat this, active research is going on. This review highlights the current concepts and recent advances in our understandings and future treatment options for UTIs. (Korean J UTII 2006;1:17-23)

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Author Index