Urogenital Tract Infection

Volume 13 (1); April 2018

Reviews

The Effect of α-Blockers Monotherapy vs. Combination Antibiotic Therapy on Symptom Alleviation in Patients with Chronic Prostatitis/Chronic Pelvic Pain Syndrome: Kyu Shik Kim, Hong Sang Moon; Urogenit Tract Infect 2018;13(1):1-6. Published online April 30, 2018

Abstract PDF: Prostatitis is a pathologic state of prostate inflammation accompanied by lower urinary tract symptoms and pelvic pain, reducing the quality of life in males of all ages. There is currently no established treatment modality for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). In this review, alpha-blocker monotherapy was compared with combination antibiotic therapies. Alpha-blockers are the most commonly used medications to treat CPPS, administered to over 40% of CPPS patients. The use of antibiotics in CP/CPPS is an alternative treatment option. There are no studies showing the efficacy of antibiotics in CP/CPPS patients. However, antibiotics are commonly prescribed to patients with CP/CPPS, often leading to patient improvement. A combined regimen of alpha-blocker, antibiotic, and anti-inflammatory therapy showed improvement in patient symptoms; however, the results were similar to monotherapy with alpha-blockers. When alpha-blocker monotherapy was compared with three multidrug therapies via randomized controlled trials, monotherapy was shown to be more effective than multidrug treatment. There is no definite treatment for CP/CPPS because it is caused by various factors, and symptoms are different for each patient. CP/CPPS patient care should be managed in a manner that identifies and treats all symptoms simultaneously and appropriately. Recently, urinary, psychosocial, organ-specific, infection, neurologic/systemic, and tenderness (UPOINT) was introduced in order to better treat patients. However, UPOINT has not been extensively studied in clinical trials, and the mechanical principles of UPOINT have yet to be elucidated. Alpha-blocker monotherapy and antibiotic combination therapy showed considerable improvement in CP/CPPS patients (by National Institutes of Health Chronic Prostatitis Symptom Index scores).

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Lactobacillus and Urine Microbiome in Association with Urinary Tract Infections and Bacterial Vaginosis: Jun-Mo Kim, Yoo-Jin Park; Urogenit Tract Infect 2018;13(1):7-13. Published online April 30, 2018

Abstract PDF: The traditional concept of “urine is sterile if urine culture and urinalysis are negative” has been overcome by new approaches using 16S ribosomal ribonucleic acid (rRNA) that demonstrated the presence of urinary microbiota. This mini-review article provides updated information of the human urinary microbiome related to urogenital tract infections (UTIs) and describes Lactobacillus in the maintenance of urogenital health and prevention of UTIs. The following keywords were used in combination with “Urinary tract symptoms”, “Urogenital symptoms”, and “Probiotics” in a search: “Bacterial Vaginosis”, “Human Microbiome Project”, “Lactobacillus”, “Microbiome”, and “Urinary Tract Infections.” Here, changes in the urinary microbiome and differences in the abundance of Lactobacillus were identified in patients with UTI. Further development of key characteristics of urinary microbiomes that utilize 16S rRNA gene sequencing will play a key role in improving our understanding of urinary health diseases, such as UTIs.

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Original Article

Epidemiology and Outcomes of Acute Flank Pain in University-Affiliated Regional Emergency Medical Centers: Seon Tae Kim, Young Hwang, Seung Chol Park, Jea Whan Lee; Urogenit Tract Infect 2018;13(1):14-20. Published online April 30, 2018

Abstract PDF: Purpose: Acute abdominal pain accounts for 7-10% of all emergency department visits. The purpose of this study is to investigate the epidemiology and outcome of acute flank pain at regional emergency medical centers (EMC) and to investigate the necessity of urologists.
Materials and Methods: We retrospectively reviewed all records of EMC visits for flank pain between 1 July 2015 and 30 June 2017. The renal colic was defined according to the code allocation of the Korean standard classification of disease-6 code N132, N200-N203, and N210-N211. The results of this study were retrospectively analyzed and the characteristics of the patients.
Results: The total number of visits to the EMC was 67,792, and the number of visits for acute abdominal pain was 9,641. The number of visits for acute flank pain was 1,133 and the number of patients was 1,018. The departments included emergency medicine (n=235), urology (n=711), internal medicine (n=132), general surgery (n=19), gynecology (n=10), and others (n=26). The causes of urological flank pain were urolithiasis in 628 cases, infection in 41 cases, and other diseases in 42 cases. Among these, 244 cases were admitted, and 193 cases of them were urolithiasis patients, and 171 patients underwent stone removal surgery.
Conclusions: According to our study, patients with flank pain accounted for 11.8% of patients with abdominal pain. However, considering hospitalization and frequency of surgery, it is necessary to take the national measurement for the long-term supply of urology.

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