Urogenital Tract Infection

Is Human Mpox a New Sexually Transmitted Infection in Korea That Should Be Monitored?: Gilho Lee; Urogenit Tract Infect 2023;18(2):35-44. Published online August 31, 2023; DOI: https://doi.org/10.14777/uti.2023.18.2.35

Abstract PDF Supplementary Material PubReader ePub: Human monkeypox (mpox) outbreaks have been reported in more than 110 countries, with more than 86,930 confirmed cases. The World Health Organization has realized the seriousness of personal transmission and has declared a global health emergency against the infection. Traditionally, contact with infected animals in a few endemic countries has been a major transmission route of the mpox virus. On the other hand, the global mpox outbreak in 2022 has been primarily associated with sexual networks of men who have sex with men (MSM) and bisexual men exhibiting high-risk behaviors. Their common symptoms are initial fever, headache, swollen lymph nodes, and subsequent skin rashes. These presentations did not consistently occur in the 2022 outbreak. Many patients presented with skin lesions on the anogenital areas without prodromal symptoms. In addition, the atypical characteristics of the recent outbreak may result in a misdiagnosis of other skin lesions, such as chickenpox. Furthermore, infected persons are frequently co-infected with sexually transmitted infections (STIs) with similar skin lesions. The newly confirmed cases in Korea on April 2023 must have been infected through community transmission because these new patients had not traveled overseas in the past three months. Therefore, mpox is something that everybody should be concerned about in Korea. Medical practitioners must know the characteristics of the infection because patients with mpox may visit their offices with some genital lesions or other STIs. The clinical information from this paper may broaden and deepen the understanding of human mpox and curb the early transmission of the infection.

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Role of Human Papillomavirus Vaccination for Prevention of Male Infertility: Taeyong Park; Urogenit Tract Infect 2023;18(2):45-49. Published online August 31, 2023; DOI: https://doi.org/10.14777/uti.2023.18.2.45

Abstract PDF PubReader ePub: The human papillomavirus (HPV) is a common sexually transmitted infection that can cause various diseases, including genital warts and malignant diseases, such as cervical, head and neck, and anal cancer. Emerging evidence suggests that a HPV infection can also adversely affect male fertility. The HPV has been detected in the semen and testicular tissues of infected individuals, indicating that the virus can directly impact the male reproductive system. Indeed, many studies showed that the HPV infection could cause sperm DNA damage, decreased sperm motility, and reduced sperm concentration, contributing to male infertility. The HPV vaccination is currently only being administered to females in Korea. On the other hand, the vaccine could help mitigate these negative impacts on male fertility by protecting males against HPV infection. This paper reviews the effects of the HPV on male fertility and the potential benefits of HPV vaccination in protecting male fertility.

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Exploring National Trends in Bladder-Related Urological Procedures: A Nationwide Population-Based Cohort Study: Hyosang Kwon, Wonjong Yang, Sangyong Park, Heesub Lee, Jong Keun Kim, Jun Hyun Han; Urogenit Tract Infect 2023;18(2):50-59. Published online August 31, 2023; DOI: https://doi.org/10.14777/uti.2023.18.2.50

Abstract PDF PubReader ePub: Purpose: This study examined the epidemiological trends of bladder-related urological procedures in South Korea from 2009 to 2021.
Materials and Methods: The data were obtained from the Health Insurance Review and Assessment Service (HIRA) database, encompassing various bladder-related urological procedures. The frequencies and trends were analyzed using statistical methods.
Results: Uroflowmetry, cystoscopy, prostate biopsy, and urethral dilation showed a positive trend, while prostate massage exhibited a negative trend. The 72-hour voiding function test, which started in 2017, also demonstrated a positive trend in frequency. A urodynamic study and mid-urethral sling operation exhibited an overall decreasing trend. Bladder-indwelling catheter, Nelaton catheterization, and cystostomy catheter change showed increasing trends, while suprapubic cystostomy showed a decreasing trend.
Conclusions: This 12-year analysis provided valuable insights into the epidemiological patterns and utilization of bladder-related urological procedures in South Korea. These trends highlight the evolving landscape of diagnostic and therapeutic approaches in bladder-related conditions and the importance of interdisciplinary collaboration between urology and other medical departments. The results highlight the need for optimizing catheter-related care protocols, resource allocation, and continued monitoring of practices across healthcare settings.

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Feasibility of Anesthesia-Free Ureteroscopic Lithotripsy in Elderly Patients with Urinary Tract Infections: Duk Yoon Kim, Hyun Jin Jung, Eun Kyoung Yang, Won Yeol Cho; Urogenit Tract Infect 2023;18(2):60-63. Published online August 31, 2023; DOI: https://doi.org/10.14777/uti.2023.18.2.60

Abstract PDF PubReader ePub: Purpose: Patients with underlying diseases, particularly in the elderly, urinary tract obstruction with a ureter stone would progress to severe conditions. Some of them have poor general conditions to endure anesthesia. Therefore, this study validated the feasibility of ureteroscopic stone removal without anesthesia for elderly patients with ureter stones who were under impending septic conditions or severe urinary tract infections.
Materials and Methods: Thirty-four patients (16 males and 18 females) were included in this study. All of them had serious problems, making it difficult to endure anesthesia. Most of them were inserted pre-operative percutaneous nephrostomy catheter, and ureteroscopic lithotripsy was performed successfully after intravenous analgesic injection (pethidine 25 mg).
Results: The mean age was 71.8±10.84 years. The locations of the stones were upper ureter in 11, mid-ureter in 6, and lower ureter in 17 cases. Urine and blood cultures identified bacteria from 17/34 patients. Escherichia coli was the most common (10/17), followed in order by Klebsiella pneumoniae and Staphylococcus epidermidis in 5 and 2 cases, respectively. Most patients had an abnormal white blood cell count (19,400±4,233.3/l) and elevated C-reactive protein levels (110.3±83.6 mg/L). No patient had to stop the operation because of intolerable pain. The mean of the visual analog pain scale was 3.2±0.86. The overall success rate was 100%.
Conclusions: The trial of ureteroscopic lithotripsy after administering analgesics could improve the condition of elderly patients whose general condition is too poor to endure anesthesia without serious complications.

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Fournier’s Gangrene: A 10-Year Clinical Experience at a Tertiary Academic Medical Center: Woo Seop Seong, Byeong Jin Kang, A Reum Kim, Kyung Hwan Kim, Hong Koo Ha; Urogenit Tract Infect 2023;18(2):64-69. Published online August 31, 2023; DOI: https://doi.org/10.14777/uti.2023.18.2.64

Abstract PDF PubReader ePub: Purpose: This retrospective study examined the factors influencing clinical outcomes and mortality in patients with Fournier's Gangrene (FG). The medical history, diagnostic procedures, treatment approaches, complications, and mortality factors associated with FG were analyzed.
Materials and Methods: This study retrospectively analyzed the medical records of 40 patients with FG treated over 10 years. The collected data included the patient demographics, comorbidities, vital signs, laboratory tests, Fournier’s Gangrene Severity Index (FGSI) scores, wound swab culture results, treatment approaches, and length of hospitalization.
Results: Among the patients with FG, diabetes mellitus and hypertension were the most common comorbidities. The hemodialysis dependence has been identified as a significant risk factor of mortality. In addition, septic shock and an FGSI >9 were associated with increased mortality. Escherichia coli was the most prevalent bacterium in wound swab cultures, and the presence of antibiotic-resistant bacteria was significantly higher in the non-survivors. Treatment involved broad-spectrum antibiotics, emergency surgical debridement, and subsequent adjustments based on culture results.
Conclusions: Early diagnosis and prompt initiation of treatment are essential for improving the outcomes of patients with FG. Hemodialysis dependency, septic shock, FGSI scores, and the presence of antibiotic-resistant bacteria are important factors associated with mortality in patients with FG. Further research will be needed to validate these findings and explore adjunctive therapies to enhance the patient outcomes and improve FG management.

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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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