Purpose: Today, many urologists use nucleic acid amplification tests (NAAT) in diagnosis of Chlamydia trachomatis infection in Korea. A new variant of C. trachomatis with a deletion in the cryptic plasmid, which cannot be detected using commercial tests targeting the deleted DNA sequences, has been found in Sweden. Therefore, the partial deletion of cryptic plasmid DNA means that the diagnostic standards cannot detect chlamydial infection any more in cases of new mutants. The mutant type has been prevalent in Sweden, however, its incidence was not high in other countries such as France, Holland, and Denmark. In or to study the existence of this mutant C. trachomatis in Korea, we developed new primer sets for detection of this mutation.

Materials and Methods: We collected the first voided urine from male urethritis patient from April 2012 to August 2013 (Dankook University Hospital, Cheonan, Korea). We used the 25 confirmed C. trachomatis-positive specimens by using KL1 and KL2 primers for C. trachomatis and tested the existence of mutant chlamydial infection with the newly developed primer sets.

Results: We could not detect any new variant in the samples.

Conclusions: Although this mutant C. trachomatis is not seen in Korea, we should watch for the occurrence of the type in the future. I would like to briefly report on implications of the surging mutant forms and how we might attain an understanding of this phenomenon.

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.

Purpose: Bladder stones is not a rare disease, however, the number of patients with bladder stones has decreased due to improvement of nutrition, hygiene, and optimal antibiotics. Bladder stones are typically found in adults with urinary stasis, such as foreign body, benign prostate hyperplasia, spinal cord injury, and urinary tract infection, and in children with congenital genito-urinary abnormality. The aim of this study was to identify the clinical and microbiological characteristics of patients with bladder stones.

Materials and Methods: Patients who had bladder stones between March 2009 and December 2012 were retrospectively reviewed (Jeju National University Hospital, Jeju, Korea). We analyzed the presence of spinal cord injury, cancer, previous urinary tract calculi, and urinary tract infection associated with bladder stones and also investigated the largest diameter of bladder stone, and the number of bladder stones, as well as urine and blood culture.

Results: A total of 39 patients underwent cystolithotomy or cystolithotripsy. The most common presenting symptoms were voiding disturbance (n=15, 38.5%) and hematuria (n=10, 25.6%). Of these patients, 17 (43.3%) had positive growth of organisms. Of these organisms, Escherichia coli was found in five patients, Enterococcus fecalis in three patients, Pseudomonas aeruginosa in three patients, Klebsiella pneumoniae in two patients, Staphylococcus aureus in two patients, Proteus mirabilis in one patient, and Citrobacter in one patient.

Conclusions: We believe that urinary tract infection is a major risk factor in patients with bladder stones. Proper antibiotics would be required in order to reduce the risk of formation of bladder calculi. Further investigation will be needed.

Purpose: We have many choices of surgical methods with scrotal reconstruction after Fournier’s gangrene. From the aesthetic perspective, the reconstruction method with anterolateral thigh perforator pedicled flap is better than other options. We report our experience with postoperative results and aesthetics of the anterolateral thigh perforator pedicled flap.

Materials and Methods: From November 2011 to May 2013, 4 patients underwent anterolateral thigh perforator pedicled flaps. The authors checked the aesthetic results and occurrence of complications at follow-up exams.

Results: There was no total or partial necrosis of flap among the four patients. The only complication was wound dehiscence followed by infection that healed secondarily during the follow-up period.

Conclusions: Anterolateral thigh perforator pedicled flap is a very useful choice for surgery at the defect caused by Fournier’s gangrene because it is relatively thin, offering an excellent aesthetic result.

Malakoplakia is a rare chronic granulomatous disease, which was originally described in the urinary bladder, but can involve many other organs and soft tissues. Malakoplakia is often associated with immunosuppression or immunodeficiency and is believed to be caused by an alternation in the bacterial phagocytic system. Histologically, the presence of Michaelis-Gutmann bodies is pathognomonic. We report on a case of malakoplakia of the bladder in a 62-year-old female.