Urogenital Tract Infection

Pelvic Pain in Men with Mycoplasma Genitalium: Yumi Seo; Urogenit Tract Infect 2024;19(1):16-23. Published online April 30, 2024; DOI: https://doi.org/10.14777/uti.2024.19.1.16

Abstract PDF PubReader ePub: Purpose: There are debates about Mycoplasma genitalium (M. genitalium) causing prostate infection and inducing pelvic pains. Consequently, M. genitalium-associated pelvic pains were characterized and their manifestation in male pelvic pain syndrome (MPPS) was evaluated through a case-control study.
Materials and Methods: The presence of M. genitalium-associated pelvic pains was examined in 113 M. genitalium-infected men, and the typical presentations of mycoplasma-associated MPPS were characterized through a case-control study involving 80 mycoplasma-infected and 234 case-matched uninfected controls. Finally, changes in symptoms following antimicrobial treatments were compared between 27 cured and 14 persistently infected cases.
Results: Pain locations from 113 men were followed as items-1a for 25.7%, 1b for 21.2%, 1c for 31%, 1d for 18.6%, 2a for 59.3%, and 2b for 23% from the Korean National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) questionnaire. In addition, the sum scores from the pain domain, voiding domain and total score were 6.68±4.75, 2.69±2.66, and 15.00±8.66, respectively. Successful antibiotic therapy significantly reduced the total score from baseline (15.148±6.798 vs. 5.357±7.025, p=0.001). From the case-control study, mycoplasma-infected men had pains more frequently during urination (1c) and on the tip of the penis (2a) (all p=0.0001) than the controls.
Conclusions: It was found that M. genitalium infection is associated with clinically significant male pelvic pains, which improved with adequate antimicrobial therapies. Urethral irritation symptoms without pyuria may be the typical characteristics of mycoplasma-associated pelvic pains in MPPS.

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The Feasibility of Radical Prostatectomy for Medication Refractory Chronic Prostatitis/Chronic Pelvic Pain Syndrome: Seung Chan Jeong; Urogenit Tract Infect 2022;17(3):76-80. Published online December 31, 2022; DOI: https://doi.org/10.14777/uti.2022.17.3.76

Abstract PDF PubReader ePub: Purpose: The purpose of this study was to compare the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) scores of patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) given pharmacological treatment with those who additionally had prostate cancer and underwent surgical treatment.
Materials and Methods: From January 2000 to March 2021, a total of 7,650 patients were diagnosed with chronic prostatitis (N41.1) at our hospital, of which 234 patients were additionally diagnosed with prostate cancer. After excluding patients with severe benign prostatic hyperplasia (＞100 g)-related lower urinary tract symptoms or neurological and psychiatric abnormalities, or advanced prostate cancer, 52 patients undergoing pharmacological treatment with a combination of drugs and 20 patients who underwent radical prostatectomy due to additional prostate cancer were included in the analysis. The NIH-CPSI scores of the two groups were compared at the first outpatient visit, 3 months, and 6 months after the first visit. The p-values were calculated using the Mann-Whitney U test, and the Wilcoxon signed rank test.
Results: Patients who underwent radical prostatectomy for prostate cancer showed significant reductions in the voiding and quality of life scores in the NIH-CPSI, but not the pain score at 3 months. After 6 months, there was a significant decrease in the overall NIH-CPSI. On the other hand, in the group on pharmacological therapy, the decrease was statistically significant only in the voiding score at 6 months. However, in the surgery group, 3 patients were found to be suffering from urinary incontinence, and 7 patients from erectile dysfunction.
Conclusions: Radical prostatectomy, therefore, appears to be a promising treatment that can be carefully considered for patients with refractory CP/CPPS who do not receive adequate treatment and thus have a poor quality of life.

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UPOINT System: A Diagnostic/Therapeutic Algorithm for Chronic Prostatitis/Chronic Pelvic Pain Syndrome: Phil Hyun Song; Urogenit Tract Infect 2020;15(2):27-32. Published online August 31, 2020; DOI: https://doi.org/10.14777/uti.2020.15.2.27

Abstract PDF PubReader ePub: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common condition that significantly affects the quality of life. On the other hand, urologists find it challenging to treat this disorder effectively. To date, the Urinary, Psychosocial, Organ-Specific, Infection, Neurological/Systemic, and Tenderness (UPOINT) system is the only classification tool that can improve the treatment outcomes significantly compared to monotherapy. This review focused on the most recent advances in the diagnosis and treatment of CP/CPPS.

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