Urogenital Tract Infection

Klebsiella pneumoniae-Induced Emphysematous Prostatic Abscess Accompanied by a Spinal Cord Infarction: Case Report: Seong Uk Jeh, Min Sung Choi, Chang Seok Kang, Dae Hyun Kim, Jae Hwi Choi, See Min Choi, Sung Chul Kam, Jeong Seok Hwa, Jae Seog Hyun; Urogenit Tract Infect 2024;19(3):104-108. Published online December 31, 2024; DOI: https://doi.org/10.14777/uti.2448024012

Abstract PDF PubReader ePub: Various strains can be found in emphysematous prostatic abscesses (EPAs), but the most frequent causative organism is Klebsiella pneumoniae . Hypervirulent K. pneumoniae can disseminate to distant sites by forming a muco-polysaccharide network outside the capsule. Here, we present the first case of K. pneumoniae in an EPA accompanied by a spinal cord infarction. A 65-year-old man was referred to our hospital due to sudden-onset paraplegia after a 5-day history of fever, myalgia, and voiding difficulty. Abdominal computed tomography revealed a collection of air pockets in the prostate, and diffusion-weighted magnetic resonance imaging showed high signal intensity in the thoracic spinal cord. The patient was initially treated with antibiotics and surgical drainage. On the third hospital day, therapeutic heparin was added after discussion with a neurologist. The patient had no inflammatory symptoms, experienced some improvement in paraplegia, and was discharged on the 14th hospital day. This study adhered to the case report guidelines.

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Hyperbaric Oxygen Therapy for the Treatment of Chronic Prostatitis/Chronic Pelvic Pain Syndrome: Case Report: Kwang Jin Kim, Yoonsuk Lee, Yong Sung Cha, Tae Wook Kang, Hyun Chul Chung, Hong Chung, Hyun Kim, Jae Hung Jung; Urogenit Tract Infect 2024;19(2):44-47. Published online August 31, 2024; DOI: https://doi.org/10.14777/uti.2024.19.2.44

Abstract PDF PubReader ePub: Hyperbaric oxygen therapy (HBOT) was conducted on two male patients with chronic prostatitis/chronic pelvic pain syndrome who were resistant to conventional medical therapies. Both patients underwent 20 sessions of 100% oxygen inhalation (2.0 atmosphere absolute for 90 min/day, five days/week for four weeks) in a hyperbaric chamber. The follow-up period was three months. Although the patients reported a slight improvement in the pain domain of the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) after HBOT, no changes were noted in the other domains of NIH-CPSI and International Prostate Symptom Score. No adverse events were encountered during or after HBOT.

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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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Case of Life-Threatening Pneumonia during the Treatment of a Patient with Acute Bacterial Prostatitis: Kyung Kgi Park, Sung Dae Kim, Young-Joo Kim, Jung-Sik Huh; Urogenit Tract Infect 2023;18(3):114-118. Published online December 31, 2023; DOI: https://doi.org/10.14777/uti.2023.18.3.114

Abstract PDF PubReader ePub: Acute bacterial prostatitis is an acute urinary tract infection associated with a bladder outlet obstruction or an immunosuppressed state. A 51-year-old man patient visited the hospital with fever, chills, and acute urinary retention that started the day before his visit after consuming a significant amount of alcohol. Conservative treatments, including catheterization for urinary drainage and antibiotics, were performed. On the third day of treatment for acute prostatitis, he complained of dyspnea. The level of oxygen differentiation was reduced significantly, and the tracheal insertion and ventilator were maintained after the radiological examination. The ventilator was discontinued, and the prostate abscess was operated on the eighth day of hospitalization. He was discharged without complications. This paper reports a case of life-threatening pneumonia and a prostate abscess during the treatment of a patient with acute bacterial prostatitis with a review of the relevant literature.

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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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