Urogenital Tract Infection

Advances in the Diagnosis of Urinary Tract Infection: A Narrative Review: Juan Victor Ariel Franco, Nicolás Meza; Urogenit Tract Infect 2025;20(1):17-27. Published online April 30, 2025; DOI: https://doi.org/10.14777/uti.2550020010

Urinary tract infections are among the most frequent bacterial infections, significantly impacting patient morbidity and healthcare resources. Prompt and accurate diagnosis is crucial to ensure effective treatment, prevent complications such as pyelonephritis or sepsis, and reduce inappropriate antibiotic use, contributing to antimicrobial resistance (AMR). Despite consensus across international guidelines from organizations, challenges persist, particularly in distinguishing true infections from asymptomatic bacteriuria or nonspecific symptoms, especially in older adults. Recent advancements in diagnostic technology have emerged to address these limitations, including molecular diagnostics, point-of-care testing (POCT), and artificial intelligence (AI)-driven predictive models. Molecular techniques, notably polymerase chain reaction, loop-mediated isothermal amplification, and metagenomic next-generation sequencing, offer enhanced sensitivity and specificity, rapid detection times, and comprehensive identification of pathogens and resistance profiles. POCT innovations, such as lateral flow immunoassays, enzymatic-based rapid tests, and novel biosensors, facilitate prompt bedside diagnosis, although specificity challenges remain. Meanwhile, AI and machine learning models demonstrate significant potential for risk stratification, prediction of infection, and improving antibiotics prescription practices yet face barriers related to validation, practical integration, and clinical acceptability. Despite promising developments, significant gaps remain, including limited real-world implementation evidence, high costs, and insufficient data from diverse populations. Further rigorous clinical studies, economic evaluations, and practical implementation assessments are urgently required. Addressing these research gaps could substantially improve patient outcomes, optimize antibiotic stewardship, and reduce the global burden of AMR.

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Editorial for UTI 2025 Vol. 20 No. 1 - Highlights of This Issue’s Papers and the UTI Editors’ Pick
Koo Han Yoo
Urogenital Tract Infection.2025; 20(1): 1. CrossRef

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Emerging Insights Into Microbiome Therapeutics for Urinary Tract Infections: A Narrative Review: Hoonhee Seo, Md Abdur Rahim, Indrajeet Barman, Mohammed Solayman Hossain, Hanieh Tajdozian, Fatemeh Ghorbanian, Md Sarower Hossen Shuvo, Jiho Choi, Sukyung Kim, Heejo Yang, Ho-Yeon Song; Urogenit Tract Infect 2025;20(1):4-16. Published online April 30, 2025; DOI: https://doi.org/10.14777/uti.2448034017

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Urinary tract infections (UTIs) are among the most common bacterial infections worldwide, affecting millions annually and posing a significant global health concern. Traditional therapies for UTIs are becoming increasingly ineffective due to rising drug resistance and their tendency to disrupt the host's healthy microbiota, leading to further side effects. Consequently, there is an urgent need to develop alternative therapeutic agents that differ from conventional regimens and have fewer or no side effects. In this context, microbiome therapeutics offer a promising solution, given their demonstrated efficacy against various infectious diseases. Advances in scientific technology, particularly next-generation sequencing, have deepened our understanding of urinary microbiome dynamics, revealing a complex interplay within the urobiome that influences the onset and progression of UTIs. Uropathogenic bacteria do not solely cause UTIs; shifts in the composition of the urinary microbiome and interactions within the microbial community, known as host-microbiota interactions, also play a significant role. Although recent studies underscore the potential of targeting the urinary microbiome to manage UTIs and related complications, this field is still emerging and faces numerous regulatory and technical challenges. Further in-depth and comprehensive research is required to advance this pioneering concept into clinical practice.

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Editorial for UTI 2025 Vol. 20 No. 1 - Highlights of This Issue’s Papers and the UTI Editors’ Pick
Koo Han Yoo
Urogenital Tract Infection.2025; 20(1): 1. CrossRef
Efficacy and safety of N-acetylcysteine vs. probiotics in in-vivo biofilm prevention on ureteral stents: a prospective randomized controlled pilot in vivo study
Iqbal Singh, Himanshu Agrawal, Shailender Maurya, Himanshu Tanwar, Sanjay Gupta, N. P. Singh
International Urology and Nephrology.2025;[Epub] CrossRef

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Artificial Intelligence for Autonomous Robotic Surgery in Urology: A Narrative Review: Dae Young Lee, Hee Jo Yang; Urogenit Tract Infect 2024;19(3):80-88. Published online December 31, 2024; DOI: https://doi.org/10.14777/uti.2448020010

Abstract PDF PubReader ePub: Artificial intelligence (AI) has emerged as a transformative force in various sectors, including medicine, where it processes high-dimensional data to improve diagnostics and treatment outcomes. This review explores AI applications in urological surgery, highlighting advancements such as image classification and robotic assistance in surgical procedures. AI has demonstrated exceptional diagnostic accuracy, with some systems achieving up to 99.38% in detecting prostate cancer. Additionally, AI facilitates real-time anatomical recognition and instrument delineation, increasing surgical precision. While current robotic systems operate under human supervision, ongoing research aims to advance autonomous surgical capabilities. The future of AI in robotic surgery is promising, especially regarding the possibility of improved outcomes; nonetheless, challenges related to autonomy, safety, and ethics remain.

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The Necessity of Human Papillomavirus Vaccination in Men: A Narrative Review: Sooyoun Kim, Sangrak Bae; Urogenit Tract Infect 2024;19(3):51-59. Published online December 31, 2024; DOI: https://doi.org/10.14777/uti.2448030015

Abstract PDF PubReader ePub: Anogenital wart caused by human papillomavirus (HPV) is the most common sexually transmitted infection. High-risk strains, such as types 16 and 18, cause penile cancer in men, cervical and vulvar cancers in women, and head and neck cancers and anal cancer in both sexes. Since these malignant tumors can be prevented through vaccination, the importance of vaccination is emphasized. However, because HPV is known to cause cervical cancer, vaccination is only being administered to women. Some countries vaccinate men as well, but in South Korea, only girls are included in the National Immunization Program. However, screening for HPV in men is not possible, and the virus causes various malignant tumors, with a sharp increase in head and neck cancers, as well as a surge in genital warts in the country. In addition, HPV worsens sperm quality. Moreover, the need for vaccines is increasing as the known methods for preventing HPV-related diseases in men are decreasing and the disease burden is increasing. As cost-effectiveness studies have shown that the cost-effectiveness of vaccination is lower for men than for women, it is unlikely that male vaccination will be included in national immunization programs. Many countries overseas, especially a very small number of OECD (Organization for Economic Cooperation and Development) countries including South Korea, are implementing mandatory vaccination for women. Vaccinating men and women, would be cost-effective and efficient in achieving herd immunity. In addition to herd immunity, the inclusion of male vaccination in the National Immunization Program is imperative given the rapidly increasing incidence of diseases in men.

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Molecular Mechanisms of Antibiotic Resistance in Uropathogenic Escherichia coli: A Narrative Review: Nakjun Choi, Dong Uk Kim, Eun-Jin Lee; Urogenit Tract Infect 2025;20(2):96-106. Published online August 31, 2025; DOI: https://doi.org/10.14777/uti.2550018009

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Urinary tract infections (UTIs) are among the most prevalent bacterial infections worldwide, with uropathogenic Escherichia coli (UPEC) serving as the primary causative agent. Although antibiotic therapy remains the standard of care for UTI treatment, the increasing prevalence of antimicrobial resistance has substantially reduced the effectiveness of commonly prescribed antibiotics. Resistance to trimethoprim-sulfamethoxazole (TMP-SMX), β-lactams, and fluoroquinolones is particularly concerning, as these agents constitute the principal therapeutic options for UTIs. This review examines the molecular mechanisms underlying UPEC resistance to these three classes of antibiotics, including target site modifications, efflux pump overexpression, porin regulation, and enzymatic degradation. Furthermore, it explores how these resistance determinants contribute to the development of multidrug-resistant (MDR) UPEC strains, which demonstrate cross-resistance to multiple antibiotics and present significant challenges for clinical management. Novel therapeutic strategies, such as efflux pump inhibitors, bacteriophage therapy, and genomic-guided precision medicine, are under investigation as potential solutions to address the growing global burden of MDR UPEC, alongside alternative non-antibiotic treatments. This review aims to provide a comprehensive overview of the genetic and regulatory pathways driving antibiotic resistance in UPEC, offering insights that may guide the development of effective treatment strategies and help mitigate the ongoing spread of antimicrobial resistance.

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Editorial for Urogenital Tract Infection (UTI) 2025 Vol. 20 No. 2 – Highlights of This Issue’s Papers and the UTI Editors’ Pick
Koo Han Yoo
Urogenital Tract Infection.2025; 20(2): 55. CrossRef

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Efficacy of Urovaxom for Improving Chronic Pelvic Pain Syndrome Symptoms in Prostate Cancer Patients Who Underwent Radical Prostatectomy: A Multicenter, Prospective Cohort Study: Jun-Koo Kang, Yun-Sok Ha, Sungchan Park, Tae Gyun Kwon, Tae-Hwan Kim; Urogenit Tract Infect 2025;20(1):42-47. Published online April 30, 2025; DOI: https://doi.org/10.14777/uti.2550014007

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Purpose
Chronic pelvic pain syndrome (CPPS) is a multifactorial condition that can significantly diminish quality of life. Although some patients have reported persistent pelvic pain after radical prostatectomy (RP), the prevalence and direct causal relationship between CPPS and RP remain unclear. This multicenter prospective study aimed to evaluate the efficacy of Urovaxom for improving CPPS symptoms. Materials and Methods: A total of 52 prostate cancer patients who underwent RP were enrolled and administered Urovaxom (60 mg/day) for 12 weeks. Changes in National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), overactive bladder symptom score (OABSS), International Prostate Symptom Score (IPSS), and inflammation markers (white blood cell [WBC], C-reactive protein [CRP]) were analyzed using the Wilcoxon signed-rank test.
Results
After 12 weeks of treatment, the NIH-CPSI total score significantly decreased from 19 (interquartile range [IQR], 16–23) to 12.5 (IQR, 8.0–16.8) (p<0.001). The OABSS total score decreased from 8 (IQR, 4–11) to 5 (IQR, 3.0–7.8), and the IPSS total score decreased from 13.5 (IQR, 10.0–22.8) to 10.5 (IQR, 5.0–17.0) (p<0.001). WBC levels showed a slight increase (p=0.028), but the clinical relevance of this change is uncertain and warrants further investigation. CRP changes were not statistically significant (p=0.274).
Conclusions
Urovaxom demonstrated significant efficacy in improving CPPS symptoms, particularly pain and reduced quality of life, in patients following RP. These findings suggest Urovaxom as a potential therapeutic option for CPPS after management using RP.

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Editorial for UTI 2025 Vol. 20 No. 1 - Highlights of This Issue’s Papers and the UTI Editors’ Pick
Koo Han Yoo
Urogenital Tract Infection.2025; 20(1): 1. CrossRef

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Asymptomatic Bacteriuria in Older Adults – Diagnosis, Management, and Future Directions: A Narrative Review: Ki Hong Kim, Hee Jo Yang; Urogenit Tract Infect 2025;20(2):58-66. Published online August 31, 2025; DOI: https://doi.org/10.14777/uti.2550002001

Abstract PDF PubReader: Asymptomatic bacteriuria (ASB) is defined as the presence of bacteria in the urine in the absence of urinary tract infection (UTI) symptoms. The prevalence of ASB increases with advancing age, particularly among older patients with underlying health conditions. ASB is especially common among residents of long-term care facilities; however, distinguishing ASB from symptomatic UTI in this population remains a significant clinical challenge. The frequent occurrence of ASB often results in unnecessary antibiotic administration, thereby contributing to the development of antibiotic resistance. Current clinical guidelines recommend screening for and treating ASB only in certain circumstances, such as prior to urological procedures or in pregnant women. There is a pressing need for improved diagnostic approaches to differentiate ASB more accurately from UTI, particularly in older adults. Reducing unnecessary urine testing and inappropriate antibiotic use may help prevent over-treatment and minimize associated risks, including Clostridium difficile infection and increased antimicrobial resistance.

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Mortality and Risk Factors for Emphysematous Pyelonephritis in Korea: A Multicenter Retrospective Cohort Study: Seung-Kwon Choi, Jeong Woo Lee, Seung Il Jung, Eu Chang Hwang, Joongwon Choi, Woong Bin Kim, Jung Sik Huh, Jin Bong Choi, Yeonjoo Kim, Jae Min Chung, Ju-Hyun Shin, Jae Hung Jung, Hong Chung, Sangrak Bae, Tae-Hyoung Kim; Urogenit Tract Infect 2025;20(1):34-41. Published online April 30, 2025; DOI: https://doi.org/10.14777/uti.2550006003

Abstract PDF PubReader ePub

Purpose
Emphysematous pyelonephritis (EPN) is a life-threatening disease requiring immediate treatment. This multicenter retrospective cohort study aimed to analyze the mortality rate and risk factors associated with EPN. Materials and Methods: Between January 2011 and February 2021, 217 patients diagnosed with EPN via computed tomography who visited 14 teaching hospitals were retrospectively analyzed. Clinical data, including age, sex, comorbidities, Huang and Tseng classification, hydronephrosis, acute kidney injury, blood and urine tests, surgical interventions, percutaneous drainage, and conservative treatments, were compared between the survival and death groups. Risk factors for mortality due to EPN were analyzed using univariate and multivariate methods.
Results
The mean age of survivors and deceased patients was 67.8 and 69.0 years, respectively (p=0.136). The sex distribution (male/female) was 48/146 and 8/15, respectively (p=0.298). Of the 217 patients, 23 died, resulting in a mortality rate of 10.6%. In univariate analysis, the Huang and Tseng classification (p=0.004), platelet count (p=0.005), and acute kidney injury (p=0.007) were significantly associated with mortality from EPN. In multivariate analysis, only the Huang and Tseng classification (p=0.029) was identified as a risk factor. Mortality rates according to the Huang and Tseng classification were as follows: class I (5.88%), class II (7.50%), class IIIa (14.28%), class IIIb (25.00%), and class IV (23.07%).
Conclusions
EPN is associated with a high mortality rate. Among various clinical factors, the Huang and Tseng classification was the most significant indicator for predicting mortality.

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Editorial for UTI 2025 Vol. 20 No. 1 - Highlights of This Issue’s Papers and the UTI Editors’ Pick
Koo Han Yoo
Urogenital Tract Infection.2025; 20(1): 1. CrossRef

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Prophylactic Antimicrobial Therapy and Antimicrobial Stewardship in Urologic Surgery: Hee Jo Yang; Urogenit Tract Infect 2023;18(1):8-14. Published online April 30, 2023; DOI: https://doi.org/10.14777/uti.2023.18.1.8

Abstract PDF PubReader ePub: Postoperative infectious complications are a worrying problem for surgeons. Urological surgery has a higher risk of postoperative urinary tract infection than other surgeries because of the common use of various types of catheters. Due to the recent increase in antibiotic resistance, antimicrobial stewardship recommends using appropriate antibiotics for a suitable period. It is generally advocated that prescribing antibiotics in the absence of infection is equivalent to the inappropriate use of antibiotics. Based on numerous studies reported by several academic societies, appropriate use of antibiotics before surgery has been suggested. It was confirmed that using antibiotics according to these guidelines reduces the use of antibiotics without increasing the incidence of postoperative infectious complications. Furthermore, endourological surgery reports have proved the efficacy of antibiotics given once before surgery. Differences in antibiotic resistance by region must be taken into consideration when selecting the appropriate antibiotic type.

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Mechanistic Insights Into Persistent Bacterial Cystitis as a Basis for Vaccine Development: A Narrative Review: Karen Serrano-Arevalo, Manisha Naskar, Hae Woong Choi; Urogenit Tract Infect 2024;19(3):60-72. Published online December 31, 2024; DOI: https://doi.org/10.14777/uti.2448022011

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Urinary tract infections (UTIs) are primarily caused by uropathogenic Escherichia coli (UPEC), which frequently lead to recurrent infections. These bacteria utilize several strategies to establish infection in the host; in particular, virulence factors such as fimbriae and α-hemolysin facilitate persistent infection, evade host immune responses, and minimize antibiotic exposure. To date, antibiotics have been the primary treatment for UTIs. However, an increasing emphasis has been placed on the need for UTI vaccines, with mucosal vaccine products now available in several countries. Additionally, vaccines targeting intracellular UPEC, utilizing adjuvants, are currently under development. Understanding the pathogenic mechanisms of uropathogens has enabled the development of new treatment approaches, paving the way for next-generation preventive and therapeutic methods that could effectively manage recurrent UTIs in the future.

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Bacterial biofilm – as a contributor to urinary tract infections
Zuzanna Trześniewska-Ofiara, Mariola Mendrycka, Agnieszka Woźniak-Kosek
Biuletyn Głównej Biblioteki Lekarskiej.2025; 58(384): 83. CrossRef

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Beta-Lactamase-Mediated Antibiotic Resistance in Urinary Tract Infections: Mechanisms and Therapeutic Strategies: Fanglin Shao, Dengxiong Li, Jie Wang, Zhouting Tuo, Zhipeng Wang, Wuran Wei, Ruicheng Wu, Dechao Feng; Urogenit Tract Infect 2025;20(2):67-81. Published online August 31, 2025; DOI: https://doi.org/10.14777/uti.2550012006

Abstract PDF PubReader: Urinary tract infections (UTIs) are among the most prevalent bacterial infections globally, and are primarily caused by Escherichia and Klebsiella. The overprescription and inappropriate use of antibiotics have accelerated the emergence of multidrug-resistant bacteria. Beta-lactamases play a critical role in mediating antibiotic resistance in UTIs. These enzymes promote bacterial resistance through multiple mechanisms, including gene mutation, plasmid-mediated horizontal gene transfer, and the involvement of integrons. Comprehensive knowledge of the ways in which beta-lactamases contribute to resistance in UTIs is essential for improving treatment strategies. Advances in detection technologies, such as gene sequencing and mass spectrometry, have greatly enhanced the ability to monitor and predict bacterial resistance. Current therapeutic strategies include the application of beta-lactamase inhibitors, the development of novel antibiotics, and alternative treatments that have shown efficacy against beta-lactamase-mediated antibiotic resistance. This paper reviews the mechanisms of beta-lactamase-mediated resistance in UTIs and provides an in-depth overview of several detection methods and therapeutic approaches.

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The Role of the Urinary Microbiome in the Prevention of Pediatric Urinary Tract Infections: A Narrative Review: Byeongdo Song; Urogenit Tract Infect 2025;20(2):82-95. Published online August 31, 2025; DOI: https://doi.org/10.14777/uti.2550016008

Abstract PDF PubReader

Urinary tract infections (UTIs) are a common condition in children and often lead to hospitalization. A considerable proportion of children with UTIs (up to 30%) experience at least one recurrence, placing them at risk for long-term complications such as renal scarring. Since the concept of the microbiome was first introduced in 2001, increasing attention has been given to the role of the urinary tract microbiome in maintaining urinary tract homeostasis. Dysbiosis of the urinary microbiome has been recognized as a factor associated with an increased risk of various urinary tract diseases, including UTIs. However, the specific role of the urinary microbiome in the pathophysiology of pediatric UTIs remains incompletely understood. The present review examines recent studies on the urinary microbiome in children and summarizes current strategies for modulating the urinary microbiome to prevent UTI recurrence in the pediatric population.

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Editorial for Urogenital Tract Infection (UTI) 2025 Vol. 20 No. 2 – Highlights of This Issue’s Papers and the UTI Editors’ Pick
Koo Han Yoo
Urogenital Tract Infection.2025; 20(2): 55. CrossRef

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A Narrative Review of Syphilis Notification Systems in Korea: Change to Mandatory Surveillance System: Seung-Ju Lee, Jin Bong Choi; Urogenit Tract Infect 2025;20(1):28-33. Published online April 30, 2025; DOI: https://doi.org/10.14777/uti.2550004002

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New cases of syphilis are clearly showing an increasing trend worldwide. However, in a sentinel surveillance system, the collection of information on disease outbreaks is limited, making it difficult to understand the overall outbreak situation and perform detailed analyses of patients' demographic characteristics and disease stages. In accordance with the revision of the Infectious Disease Prevention Act, syphilis was converted from a grade 4 infectious disease subject to sentinel surveillance to a grade 3 infectious disease subject to mandatory surveillance from January 1, 2024, with all medical institutions required to report syphilis diagnosis within 24 hours.

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Editorial for UTI 2025 Vol. 20 No. 1 - Highlights of This Issue’s Papers and the UTI Editors’ Pick
Koo Han Yoo
Urogenital Tract Infection.2025; 20(1): 1. CrossRef

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Antimicrobial Therapy and Antimicrobial Stewardship in Urosepsis: Tae Hoon Oh; Urogenit Tract Infect 2023;18(1):15-19. Published online April 30, 2023; DOI: https://doi.org/10.14777/uti.2023.18.1.15

Abstract PDF PubReader ePub: Since the latest knowledge on the treatment and countermeasures for sepsis is being updated at a rapid pace, becoming familiar with the Surviving Sepsis guidelines is helpful for patient prognosis. Extended-spectrum beta-lactamases (ESBL) are important factors when selecting early empirical antibiotics for sepsis caused by urinary tract infections. For severe septic shock, prolonged infusion and combination therapy need to be considered.

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Editorial for UTI 2025 Vol. 20 No. 1 - Highlights of This Issue’s Papers and the UTI Editors’ Pick: Koo Han Yoo; Urogenit Tract Infect 2025;20(1):1-3. Published online April 30, 2025; DOI: https://doi.org/10.14777/uti.2025edi01

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Outbreak of Cystoscopy-Related Urinary Tract Infections With Pseudomonas aeruginosa in South Korea, 2022: A Case Series: Beomsoo Kim, Young-Sin Choi, Jun-Koo Kang, Yun-Sok Ha, Seock Hwan Choi, Bum Soo Kim, Hyun Tae Kim, Eun Sang Yoo, Tae Gyun Kwon, Jae-Wook Chung, Tae-Hwan Kim; Urogenit Tract Infect 2024;19(3):97-103. Published online December 31, 2024; DOI: https://doi.org/10.14777/uti.2448028014

Abstract PDF PubReader ePub

Purpose
This study conducted an epidemiological investigation of Pseudomonas aeruginosa urinary tract infections (UTIs) following cystoscopy at Chilgok Kyungpook National University Hospital. Materials and Methods: From May 16 to July 15, 2022, among 353 patients who underwent cystoscopy, 6 patients reported febrile UTIs following cystoscopy. They were admitted to the urology department of the hospital after visiting the Emergency Department. P. aeruginosa was found in the urine cultures of 4 of the 6 hospitalized patients. During the epidemiological investigation, no changes were observed in factors such as the reprocessing procedures for endoscopic equipment. Therefore, microbiological tests were performed using environmental samples derived from the endoscopic equipment and cleaning process.
Results
P. aeruginosa was identified in a dual-enzymatic detergent (EmPower) used during the endoscope cleaning process. After changing the disinfectant and cleaning process, no further bacterial growth was observed in subsequent microbiological tests.
Conclusions
This study highlights the potential of cystoscopes to serve as reservoirs for bacteria due to inadequate cleaning during the disinfection process. To minimize the risk of infections following cystoscopy, it is important to pay close attention to the reprocessing and cleaning of cystoscopes.

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A Commentary on “Outbreak of Cystoscopy-Related Urinary Tract Infections With Pseudomonas aeruginosa in South Korea, 2022: A Case Series”
Byoungkyu Han
Urogenital Tract Infection.2025; 20(1): 52. CrossRef

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Risk Factors for Sepsis after Retrograde Intrarenal Surgery: Single Center Experience: Jinseok Kang, Koo Han Yoo, Taesoo Choi, Gyeong Eun Min, Dong-Gi Lee, Hyung-Lae Lee, Jeonghyouk Choi; Urogenit Tract Infect 2023;18(3):93-100. Published online December 31, 2023; DOI: https://doi.org/10.14777/uti.2023.18.3.93

Abstract PDF PubReader ePub

Purpose: To evaluate risk factors for sepsis after retrograde intrarenal surgery for treatment of renal stones.
Materials and Methods: We analyzed the clinical data of 243 patients with kidney stones who visited our institution between April 2017 and April 2023. Age, sex, body mass index, underlying disease, location and size of stones, previous history of stones, previous history of urinary tract infections, duration of surgery, preoperative drainage, application of ureteral balloon dilation, and laboratory test results were included in the analysis.
Results: The mean age of the patients was 58.4 (±15.0) years; there were more men (53.1%) than women (46.9%). Of the 243 patients, the overall rate of sepsis was 5.8% (n=14) and the total mortality rate was 0.4% (n=1). In univariate analysis, history of urinary tract infection (p=0.019), positive preoperative urine culture test (p=0.009), operative duration of more than 90 min (p=0.004), and application of ureter balloon dilation (p=0.016) were statistically significant. In multivariate analysis, positive finding in the urine culture test performed before surgery (p=0.003), operation duration >90 min (p=0.005), and use of balloon dilation during surgery (p=0.011) were statistically significant.
Conclusions: There is a risk of progression to postoperative sepsis if bacteria are detected in the urine culture before surgery, if the operative time exceeds 90 min, or if balloon dilation is performed during surgery. Given that the probability of progression to sepsis is approximately 6%, close observation and active treatment are needed for patients with these risk factors.

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Analysis of postoperative infection factors of retrograde intrarenal surgery combined with negative pressure equipment for renal stones
Deheng Cui, Qinghong Ma, Qiuyan Zhang, Lian Zhang, Guoqiang Chen
Scientific Reports.2024;[Epub] CrossRef

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Impact of Microbial Infection on Sperm Parameters of Seminal Bacteria in Asymptomatic Subfertile Males: Sae Byuk Chang, Tae Jin Kim, Tae Heon Kim, Seung-Ryeol Lee, Young Kwon Hong, Dong Soo Park, Sun-Mi Cho, Dong Hyeon Lee, Young Dong Yu; Urogenit Tract Infect 2023;18(3):82-92. Published online December 31, 2023; DOI: https://doi.org/10.14777/uti.2023.18.3.82

Abstract PDF PubReader ePub: Purpose: This study examined the effects of asymptomatic bacteriospermia on the semen quality of subfertile males. The types of bacteria and their antibiotic susceptibility were also analyzed.
Materials and Methods: Semen was collected and analyzed from 510 subfertile males. One hundred and seventy-nine males showed bacteriospermia, while 331 males did not. The bacterial species, sperm parameters, hormone levels, underlying disease, and lifestyle patterns were compared between the two study groups.
Results: The bacteriospermic males showed significantly higher rates of leukocytospermia (p=0.001) and deoxyribonucleic acid (DNA) fragmentation than the non-bacteriospermic males. Sperm motility was significantly lower in the bacteriospermic males than in non-bacteriospermic males. The most common seminal bacterial species were Prevotella bivia (P. bivia, 41.3%) and Ureaplasma urealyticum (U. urealyticum, 13.4%). U. parvum showed the highest recurrence rates (31.8%) three months after the initial antibiotic treatment. Regarding the sperm parameters of bacteriospermic males, the sperm concentration, total motility, progressive motility, leukocytospermia, and DNA fragmentation were improved significantly after the initial antibiotics treatment. Multivariate logistic regression analyses revealed P. bivia, U. urealyticum, and U. parvum to be associated with the decreased motility and increased DNA fragmentation of spermatozoa. P. bivia was also associated with a decreased sperm concentration (p=0.002) and vitality (p=0.013).
Conclusions: Bacteriospermia decreased the sperm concentration, motility, normal morphology, and vitality. P. bivia is the most commonly observed bacteria in subfertile males. Appropriate antibiotic therapy of seminal bacteria species had a strong positive impact on improving the semen parameters.

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Diagnostic Utility of the Sysmex UF-5000 Flow Cytometer in Acute Bacterial Prostatitis: A Retrospective Pilot Study: Young Kyu Han, Jeong Woo Lee, Hae-Il Park, Jin Bong Choi; Urogenit Tract Infect 2025;20(2):107-113. Published online August 31, 2025; DOI: https://doi.org/10.14777/uti.2550022011

Abstract PDF Supplementary Material PubReader

Purpose
To evaluate the diagnostic performance of the Sysmex UF-5000 flow cytometer in detecting acute bacterial prostatitis (ABP) compared to standard urine culture. Materials and Methods: This retrospective study analyzed 45 urine samples from patients with a clinical diagnosis of ABP. Each sample was evaluated using the UF-5000 to measure red blood cells (RBC), white blood cells (WBC), and bacterial counts, and the results were compared with those from standard urine culture and Gram staining. Receiver operating characteristic curves were generated, and sensitivity, specificity, positive predictive value (PPV), and negative predictive value were determined. Concordance between Gram classification by the UF-5000 and conventional Gram staining was also evaluated.
Results
Of the 45 patients, 84.4% had positive urine cultures. The bacterial count parameter demonstrated the highest diagnostic performance (area under the curve [AUC]=0.79; sensitivity, 89.5%; PPV, 91.9%), outperforming WBC (AUC=0.76) and RBC (AUC=0.55). The Gram classification flag showed an overall concordance of 85.7% with conventional Gram staining, with a concordance rate of 88% for Gram-negative organisms.
Conclusions
The Sysmex UF-5000 exhibited good concordance with urine culture for patients with ABP, particularly through the bacterial count parameter. Although it does not replace culture, the UF-5000 may serve as a rapid adjunctive tool to support early clinical decision-making in suspected ABP cases.

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Editorial for Urogenital Tract Infection (UTI) 2025 Vol. 20 No. 2 – Highlights of This Issue’s Papers and the UTI Editors’ Pick
Koo Han Yoo
Urogenital Tract Infection.2025; 20(2): 55. CrossRef

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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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Spontaneous Bladder Perforation in a Patient with a Long-Term Intraurethral Catheter: Taegi Choi, Hyunkyung Lee, Junseok Kim, Sunghoon Lee, Younkyung Cho, Eunyoung Kang, Jinsun Kang, Sumin Lee, Eunju Na; Urogenit Tract Infect 2023;18(3):110-113. Published online December 31, 2023; DOI: https://doi.org/10.14777/uti.2023.18.3.110

Abstract PDF PubReader ePub: Urinary catheters are commonly used to address various urinary problems. However, the catheter itself can be a cause of several complications, including catheter-associated urinary tract infections, damage to the bladder and kidneys, and, in extremely rare cases, bladder perforation. We present a case of spontaneous bladder perforation in a patient who had a long-term indwelling intraurethral catheter. The patient with prior hypoxic brain damage suddenly developed tachypnea, tachycardia, and oxygen desaturation. Computed tomography and retrograde cystography revealed an extraperitoneal bladder perforation with an intra-pelvic abscess. Antibiotics were prescribed and a urinary catheter was inserted for drainage. After 11 weeks, the abscess resolved, and the catheter was removed to enable self-voiding. The perforation was attributed to chronic inflammation and distension of the bladder wall caused by the intraurethral catheter. Given the potential complications associated with long-term urinary catheterization, the timely removal of indwelling catheters should be considered.

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A Case Report of Self-Inflicted Surgical Castration: Koo Han Yoo, Sung-Goo Chang; Urogenit Tract Infect 2023;18(3):107-109. Published online December 31, 2023; DOI: https://doi.org/10.14777/uti.2023.18.3.107

Abstract PDF PubReader ePub: Religious beliefs are a very significant part of one’s life. We report the case of a strongly religious man who sought to remove his testicles. After enlisting in the military, the man had a surgical castration performed on him while on vacation from military service. The procedure aimed to rid the man of his libido, which he saw as a hindrance to his religious life. After the removal of the testes, his serum testosterone was 0.25 ng/ml. The luteinizing hormone, 22.1 (1.7-8.6 mIU/ml), and follicle stimulating hormone, 53.5 (1.5-12.4 mIU/ml) were elevated. Testicular scans showed an absence of both testes. This appears to be an unfortunate situation caused by false religious beliefs and the reckless use of internet resources.

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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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Addressing an Unmet Need in Postprostatectomy Care: Perspectives on Urovaxom: Byeong Jin Kang; Urogenit Tract Infect 2025;20(2):118-119. Published online August 31, 2025; DOI: https://doi.org/10.14777/uti.2550030015

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Editorial for Urogenital Tract Infection (UTI) 2025 Vol. 20 No. 2 – Highlights of This Issue’s Papers and the UTI Editors’ Pick
Koo Han Yoo
Urogenital Tract Infection.2025; 20(2): 55. CrossRef

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Editorial for Urogenital Tract Infection (UTI) 2025 Vol. 20 No. 2 – Highlights of This Issue’s Papers and the UTI Editors’ Pick: Koo Han Yoo; Urogenit Tract Infect 2025;20(2):55-57. Published online August 31, 2025; DOI: https://doi.org/10.14777/uti.2025edi02

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A Commentary on “Outbreak of Cystoscopy-Related Urinary Tract Infections With Pseudomonas aeruginosa in South Korea, 2022: A Case Series”: Byoungkyu Han; Urogenit Tract Infect 2025;20(1):52-54. Published online April 30, 2025; DOI: https://doi.org/10.14777/uti.2550010005

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Editorial for UTI 2025 Vol. 20 No. 1 - Highlights of This Issue’s Papers and the UTI Editors’ Pick
Koo Han Yoo
Urogenital Tract Infection.2025; 20(1): 1. CrossRef

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Hemangioma Mistaken for Renal Cell Carcinoma in a Patient With End-Stage Renal Disease: A Case Report: Hyung-Lae Lee, Dong-Gi Lee, Jeong Woo Lee, Jeonghyouk Choi; Urogenit Tract Infect 2025;20(1):48-51. Published online April 30, 2025; DOI: https://doi.org/10.14777/uti.2550008004

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Hemangiomas are rare, benign vascular neoplasms that are more common in patients with end-stage renal disease. Here, we describe 2 cases of hemangioma misdiagnosed as renal cell carcinoma before renal transplantation. The key finding in our case was the misdiagnosis of hemangiomas as renal cell carcinoma based on computed tomography and magnetic resonance imaging in patients with end-stage renal disease. Because living transplantation was planned for our patients, we performed rapid surgical resection of the heterogeneously enhancing renal masses to avoid delays in transplantation. Our case highlights the importance of rapid surgical resection of enhanced renal masses to confirm diagnosis, thereby avoiding delays in patients scheduled for renal transplantation.

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Editorial for UTI 2025 Vol. 20 No. 1 - Highlights of This Issue’s Papers and the UTI Editors’ Pick
Koo Han Yoo
Urogenital Tract Infection.2025; 20(1): 1. CrossRef

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Postoperative Microscopic Pyuria and Role of Damage-Associated Molecular Pattern: A Literature Review: Min-Kyu Kim, Ki Hong Kim; Urogenit Tract Infect 2024;19(3):73-79. Published online December 31, 2024; DOI: https://doi.org/10.14777/uti.2448026013

Abstract PDF PubReader ePub: All patients who undergo transurethral prostate surgery exhibit pyuria and microscopic hematuria in postoperative urinalysis. Postoperative asymptomatic pyuria is associated with the inflammatory process and surface remodeling of the prostate, rather than infection. Various studies have investigated the incidence, duration, and risk factors for postoperative pyuria, noting that factors like age, surgery time, and prostate size can influence outcomes. Postoperative pyuria reflects tissue recovery and inflammation, and the use of antibiotics in asymptomatic patients may not be appropriate.

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Impact of the Timing of Percutaneous Nephrostomy on the Prognosis of Obstructive Urolithiasis With Sepsis: A Retrospective Cohort Study: Ji Eun Yu, Hyung Joon Kim, Hong Wook Kim, Young Seop Chang, Jin Bum Kim, Dong Hoon Koh; Urogenit Tract Infect 2024;19(3):89-96. Published online December 31, 2024; DOI: https://doi.org/10.14777/uti.2448018009

Abstract PDF PubReader ePub: Purpose
The aim of this study was to investigate the prognostic impact of time to percutaneous nephrostomy (PCN) insertion on obstructive ureteral stones with sepsis. Materials and Methods: Data were collected on patients who presented at our Emergency Department between 2017 and 2021 with obstructive uropathy due to urinary stones and underwent PCN insertion. Patients were stratified into 4 groups in accordance with the quick sepsis-related organ failure (qSOFA) score at presentation (<2 or ≥2) and time to PCN insertion (<4 hours or ≥4 hours) as follows: group 1, qSOFA < 2 and time to PCN insertion < 4 hours; group 2, qSOFA < 2 and time to PCN insertion ≥ 4 hours; group 3, qSOFA ≥ 2 and time to PCN insertion < 4 hours; group 4, qSOFA ≥ 2 and time to PCN insertion ≥ 4 hours. The prognostic impacts of the time to PCN insertion were compared between these groups
Results
The total cohort consisted of 96 patients, of whom 70 were classified as either group 1 or 2 (qSOFA < 2). Overall, 37 patients had a positive urine culture. The median time to PCN insertion was 218 minutes, and the median length of stay was 14 days. The hospitalization period was significantly shorter in group 3 than in group 4 (p=0.041).
Conclusions
A shorter length of stay was associated with more rapid PCN insertion in patients with obstructive uropathy and a high risk of sepsis.

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