Lee SH, et al. J Korean Med Sci. 2020 Sep;35(43):e359. https://doi.org/10.3346/jkms.2020.35.e359

Background and objectives: To investigate the risk factors for emphysematous cystitis (EC) compared to those of acute cystitis (AC) to increase clinicians awareness of the possibility for the aggravation of patient status. Materials and methods: We retrospectively reviewed a total of 54 patients who were hospitalized with a diagnosis of EC by abdominal computed tomography (CT) scan from 2006 to 2020. The control group included 92 patients who were hospitalized for the treatment of AC in the same period. We sought to identify the clinical features and predisposing diseases, such as age, sex, diabetes mellitus (DM), hypertension (HTN), cerebrovascular accident (CVA), chronic kidney disease (CKD), neurogenic bladder (NB), history of urinary tract infection (UTI), and emphysematous pyelonephritis (EPN), that were associated with the development of EC. Results: The median (interquartile range (IQR)) age of the patients with EC was older than that of the patients with AC (78.5 (15.3) years (range: 52–100) vs. 70.0 (26.5) years (range: 28–97 years)). Sepsis and mortality occurred only in the EC group (48.1% and 11.1%, respectively). The univariate analysis of predisposing factors revealed that age, DM, HTN, CVA, CKD, and NB were significantly associated with EC. In the multivariate analysis, DM (OR, 6.251; 95% CI, 2.254–17.250; p < 0.001), CKD (OR, 18.439; 95% CI, 3.421–99.404; p = 0.001), NB (OR, 7.374; 95% CI, 1.993–27.285; p = 0.003) were associated with EC. Conclusions: The results of this study revealed that DM, CKD, and NB were significant risk factors for EC. The tendency toward sepsis and high mortality underscore the need for careful observation while treating patients with EC with the risk noted above.

Choi J, et al. Investig Clin Urol. 2024 Sep;65(5):480-486. https://doi.org/10.4111/icu.20240152

Urothelial tumors are typically a disease affecting elderly individuals and are rare in young patients. Moreover, upper urinary tract urothelial carcinoma is extremely rare in the young age group. In this study, we present a case of urothelial cell carcinoma of the renal pelvis and ureter in a young man without risk factors of urothelial carcinoma, which was misdiagnosed as ureteropelvic junction obstruction and treated with a laparoscopic pyeloplasty.

Jinseok Kang, Koo Han Yoo, Taesoo Choi, Gyeong Eun Min, Dong-Gi Lee, Hyung-Lae Lee, Jeonghyouk Choi. Urogenit Tract Infect 2023;18:93-100. https://doi.org/10.14777/uti.2023.18.3.93

Background: This study aimed to evaluate the efficacy and convenience of a chlorhexidine-coated hydrophilic urethral catheter compared with a conventional silicone Foley catheter, focusing on patient discomfort, procedural time, and clinician satisfaction.Methods: This prospective randomized controlled study enrolled patients who required short-term urethral catheterization at two hospitals. The patients were randomly assigned to receive either a conventional urethral catheter (control group, n=64) or a chlorhexidine-coated hydrophilic urethral catheter (intervention group, n=67). The primary endpoints were patient-reported pain scores during catheter insertion and removal (pain scale, 0–10), procedural time (seconds), and clinician-reported satisfaction (0–10).Results: Patients in the intervention group reported significantly less pain during catheter insertion (mean score, 4.2 vs. 6.6; p<0.01) and removal (mean score, 2.8 vs. 4.5; p<0.01). The mean procedural time was shorter in the intervention group (215 seconds vs. 386 seconds; p<0.01), and clinician satisfaction was higher (mean score, 8.2 vs. 3.6; p<0.01). Patients in the intervention group were more likely to experience mild pain during catheter insertion (score, 0–3; 26.9% vs. 12.7%; odds ratio [OR], 2.53) and removal (score, 0–3; 83.6% vs. 42.9%; OR, 6.79). A greater proportion of procedures was completed within 150 seconds (59.7% vs. 44.4%; OR, 1.85), and clinicians reported higher satisfaction with the procedure (score, 8–10; 73.1% vs. 23.4%; OR, 8.71).Conclusion: Chlorhexidine-coated hydrophilic urethral catheters significantly reduced pain, shortened the procedural time, and improved clinician satisfaction. These findings suggest potential clinical benefits for both patients and clinicians.