Korean Urological Association Research Articles

Estimated prospects of demand and supply of urologists in Korea over the next 10 years.

This study aimed to provide the basic data needed to estimate future urologist supply and demand by applying various statistical models related to healthcare utilization. Data from multiple sources, including the Yearbook of Health and Welfare Statistics, Korean Hospital Association, Korean Medical Association, and the Korean Urological Association, were used for supply estimation. Demand estimation incorporated data on both clinical and non-clinical urologists, along with future population estimates. In-and-out moves and demographic methods were employed for supply estimation, while the Bureau of Health Professions model was utilized for demand estimation. Supply estimation assumptions included fixed resident quotas, age-specific death rates, migration rates, and retirement age considerations. Demand estimation assumptions included combining clinical and nonclinical urologist demands, adjusting population size for age-related healthcare usage variations. Urologist productivity was determined by adjusting productivity levels to 100%, 90%, and 80% of the base year based on actual clinical practice volumes. Estimations of both demand and supply consistently indicate an oversupply of urologists until 2025, followed by an expected shortage by 2035 owing to increased deaths and retirements attributed to the aging urologist population. This shortage becomes more pronounced when employing more reliable models, such as logit or ARIMA (autoregressive integrated moving average), underscoring the growing need for urologists in the future. All estimation models estimated an oversupply of urologists until 2025, transitioning to a deficit due to reduced supply thereafter. However, considering potential unaccounted factors, greater effort is needed for accurate predictions and corresponding measures.

Korean guideline of desmopressin for the treatment of nocturia in men.

PurposeNocturia is the most bothersome of lower urinary tract symptoms in men. Desmopressin, a synthetic analog of the human hormone vasopressin, has been used for the treatment of nocturia. However, the guidelines include varying recommendations for the use of desmopressin for the management of nocturia in men. Therefore, the Korean Urological Association (KUA) developed recommendations for desmopressin for the treatment of nocturia in men.Materials and MethodsA rigorous systematic review was performed and Grading of Recommendations, Assessment, Development, and Evaluation methodology was used to rate the certainty of evidence for patient outcomes and to develop the evidence into recommendations. The steering group, guidelines development group, systematic review team, and external review group consisted of members of the Korean Continence Society, Korean Society of Geriatric Urological Care, and KUA, respectively, who were involved in the guidelines development process.ResultsThe guidelines address the benefits, harms, patients’ values and preferences, costs, and resources related to desmopressin by using a single clinical question: What is the effectiveness of desmopressin compared to that of placebo, behavior modification, or other pharmacological therapies?ConclusionsThe guidelines development panel suggests desmopressin for men with nocturia instead of placebo, behavior modification, or alpha-blocker monotherapy (low certainty of evidence, weak recommendation). Additionally, the panel suggests desmopressin combination therapy with alpha-blockers for men with nocturia instead of alpha-blocker monotherapy or alpha-blocker combination therapy with anticholinergic agents (low certainty of evidence, weak recommendation).

History of Investigative and Clinical Urology and an analysis of published articles.

Investigative and Clinical Urology is the official journal of the Korean Urological Association (KUA). Taehan Pinyogikwa Hakhoe chi was the first version of the official journal of the KUA and was published in January 1960. The journal was renamed the Korean Journal of Urology in February 2009 and the Korean Journal of Urology changed its title to Investigative and Clinical Urology in January 2016. The official YouTube channel of Investigative and Clinical Urology has been in operation since January 2016. Investigative and Clinical Urology was registered in Science Citation Index Expanded (SCIE) on October 30, 2018. A total of 8,103 papers were published in Investigative and Clinical Urology from January 1960 to December 2018. The most common subjects in published articles were oncology (4,602), pediatric urology (1,540), endourology & urolithiasis (1,477), and sexual dysfunction & infertility (1,285). A total of 23 articles on randomized controlled trials were published from March 2010 to December 2018. The acceptance rate of original articles in Investigative and Clinical Urology has decreased continuously since 2014. Meanwhile, the submission rate by international authors has shown an increasing trend from 2014 to 2018. As the first urologic journal in South Korea, Investigative and Clinical Urology has faithfully played its academic role in the past and present for 60 years. Since joining the SCIE list in 2018, further progress of Investigative and Clinical Urology is highly expected.

Korean clinical practice guideline for benign prostatic hyperplasia.

In 2014, the Korean Urological Association organized the Benign Prostatic Hyperplasia Guideline Developing Committee composed of experts in the field of benign prostatic hyperplasia (BPH) with the participation of the Korean Academy of Family Medicine and the Korean Continence Society to develop a Korean clinical practice guideline for BPH. The purpose of this clinical practice guideline is to provide current and comprehensive recommendations for the evaluation and treatment of BPH. The committee developed the guideline mainly by adapting existing guidelines and partially by using the de novo method. A comprehensive literature review was carried out primarily from 2009 to 2013 by using medical search engines including data from Korea. Based on the published evidence, recommendations were synthesized, and the level of evidence of the recommendations was determined by using methods adapted from the 2011 Oxford Centre for Evidence-Based Medicine. Meta-analysis was done for one key question and four recommendations. A draft guideline was reviewed by expert peer reviewers and discussed at an expert consensus meeting until final agreement was achieved. This evidence-based guideline for BPH provides recommendations to primary practitioners and urologists for the diagnosis and treatment of BPH in men older than 40 years.

Taking a Great Leap Forward on a Blue Horse

The year of the blue horse has begun. In the Chinese zodiac, 2014 is the year of the blue horse. Horse symbolizes success and leaps, and blue symbolizes hope and luck. The color blue is especially meaningful to our journal because it is also the representative color of the Korean Journal of Urology (KJU). Together, we expect that KJU will make successful contributions and bring a hopeful future to the field of urology this year by taking a great, dynamic leap forward on a blue horse. Beginning with the January issue of 2014, the KJU will be an official journal of three societies: the Korean Urological Association, the Korean Endourological Society, and the Korean Society of Pediatric Urology. The Korean Endourological Society has published the Korean Journal of Endourology since 2001 and the Korean Society of Pediatric Urology has published the Korean Journal of Pediatric Urology since 2009. The main reason for merging the journals was the overlap in scope and members among the three societies. Instead of individual publications, the Korean Endourological Society and Korean Society of Pediatric Urology will be authorized to take over editing in the Endourology and Pediatric Urology sections, respectively, within the larger body of KJU. In the long term, the merging of the three individual journals is expected to provide more in-depth knowledge in the sections of Endourology and Pediatric Urology and to improve the overall quality of the journal. The goal of KJU this year is to be a cutting-edge international journal with open access, audio-video contents, and high quality research in the field of urology. First, to accomplish this, we will broaden the article contributors and members of the editorial board to include the Asia-Pacific region and maintain the open access policy to provide widespread dissemination of knowledge. Second, the KJU will promote upload and access of the visual clips to further aid users in delivering both academic knowledge and skills. Video clips related to minimally invasive surgery and advanced surgical technique can be submitted for placement on the journal website. There is also a 'Video Interview with the Author' corner on the journal's homepage where authors give audiovisual presentations of their data. Last, one of the most important aspects of the journal is improving the quality of the journal to solidify its global status as an international journal. For this, the KJU will provide readers with an up-to-date guide to international developments in urology. The impact factor from the Web of Science and impact index from SCImago Journal of the KJU began to increase dramatically beginning in 2011. Huh [1] commented that the KJU has already been established as an international journal, because more than 85% of the citations come from international researchers. In addition, the research and publication ethics should be regarded as an integral part of a qualified journal [2]. The editorial team of KJU screens published and submitted content for originality by using Crosscheck to prevent plagiarism and also checks submitted articles to see whether they meet the criteria of publication ethics. In order to achieve our New Year's pledge of making the KJU an internationally renowned journal, the editorial team of the KJU will work hard by taking in the promising energy of the blue horse. We look forward to making great leaps toward creative academic achievements this year.

KJU indexed in MEDLINE.

The Korean Journal of Urology (KJU) has taken a great leap towards becoming a highly regarded international journal. This July, KJU was selected to be indexed in MEDLINE, a bibliographic database of the U.S. National Library of Medicine (NLM). MEDLINE includes citations from over 5,600 scholarly journals published around the world. Currently, KJU is among 18 journals in Korea that are indexed. The National Institutes of Health-chartered advisory committee, the Literature Selection Technical Review Committee (LSTRC), reviews and recommends journals for MEDLINE. The LSTRC considers the quality of the scientific content of a journal, including originality and the importance of the content for the MEDLINE global audience. A distinctive feature of MEDLINE is that it uses the NLM controlled vocabulary, Medical Subject Headings (MeSH), to index citations. The KJU has been indexed in PubMed and PubMed Central since 2010 [1]. With the January issue of 2010, KJU took a giant leap towards its quest to becoming an international journal. At that time, the official language of the journal changed from Korean to English, which was a historical event in the life of the Korean Urological Association [2]. After the journal was indexed in PubMed and PubMed Central, the journal’s impact factor from the Web of Science and its impact index from SCImago Journal began to increase dramatically [3]. Likewise, being indexed in an internationally well-known journal database such as MEDLINE will provide easy access to the KJU for many international readers and researchers. MEDLINE is an internationally respected premier database in the field of biomedicine. Therefore, the indexing of the KJU by MEDLINE is an outstanding achievement and another giant leap on the journal’s path to becoming a renowned international journal. This achievement will broaden the range of international readers and will increase the number of submissions of high-quality articles. It will also provide a strong driving force for our editorial team in their efforts to build a high-quality international

P311 A Survey On The Likely Resources Of Guideline Dissemination And The Perceived Barriers To The Utilization In Korea

BackgroundDissemination resources are very important to utilise Guidelines. To provide useful information to make a strategy for promoting implementation effectiveness, identifying the barriers to the utilisation should be done.ObjectivesTo identify...

P281 Applying The Re-Aim Framework To Evaluate Dissemination And Implementation Of Clinical Practice Guideline For Sexually Transmitted Infections In Korea

BackgroundClinical practice guideline for Sexually Transmitted Infections were developed in 2011 by The Korean Urological Association supported financially by the Korean government. It is necessary to establish the theory-based strategy...

Urologist's Practice Patterns Including Surgical Treatment in the Management of Premature Ejaculation: A Korean Nationwide Survey

PurposeAccording to previous studies, the prevalence of premature ejaculation (PE) in Korea ranges from 11.3% to 33%. However, the actual practice patterns in managing patients with PE is not well known. In this study, we have endeavored to determine how contemporary urologists in Korea manage patients with PE.Materials and MethodsThe e-mailing list was obtained from the Korean Urological Association Registry of Physicians. A specifically designed questionnaire was e-mailed to the 2,421 urologists in Korea from May 2012 to August 2012.ResultsUrologists in Korea diagnosed PE using various criteria: the definition of the International Society for Sexual Medicine (63.4%), Diagnostic and Statistical Manual of Mental Disorders (43.8%), International Statistical Classification of Disease, 10th edition (61.7%), or perceptional self-diagnosis by the patient himself (23.5%). A brief self-administered questionnaire, the Premature Ejaculation Diagnostic Tool, was used by only 42.5% of the urologists. Selective-serotonin reuptake inhibitor (SSRI) therapy was the main treatment modality (91.5%) for PE patients. 40.2% of the urologists used phosphodiesterase type 5 inhibitors, 47.6% behavior therapy, and 53.7% local anesthetics. Further, 286 (54.3%) urologists managed PE patients with a surgical modality such as selective dorsal neurotomy (SDN).ConclusionsA majority of Korean urologists diagnose PE by a multidimensional approach using various diagnostic tools. Most urologists believe that medical treatment with an SSRI is effective in the management of PE. At the same time, surgical treatment such as SDN also investigated as one of major treatment modality despite the lack of scientific evidence.

Fate of Abstracts Presented at the Annual Meeting of the Korean Urological Association

PurposeThe acceptance rate for journal publication of the abstracts presented at the annual Korean Urological Association (KUA) meeting, the time to publication, and the effect of abstract characteristics on the publication pattern were analyzed and compared with data for abstracts from other major urological meetings.Materials and MethodsA total of 1,005 abstracts listed in the abstract books of the 2006 (58th) and 2007 (59th) annual KUA meetings were analyzed, and their subsequent publication as listed in PubMed or KoreaMed between August 2006 and August 2011 was evaluated.ResultsA total of 41.59% of abstracts were published as full-length reports. s on sexual dysfunction, neurourology, prostate cancer, basic research, and benign prostatic hyperplasia showed the highest publication rates (54%, 52.27%, 48%, 47.56%, and 45%, respectively). It took 19.01±12.83 months on average for abstracts to be published in a journal, whereas it took 25.24±14.64 months and 17.51±11.89 months for publication in foreign and Korean journals, respectively (p<0.001).ConclusionsApproximately 40% of studies presented as abstracts at the KUA meeting are subsequently published as full-length articles. The KJU is the most targeted journal. The mean time to publication is 1.5 years, and publication seems to be influenced by the study subject.

Analysis of Content Legibility for Smartphones of Websites of the Korean Urological Association and Other Urological Societies in Korea

PurposeWe performed an analysis of the smartphone legibility of the websites of the Korean Urological Association (KUA) and other urological societies.Materials and MethodsThis study was conducted on the websites of the KUA and nine other urological societies. Each website was accessed via iPhone Safari and Android Chrome, respectively, to evaluate the establishment and readability of the mobile web pages. The provision of Really Simple Syndication (RSS) feeds by the websites and whether the websites had Twitter and Facebook accounts were evaluated. In addition, a validation test on the web standards was performed by using the World Wide Web Consortium (W3C®) Markup Validation Service, and subsequently the numbers of errors and warnings that occurred were analyzed.ResultsWhen accessed via Safari, two websites were legible, four were somewhat legible, and four were somewhat illegible. When accessed via Chrome, two websites were legible, six were somewhat legible, and two were somewhat illegible. One website provided an RSS feed and two websites managed members via separate Twitter accounts. No website supported mobile web pages. The result of the W3C® Markup Validation test on 10 websites showed a mean error rate of 221.6 (range, 13-1,477) and a mean warning rate of 127.13 (range, 0-655).ConclusionsThe smartphone legibility level of the websites of urological societies was relatively low. Improved smartphone legibility and web standard compliance of the websites of urological societies are required to keep up with the popularity of smartphones.

A Giant Leap toward a Renowned International Journal

Starting with the January issue of 2010, the Korean Journal of Urology became an entirely English-language journal. This was a historical event in the Korean Urological Association, because the official language of the journal changed from Korean to English. The Korean Journal of Urology was first published in 1960. The Korean title of the journal was the 'Taehan Pinyogikwa Hakhoe Chapchi,' but with the August 1979 issue, it was renamed as the 'Taehan Pinyogikwa Hakhoe chi.' In February 2009, the title of the journal was changed to the English 'Korean Journal of Urology' to increase the international recognition of the journal [1]. Owing to the recognition of its scientific excellence, the Korean Journal of Urology (KJU) was indexed in SCOPUS and EMBASE, which are international scientific search engines on the web, in 2008. The KJU is a peer-reviewed, monthly publication covering clinical and basic science information relevant to physicians and researchers in the field of urology. Because the incidences, characteristics, and management of diseases vary according to region and race, the KJU will provide international readers access to Asian data on various urological diseases. The topics of the KJU include urological oncology, laparoscopy/robotics, lasers in urology, voiding dysfunction, female urology, sexual dysfunction, male infertility, pediatric urology, investigative urology, and results of innovative treatments, providing readers with an up-to-date guide to international developments in urology. Starting in 2010, we will publish special features including online video clips and illustrations of newly developed surgical techniques. When the KJU became an entirely English journal, we invited 10 international editorial board members from Asia-Pacific areas who are highly qualified world leaders in each field. We will continuously invite world- renowned editorial board members and reviewers. The Information for Authors of the KJU was revised in January 2010. The Journal publishes original articles, invited review articles, illustrated surgical techniques in urology, case reports, and letters to the editor in the fields of clinical and experimental urology. We reinforced the research and publication ethics. Any research that deals with a clinical trial is recommended to be registered with a primary national clinical trial registration site or other sites accredited by the WHO or the International Committee of Medical Journal Editors. Recently, we were awarded a grant for globalization of the journal from the Korean Federation of Science and Technology Societies. This grant will support the KJU in becoming indexed in Pubmed Central and SCI(E). The KJU is currently a free access journal that opens in Google Scholar and will become an open access journal soon. This coming year, the editorial team of the KJU will apply for our journal to be indexed in Pubmed Central and Medline. We hope that the KJU will soon be recognized among other high-quality, international, peer-reviewed journals.

The Urologist's View of Male Overactive Bladder: Discrepancy between Reality and Belief in Practical Setting

PurposeIn order to gain insight into the physicians' awareness of and attitude towards management of overactive bladder (OAB) in males, we performed a nationwide survey of the current strategies that urologists use to diagnose and manage OAB in male patients.Materials and MethodsA probability sample was taken from the Korean Urological Association Registry of Physicians, and a random sample of 289 Korean urologists were mailed a structured questionnaire that explored how they manage benign prostatic hyperplasia (BPH).ResultsA total of 185 completed questionnaires were returned. The consent rate in the survey was 64.5%. Eighty-one (44%) urologists believed that of all males with lower urinary tract symptoms (LUTS), 20% or more had OAB and 72 (39%) believed that 10-20% had OAB. Half of the urologists surveyed believed that the most bothersome symptom in male OAB patients was nocturia. Seventy-three percent of respondents reported that they prescribed alpha blockers with anticholinergics for first line management, while 19% of urologists prescribed alpha blocker monotherapy but not anticholinergics for OAB patients. Though acute urinary retention (AUR) was considered the anticholinergic adverse event of most concern, the most frequently observed adverse event was dry mouth (95%).ConclusionThe present study provides insights into urologist views of male OAB. There is a discrepancy between the awareness of urologists and actual patterns of diagnosis and treatment of male OAB. This finding indicates the need to develop further practical guidelines based on solid clinical data.

Korean Urologist's View of Practice Patterns in Diagnosis and Management of Benign Prostatic Hyperplasia: A Nationwide Survey

PurposeIn Korea, there was no specific guidelines for the management of benign prostatic hyperplasia (BPH). We reviewed the practice patterns of Korean urologists in the management of BPH and aimed to describe the need to develop specific guidelines.Materials and MethodsA probability sample was taken from the Korean Urological Association Registry of Physicians, and a structured questionnaire, that explored practice patterns in the management of BPH, was mailed to a random sample of 251 Korean urologists.ResultsFor the initial evaluation of BPH, most urologists routinely performed prostatic specific antigen (PSA) (96.4%), digital rectal exam (94.4%), international prostate symptom score (IPSS) (83.2%) and transrectal ultrasound (79.2%). Symptom assessment (36.4%) followed by transrectal ultrasound of prostate (TRUS) (20.0%) was considered as the most important diagnostic examination affecting the decision about individual treatment options. Almost all urologists (92.2%) chose medical treatment as the first-line treatment option for uncomplicated BPH with moderate symptoms. Of the respondents, 57.2% had prescribed alpha blocker and 41.6% alpha blocker plus 5-alpha reductase inhibitors as the medical treatment option for BPH. The prescription of 5-ARIs was dependent on the size of the prostate and the severity of symptoms.ConclusionThe results of our current survey provide useful insight into variations in the clinical practice of Korean urologists. They also indicate the need to develop further practical guidelines based on solid clinical data and to ensure that these guidelines are widely promoted and accepted by the urological community.

Evaluation of the Quality of Life and the Efficacy of Treatment after High Power Potassium-titanyl-phosphate (KTP) Laser Vaporization for Patients with a Prostate Volume Greater than 40cc

Purpose: This study was conducted to evaluate the quality of life and efficacy of treatment after 80 watts high power potassium-titanyl-phosphate laser vaporization for patients with a prostate volume greater than 40cc. We adopted the benign prostatic hyperplasia (BPH) quality of life (QoL)-K1 short form that was developed by the Korean Urological Association in 2001 to more accurately assess the quality of life of patients with BPH. Materials and Methods: From July 2005 to March 2006, we performed KTP laser vaporization on a total of 38 patients with symptomatic benign prostatic hyperplasia of the prostate and all their prostate volumes were more than 40cc. All the patients were evaluated preoperatively and then again at 3 and 6 months postoperatively based on the International Prostate Symptom Score (IPSS), the maximum urinary flow rate (Qmax) and the postvoid residual urine (PVR). We conducted a survey of all the patients regarding BPH with using the QoL-K1 short form by means of mail and phone at a mean of 8.7 months (range: 5-12) postoperatively. Results: The mean operation timewas 50.5 minutes (range: 20-120), and the mean duration of admission and catheterization were 2.9±0.4 days and 22.0±10.9 hours, respectively. The mean total score for the BPH QoL-K1 short form improved from 34.5 preoperatively to 22.5 at 6 months postoperatively (p<0.001). There was a significant improvement in the IPSS, Qmax and PVR after the operation, but there were no differences between these parameters at 3 months and 6 months after KTP laser vaporization. There was dysuria in 9 (24%) patients postoperatively and urinary tract infection occurred in 10 (26%) of all the patients. Conclusions: This study showed that KTP laser vaporization was effective in patients with a prostate volume more than 40cc, and the procedure produced improvements in the IPSS, Qmax,PVR and the BPH QoL-K1 short form. Despite the high rate of dysuria and urinary tract infection, the patients treated with KTP laser showed satisfaction about the operation because of the shortened duration of both admission and catheterization. (Korean J Urol 2007;48:956-964)

Patterns in the Diagnosis and Management of Benign Prostatic Hyperplasia in a Country that does not have Country-Specific Clinical Practice Guidelines

PurposeWe have evaluated the patterns of diagnostic and treatment practices for benign prostatic hyperplasia (BPH) in a country that does not have country-specific clinical practice guidelines.Materials and MethodsProbability samples were taken from the Korean Urological Association Registry of Physicians, and randomly sampled Korean urologists were asked to complete a questionnaire. The survey explored practice characteristics and attitudes, as well as diagnostic and treatment strategies, for the management of BPH.ResultsOf the 850 questionnaires sent, 302 were returned, and 277 of those were included in the final analysis (response rate 32.6%). For the initial evaluation, most urologists routinely used digital rectal examinations (DRE) and urinalysis. Uroflowmetry was used 34.7% of the time. Pressure-flow studies were rarely done. Symptom assessment was used in only 46.9% of cases. In addition, a significant number (58.8%) reported that treatment decisions were not based on the symptom questionnaire. Before surgery, almost all urologists routinely used DRE, urinalysis, and prostate-specific antigen tests. Of the respondents, 55.6% and 41.9% had prescribed alpha-blockers and alpha-blockers with 5-alpha reductase inhibitors, respectively. 81.2% of urologists perceived that selective alpha-blockers are different in terms of efficacy, and 82.7% felt that they differed in safety. Most respondents prescribed 5-alpha reductase inhibitors based on the prostate size.ConclusionThese data provide a picture of current practices regarding the management of BPH in Korea. The diagnostic and treatment practices for BPH do not follow published guidelines. Our findings ask the question "How influential are international guidelines, and do they really affect patient management in countries that do not have country-specific guidelines?"

Questionnaire Survey of Urologists’ Initial Treatment Practices for Acute Urinary Retention Secondary to Benign Prostatic Hyperplasia in Korea

Background: We undertook a survey of Korean urologists to establish initial treatment practices for acute urinary retention secondary to benign prostatic hyperplasia. Methods: Probability samples were drawn from the Korean Urological Association Registry of Physicians, and a random sample of 850 Korean urologists were asked to complete a questionnaire that explored practice characteristics and treatment strategies in the management of acute urinary retention. The returned questionnaires were statistically analyzed. Results: Of the 850 questionnaires sent, 302 were returned, and 277 of those were included in the final analysis (response rate 32.6%). Korean urologists preferred urethral catheterization as the initial management. Of respondents, 154 (55.6%) and 109 (39.4%) started their patients on α-blockers and α-blockers with finasteride, respectively. Nearly half (50.2%) used a trial without catheter 7 days after catheterization. One failed trial without catheter was an indication for surgery for only 69 (24.9%) of the respondents. A second trial without catheter was advocated by 108 (39.0%). Most urologists (82.3%) expected to be successful with the above management in 50% or greater. Physician’s demographics or types of initial management did not influence physician’s perception of expected success rate when the expected success rate was divided as ≤50% and >50. Conclusions: These data provide a picture of current practice regarding the management of acute urinary retention secondary to benign prostatic hyperplasia in Korea. There is no uniformity in the management of acute urinary retention in Korea.

Chronic prostatitis in Korea: a nationwide postal survey of practicing urologists in 2004

To examine the diagnosis and treatment of chronic prostatitis by means of a nationwide postal survey of practicing urologists in 2004. A random sample of 850 Korean urologists from the Korean Urological Association Registry of Physicians were asked to complete a questionnaire that explored practicing characteristics, attitudes and diagnostic and treatment strategies in the management of chronic prostatitis. Of the 850 questionnaires sent, 302 were returned (response rate 35.5%) and 275 were induced in the final analysis. More than 50% believed in a multifactorial etiology for chronic prostatitis and 52% considered chronic abacterial prostatitis to be bacterial in nature. For routine diagnostic assessment, the most commonly used tests were reported to be urinalysis (95.3%), analysis of expressed prostatic secretions (89.5%) and digital rectal examination (81.1%). Only a few urologists use specific lower urinary tract cultures. Symptom assessment according to the National Institute of Health-Chronic Prostatitis Symptom Index was less frequently used (12.7%). First choices for therapy included antibiotics (96.4%), alpha-blockers (71.6%) and sitz baths (70.5%). If unsuccessful, urologists frequently continued to prescribe a second course of either alpha-blockers (69.5%) or antibiotics (57.8%). These data provide a picture of current practice regarding the management of chronic prostatitis in Korea. The diagnostic and treatment practices for prostatitis do not follow standard textbook algorithms. Further studies are needed to elucidate the etiology and pathogenesis of chronic prostatitis and to establish guidelines for its diagnosis and treatment.

Factors influencing practices for chronic prostatitis: A nationwide survey of urologists in South Korea

We investigated the influence of physicians' attitudes on the treatment of chronic prostatitis, and attempted to correlate demographic and professional characteristics with patterns of therapy regarding chronic prostatitis. Probability samples were drawn from the Korean Urological Association Registry of Physicians, and a random sample of 850 Korean urologists were asked to complete a questionnaire which explored practice characteristics, attitudes, and diagnostic and treatment strategies for the management of chronic prostatitis. The returned questionnaires were statistically analysed. Of the 850 questionnaires sent, 302 were returned, and 275 of those were included in the final analysis (response rate 32.4%). Multivariate logistic regression analysis indicated that the type of hospital (P < 0.001) and belief that culture tests helped diagnose chronic prostatitis (P = 0.001) were the most determinant factors with respect to the routine performance or non-performance of culture tests. Most Korean urologists (96.4%) prescribed antibiotics for the primary treatment of chronic prostatitis. Even when primary antibiotic treatment was unsuccessful, urologists frequently prescribed a second course of antibiotics (57.8%). In the multivariate model used, the likelihood of prescribing antibiotics as a secondary treatment varied by the type of hospital, with 0.4-fold odds (odds ratio [OR], 0.43; 95% confidence interval [CI], 0.21-0.87; P = 0.019) of the practice occurring in university hospitals, as opposed to primary clinics. According to the same model, the belief that culture tests help to diagnose chronic prostatitis was also an independent influencing factor (OR, 2.29; 95% CI, 1.39-3.77; P = 0.001), whereas the actual performance of culture tests had no statistical significance. Our findings suggest that the personal beliefs and professional characteristics of physicians may influence the diagnosis and treatment of chronic prostatitis in Korea.

The Last Fifty Years of Western Medicine in Korea: Korean Urological Association

The Last Fifty Years of Western Medicine in Korea: Korean Urological Association