Jeong Seok Hwa

Oxidative stress is a well-recognized contributor to male reproductive dysfunction, yet discussion of this mechanism has focused almost exclusively on sperm damage. This focus overlooks the somatic and stromal networks that support testicular development, steroidogenesis, tissue architecture, and erectile function. Platelet-derived growth factor receptor alpha (PDGFRα) is expressed in heterogeneous interstitial and progenitor-enriched populations and has established roles in testicular development. This narrative review examines the evidence on PDGFRα in male reproductive tissues and considers the potential relevance of redox mechanisms identified predominantly in other organ systems. Genetic studies show that Pdgfa deficiency impairs the postnatal establishment of the adult Leydig-cell population, whereas Pdgfra deficiency disrupts fetal testis cord organization and Leydig-cell differentiation. Studies of the adult testis document receptor localization and, in cell-based models, downstream signaling capacity. Preclinical work has further identified PDGFRα-positive cavernosal fibroblasts associated with vascular remodeling in erectile dysfunction, although a receptor-specific function for these cells remains unproven. We propose that PDGFR-associated redox signaling may shape stromal responses to injury in the testis and penis; however, direct evidence for this mechanism in male reproductive tissue is currently lacking. Testing this hypothesis will require cell-resolved measurements of receptor phosphorylation and localized reactive oxygen species, together with lineage-restricted, receptor-specific perturbation. Establishing whether such a pathway exists could open a mechanistic link between oxidative stress and stromal, rather than purely germ-cell, contributions to male reproductive dysfunction—with implications for both testicular endocrine failure and vasculogenic erectile dysfunction.

Kim DH, et al. Investig Clin Urol. 2026 Mar;67(2):192-200. https://doi.org/10.4111/icu.20250360

Jeh SU, et al. World J Mens Health. 2026 Jan;44(1):129-135. https://doi.org/10.5534/wjmh.240306

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.

Kim DH, et al. Investig Clin Urol. 2024 Apr;65:e28. https://doi.org/10.4111/icu.20230284

Choi SM, et al. Investig Clin Urol. 2024 Feb;65:e17. https://doi.org/10.4111/icu.20230276

Jeh S, et al. Investig Clin Urol. 2024 Jan;65(1):69-76. https://doi.org/10.4111/icu.20230249

This study aimed to evaluate the effectiveness of combined pelvic floor muscle exercise (PFME) and duloxetine treatment in the recovery from postprostatectomy urinary incontinence (PPUI). Participants were patients who underwent radical prostatectomy (RP) between 2018 and 2021 and who were able to attend follow-up appointments every 3 months for at least 12 months. Continence was defined as the use of ≤1 pad per day. PPUI was compared at each follow-up period by dividing the participants into the PFME group (PFME only after RP) and the PFME + DUL group (PFME and 30 mg duloxetine daily after RP). A total of 197 patients were included. No significant differences were observed in the baseline characteristics between the 2 groups. In the PFME group (n = 127), the PPUI was 77.17%, 27.56%, 17.32%, 12.60%, and 9.45% at 2 weeks, 3 months, 6 months, 9 months, and 12 months, respectively. In the PFME + DUL group (n = 70), the PPUI was 62.50%, 17.86%, 12.50%, 8.93%, and 5.36%, respectively, at the same follow-up period. At 2 weeks, the PFME + DUL group demonstrated a better incontinence rate than the PFME group (P = .019). However, no significant differences were found in the incontinence rates between the 2 groups at each follow-up period after 3 months. Compared to PFME monotherapy, the combination therapy of PFME and duloxetine has short-term effectiveness in improving PPUI, but it does not have a significant long-term impact. Therefore, for early recovery from PPUI, duloxetine should be administered for a short period during PFME.

Kim DH, et al. World J Mens Health. 2023 Apr;41:e41. https://doi.org/10.5534/wjmh.220225

Background/Aim: The purpose of this study was to examine the expression of estrogen receptor α (ERα) and β (ERβ), androgen receptor (AR), SIRT1, SIRT2 and SIRT3 in prostate cancer (PCa). Materials and Methods: From October 2010 to January 2015, 70 patients who had undergone radical prostatectomy following a PCa diagnosis were enrolled in our study. Normal prostate tissue (NPT) and prostate cancer tissues (PCAT) were separated, and the expression of each receptor in each tissue was analyzed with immunochemical staining. Univariate and multivariate analyses were performed to identify factors affecting the development of PCa. Results: ERβ and AR were highly expressed in PCAT compared with NPT (p<0.05). SIRT2 was highly expressed in NPT and PCAT (p<0.05). Univariate and multivariate analyses showed that AR and SIRT2 affect PCa development. Conclusion: AR is a risk factor for PC, and SIRT2 is associated with a lower incidence of PCa.