Abstract
Background
Epididymitis is most commonly idiopathic but can also be associated with urinary tract abnormalities (UTAs). The distinctive clinical and imaging findings of children with epididymitis and underlying UTAs are not known.
Objective
To describe clinical and imaging findings in children with epididymitis and the association with UTAs.
Material and methods
The study group included all children evaluated for epididymitis confirmed by scrotal US in a 6-year period. The clinical and imaging findings and disease recurrence were compared between children with and without UTAs.
Results
A total of 47 boys (mean/SD 9.61/4.40 years, range 0.1 to 17.1 years) met the entry criteria, of whom 17 had UTAs. The most common UTAs were hypospadias, neurogenic bladder, and functional bladder abnormality (six each). Age at presentation and likelihood of testicular swelling or hydrocele was not different between children with and without UTAs. Marked epididymal swelling was more common in children with UTAs (9/17, 53%) than in those without UTAs (5/30, 17%; P=0.02), as was recurrent epididymitis (with UTAs, 9/17, 53%; without UTAs, 5/30, 17%; P=0.02). Chronic epididymitis (five children), presentation with scrotal mass (four), and epididymal abscess (two) occurred only in children with UTAs.
Conclusion
Children with epididymitis who have UTAs are more likely to present with marked epididymal swelling, develop recurrent disease, and have a more protracted course.
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References
Sakellaris GS, Charissis GC (2008) Acute epididymitis in Greek children: a 3-year retrospective study. Eur J Pediatr 167:765–769
Klin B, Zlotkevich L, Horne T et al (2001) Epididymitis in childhood: a clinical retrospective study over 5 years. Isr Med Assoc J 3:833–835
Merlini E, Rotundi F, Seymandi PL et al (1998) Acute epididymitis and urinary tract anomalies in children. Scand J Urol Nephrol 32:273–275
Siegel A, Snyder H, Duckett JW (1987) Epididymitis in infants and boys: underlying urogenital anomalies and efficacy of imaging modalities. J Urol 138:1100–1103
Cappèle O, Liard A, Barret E et al (2000) Epididymitis in children: is further investigation necessary after the first episode? Eur Urol 38:627–630
Shiraishi K, Takihara H (2004) Recurrent epididymo-orchitis caused by posterior urethral valve associated with imperforate anus. Int J Urol 11:58–60
Kiyan G, Dagli TE, Iskit SH et al (2003) Epididymitis in infants with anorectal malformation. Eur Urol 43:576–579
Melekos MD, Asbach HW, Markou SA (1988) Etiology of acute scrotum in 100 boys with regard to age distribution. J Urol 139:1023–1025
Karmazyn B, Steinberg R, Livne P et al (2006) Duplex sonographic findings in children with torsion of the testicular appendages: overlap with epididymitis and epididymoorchitis. J Pediatr Surg 41:500–504
Bukowski TP, Lewis AG, Reeves D et al (1995) Epididymitis in older boys: dysfunctional voiding as an etiology. J Urol 154:762–765
Lindehall B, Abrahamsson K, Hjälmås K et al (2004) Complications of clean intermittent catheterization in boys and young males with neurogenic bladder dysfunction. J Urol 172:1686–1688
Al-Taheini KM, Pike J, Leonard M (2008) Acute epididymitis in children: the role of radiologic studies. Urology 71:826–829
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Karmazyn, B., Kaefer, M., Kauffman, S. et al. Ultrasonography and clinical findings in children with epididymitis, with and without associated lower urinary tract abnormalities. Pediatr Radiol 39, 1054–1058 (2009). https://doi.org/10.1007/s00247-009-1326-2
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DOI: https://doi.org/10.1007/s00247-009-1326-2