Epididymitis in Infants and Boys: Underlying Urogenital Anomalies and Efficacy of Imaging Modalities

Siegel, Andrew L.; Snyder, Howard M.; Duckett, John W.

doi:10.1016/s0022-5347(17)43514-2

Cited by 96 publications

(55 citation statements)

References 13 publications

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“…Children with a risk for recurrent infections should be evaluated additionally with renal US, VCUG, and in the case of negative results with video-urodynamic studies to rule out anatomical abnormalities such as ectopic ureter (to the vas, ejaculatory duct, or seminal vesicle), ejaculatory duct obstruction, urethral valves, a duplicated urethra, bulbous urethral stricture, prostatic utricle, rectourethral fistula, and urethral ejaculatory duct reflux. In one study [21] including 48 children with epididymitis, 47% had an underlying urogenital anomaly. None of the postpubertal patients had such an anomaly.…”

Section: Discussionmentioning

confidence: 99%

Acute epididymitis in Greek children: a 3-year retrospective study

Sakellaris

Charissis

2007

Eur J Pediatr

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The aim of the study was to compare historical features, physical examination findings, and testicular color Doppler ultrasound in pediatric patients with epididymitis compared to testicular torsion and torsion of the appendix testes. A retrospective review of the medical records of 66 boys presenting with clinical aspects of acute scrotum over a 3-year period was performed. Sixty-six patients were included in the study (29 with epididymitis, 8 with testicular torsion and 12 with torsion of the appendix testis, 4 with scrotal abscesses, 5 with scrotal swelling, and 1 with inflamed epididymal cyst). The duration of symptoms ranged from 6 h to 4 days with a peak on the second day. Urine cultures and viral testes were negative in all patients. Color Doppler ultrasound was diagnostic for epididymitis in 28 patients (96.6%). Systemic intravenous antibiotics were given in all 29 patients with epididymitis. No patient showed signs of testicular atrophy in the follow-up. The increasing incidence of epididymitis should question the policy of routine exploration of the acute scrotum in children. The history and physical examination cannot reliably identify those boys who can be managed conservatively. Color Doppler ultrasound is a useful adjunct in the evaluation of the acute scrotum when physical findings are equivocal but it can also be misleading.

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Section: Discussionmentioning

confidence: 99%

Acute epididymitis in Greek children: a 3-year retrospective study

Sakellaris

Charissis

2007

Eur J Pediatr

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“…Cappele et al [15] and Mushtaq et al [16] reported that VCUG survey is unnecessary for infants with first episode of epididymitis or EO, and further radiologic investigation is best reserved for those with repeated episodes. However, Siegel et al [17] have illustrated the correlation between epididymitis and underlying urogenital anomalies in infants. Ultrasound study of the kidney and bladder, followed by VCUG survey, was recommended in infants with UTI [18].…”

Section: Discussionmentioning

confidence: 99%

Clinical features of testicular torsion and epididymo-orchitis in infants younger than 3 months

Chiang

Chen

et al. 2007

Journal of Pediatric Surgery

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“…Somekh et al [1], in a 1-year prospective study of 44 boys with acute epididymitis, reported that there were only nine (20%) positive findings for bacterial or viral growth from microbiological studies of several sites, and that the treatment policy was basically to use analgesics with little role for antibiotics. Siegel et al, in a review of 47 patients with epididymitis who were younger than 18 years, reported that a positive urine culture suggested an underlying anomaly, and a negative culture virtually ruled out an anomaly [4]. Likitnukul et al [5], in a 20-year retrospective study, suggested that children younger than 2 years and older patients with recurrent episodes were at a high risk of urine reflux or an association with genitourinary abnormality.…”

Section: Discussionmentioning

confidence: 99%