Epididymitis in Older Boys: Dysfunctional Voiding as an Etiology

Bukowski, Timothy P.; Lewis, Alfor G.; Reeves, Deborah; Wacksman, Jeffrey; Sheldon, Curtis A.

doi:10.1016/s0022-5347(01)67156-8

Cited by 39 publications

(42 citation statements)

References 29 publications

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“…Furthermore, Bukowski et al have reported detrusor sphincter dyssynergia and detrusor instability as possible causes of epididymitis in children. These authors advocate the performance of noninvasive urodynamic studies in older boys with no obvious causes of epididymitis [2].…”

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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“…One etiology behind epididymitis in the infant population can be congenital anatomic malformations such as ureteral ectopia into the vas deferens (1). An alternative, and more common cause, is a non-bacterial inflammation secondary to functional disturbance or voiding dysfunction in older children (2). The pathophysiology of voiding dysfunction can lead to external urethral sphincter dyssynergia during Vol.…”

Section: Introductionmentioning

confidence: 99%

Epididymitis in Patients with Anorectal Malformations: A Cause for Urologic Concern

et al. 2014

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ARTICLE INfO ______________________________________________________________ ______________________Introduction: Epididymitis in patients with anorectal malformation (ARM) represents a unique problem because unlike the general population, an underlying urinary tract problem is frequently identified. We review our experience with epididymitis in ARM population with an emphasis on examining urologic outcomes. Materials and Methods:We performed a retrospective review of male patients with ARM cared for from 1980 to 2010. Clinical and pathologic variables recorded included age at presentation, recurrence, associated urologic anomalies, incidence of ureteral fusion with mesonephric ductal structures, glomerular filtration rate and urodynamic parameters.Results: Twenty-six patients were identified with documented episodes of epididymitis.Renal injury was noted in five patients (19%), all of whom were diagnosed with neurogenic bladder (NGB) several years after anorectoplasty. NGB was found in ten patients (38%) in our series. Ectopic insertion of ureter into a mesonephric ductal structure was discovered in five patients (19%). Twelve patients (46%) had recurrent episodes of epididymitis, with seven of these patients (58%) being diagnosed with NGB. Two patients in the pubertal group presented with a history of epididymitis and complained of ejaculatory pain. Conclusion: Epididymitis in a patient with ARM warrants a comprehensive urologic investigation, particularly in recurrent episodes. Attempts at surgical intervention (e.g. vasectomy) should be avoided until functional assessment of the urinary tract has occurred. Failure to recognize this association may lead to potentially avoidable complications and morbidity. Long term urological follow up of these patients is warranted to identify at risk patients and minimize renal deterioration

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“…In a study by Bukowski et al, 20 voiding dysfunction was detected in 10/36 children with AE using uroflowmetry and postvoid residual ultrasonography. The most common findings were high postvoid residual volumes and meatal stenosis.…”

Section: Aetiologymentioning

confidence: 98%

“…There are several theories including reflux of infected urine into the ejaculatory duct, chemical irritation from sterile urine reflux or from drugs (eg amiodarone), 18 haematogenously spread infection (viraemia or bacteraemia) and direct viral causes. 17,[19][20][21] In recurrent epididymitis, a genitourinary abnormality not previously detected should also be suspected. 22 Bennett et al demonstrated a statistically significant higher occurrence of AE in uncircumcised children.…”

Section: Aetiologymentioning

confidence: 99%

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The aetiology and current management of prepubertal epididymitis

Gkentzis

Lee

2014

annals

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INTRODUCTION The aim of this study was to review the published evidence on the pathogenesis and management of acute epididymitis (AE) in prepubertal boys after the authors encountered an unexpectedly large number of such cases in their institution. METHODS Using MEDLINE ® , a literature search was performed for articles in English with the words "pre-pubertal" OR "boys" OR "p(a)ediatric" OR "children" AND "epididymitis" OR "epididymo-orchitis". RESULTS The literature suggests that it is rare to find a bacterial infection or anatomical anomaly as a cause for AE in this population. A postviral infectious phenomenon is the most likely explanation. The management should be supportive and antibiotics reserved for those with pyuria or positive cultures. Urodynamic studies and renal tract ultrasonography have been advocated for those with recurrent epididymitis. CONCLUSIONS AE in prepubertal boys is more common than believed previously. A careful history for recent viral illnesses should be included. Antibiotics, urinary tract imaging and functional studies should be used in selected cases.

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Epididymitis in Older Boys: Dysfunctional Voiding as an Etiology

Cited by 39 publications

References 29 publications

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

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

Epididymitis in Patients with Anorectal Malformations: A Cause for Urologic Concern

The aetiology and current management of prepubertal epididymitis

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