Epidydimo-orchitis and anorectal malformations: when and in whom?

Zaccara, Antonio; Ragozzino, S.; Iacobelli, Barbara Daniela; Rivosecchi, Flaminia; Capitanucci, Maria Luisa; Mosiello, Giovanni; Silveri, Massimiliano; Gennaro, M. De; Bagolan, Pietro

doi:10.1007/s00383-015-3671-6

Cited by 7 publications

(9 citation statements)

References 18 publications

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“…In the patients with ARM, literature indicates that EO more frequently affects patients with a rectourinary fistula 1 2 7 8 and this was confirmed by our series. More specifically, patients with a prostatic fistula were affected most, representing almost half of the cases in our series.…”

Section: Discussionsupporting

confidence: 89%

“…In addition, VUR was reported in almost half of our population, and this was similar to the series reported by VanderBrink et al 8 VUR might be the indirect expression of voiding dysfunctions. Accordingly, Zaccara et al 7 compared ARM patients with rectourinary fistula experiencing EO to those without EO, and they found a significantly higher occurrence of VUR in the first group. Moreover, the majority of patients in our series had treatment for constipation.…”

Section: Discussionmentioning

confidence: 99%

“…5,6 Despite the risk of subfertility or infertility, etiology and management of EO in ARM patients are still undefined, and only few case series and collective reviews have been reported in the literature. [1][2][3][4]7,8 This is likely the result of the rarity of patients with ARM, making the incidence of EO even rarer. The ARM-Net Consortium was founded in 2010 for the knowledge limitations in the care of ARM patients, joining clinical data of several expert centers involved in the treatment of patients with ARM.…”

Section: Introductionmentioning

confidence: 99%

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Urological Impact of Epididymo-orchitis in Patients with Anorectal Malformation: An ARM-Net Consortium Study

et al. 2022

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Introduction To investigate the current experience of the ARM-Net Consortium in the management of epididymo-orchitis (EO) in patients with anorectal malformations (ARMs), and to identify specific risk factors and the need for urological care involvement. Materials and Methods We retrospectively collected data of EO in patients with ARM between 2015 and 2019. Data on urological aspects, ARM type, surgical approach, associated anomalies, diagnosis, and treatment of EO were collected and analyzed. Results Twenty-nine patients were reported by 12 centers. Twenty-six patients with EO (90%) had ARM with a rectourinary fistula. Median age at first EO was 2 years (range: 15 days–27 years). Twenty patients (69%) experienced multiple EO, and 60% of recurrences were ipsilateral. Associated urological anomalies included vesicoureteral reflux (48%), urethral anomalies (41%), neurogenic bladder (41%), and ectopic vas (10%). A positive urine culture during EO was present in 69%. EO was treated with antibiotics (90%), limiting surgical exploration to 14%. Prevention of recurrences included surgery (bulking agents 15%, vasectomy 15%, and orchiectomy 5%) and antibiotic prophylaxis (20%). Conclusion Urologists may encounter patients with EO in ARM patients, frequently with positive urine culture. An appropriate urologic work-up for most ARM patients is necessary to identify and treat underlying risk factors. A practical scheme for the work-up is suggested for a close collaboration between pediatric surgeons and urologists.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Urological Impact of Epididymo-orchitis in Patients with Anorectal Malformation: An ARM-Net Consortium Study

et al. 2022

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“…Analatresie mit rekto-urethraler Fistel [27][28] Anorektale Malformationen [29][30] Neurogene Blasenfunktionsstörung mit Detrusor-Sphinkter-Dyssynergie [20] Utriculus-prostaticus-Zyste Infravesikale Obstruktion (Meatusstenose, Urethrastriktur)…”

Section: Disposition Literaturhinweiseunclassified

Epididymitis bei Kindern: fact or fiction

Beetz¹,

Stehr

2017

Aktuel Urol

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Epididymitis is one of the most frequent causes of acute scrotum during childhood. Unlike in adults, ascending bacterial infections are rarely the underlying cause of the condition in children. Antibacterial treatment in accordance with a prior antibiogram is possible in the presence of leukocyturia and significant bacteriuria. For the remaining cases, there are no definite criteria allowing for a decision on acute antibacterial treatment. The fact that antibacterial treatment is still initiated in cases of epididymitis in the clinical routine setting is based on the assumption of a possible infection rather than being based on facts. This dilemma will probably not be entirely resolved until adequate diagnostic markers for the different trigger mechanisms of epididymitis have been found.

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“…Paediatric surgeons commonly face this problem in clinical practice whenever there is a voiding disturbance along with UTI. This is commonly encountered in patients with Anorectal malformation [1,2] or patients after hypospadias repair [2,3] both of whom can present with urethral stricture. EO after hypospadias repair has to be looked into seriously, since this may be a subtle sign of urinary outflow obstruction and therefore point to an underlying urethral stricture.…”

Section: Introductionmentioning

confidence: 99%

Long term follow up of proximal hypospadias repair-urethral stricture should be excluded in adults who present with epididymo-orchitis

Bhandarkar

Kittur

Patil

et al. 2018

Turkish Journal of Urology

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Objective: Epididymo-orchitis (EO) is a well-known complication of urinary tract infections (UTI) in children. This is commonly seen in children who had hypospadias repair or in those who had surgery for anorectal malformation especially when it results in urethral stricture. However EO occurring as a complication of urethral stricture in adults operated for hypospadias in childhood is not well documented in the literature. Material and methods:This is a retrospective review of four adults who had proximal hypospadias repair in childhood. All four men presented to us with EO. They were thoroughly investigated to rule out presence of urethral stricture. Results:Three patients had urethral stricture of which two responded well to dilatation and one required cystoscopy and visual internal urethrotomy. The fourth patient did not have urethral stricture. EO in this patient is thought to be due to excessive straining during micturition causing reflux into seminal vesicles. Conclusion:Urethral stricture should be excluded in any adult who had a hypospadias repair and presents with EO. Urethral strictures after hypospadias surgery respond well to dilatation and to endoscopic urethrotomy.

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Epidydimo-orchitis and anorectal malformations: when and in whom?

Abstract: EO occurs in approximately in 20 % of male cases with ARM, and recto-urinary communication and should be considered the primary diagnosis in the presence of testicular pain. This could avoid unnecessary surgical exploration, and the family should be counseled about this subject.

Cited by 7 publications

References 18 publications

Urological Impact of Epididymo-orchitis in Patients with Anorectal Malformation: An ARM-Net Consortium Study

Urological Impact of Epididymo-orchitis in Patients with Anorectal Malformation: An ARM-Net Consortium Study

Epididymitis bei Kindern: fact or fiction

Long term follow up of proximal hypospadias repair-urethral stricture should be excluded in adults who present with epididymo-orchitis

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