Epididymitis Research Articles

139 Viral epididymitis and orchitis – myth or reality?

139 Viral epididymitis and orchitis – myth or reality?

Values of applying color Doppler ultrasound in the diagnosis of testicular torsion and acute epididymo-orchitis

Objective To analyze and compare the values of applying color Doppler ultrasound in the diagnosis of testicular torsio and acute epididymo-orchitis. Methods 90 males in our hospital were selected and divided into the testicular torsion group and acute epididymo-orchitis group,color Doppler ultrasound was applied in the two groups. Results After examination by color Doppler ultrasound,it showed that there were significant differences in blood supply of testicle,epididymis between the two groups,the diagnostic result was accurate with statistical significance(χ2= 11.408,11.944,P< 0.05). Conclusion It can highlight the images and blood supply features of testicular torsion and acute epididymo-orchitis that applying color Doppler ultrasound,and as an economic,practical,accurate and non-invasive examination,it can diagnose testicular torsion and acute epididymo-orchitis accurately,so it's the preference for testicular torsio and acute epididymo-orchitis. Key words: Ultrasound,doppler,color; Testicular diseases

Urogenital tuberculosis – case report

Urogenital tuberculosis is uncommon in developed countries. Numerous and nonspecific urologic complaints are characteristic, e.g. lower urinary tract symptoms, haematuria, renal pain, palpable lesions in testis and epididymis and constitutional symptoms. Microbiological diagnostic tests together with imaging and endoscopy are indicated in urogenital tuberculosis. The role of surgery has changed in the era of modern antimycobacterial agents. Surgery is used in advanced stages and is reconstructive rather than ablative for removal of infected tissue. Article describes procedures for treatment of urinary obstruction, surgical procedures on kidney, ureter, bladder, prostate and urethra and testis with epididymis. Case report presents 69 year old man who presented with left side epididymitis, however after initial diagnostic tests tumour of left testis and epididymis and right kidney with liver metastasis was suspected. Computer tomography of thorax diagnosed miliary tuberculosis. Patient was transferred to pulmonary department, where tuberculosis was confirmed and medical antituberculous therapy was initiated. Adequate treatment response with regression of tuberculous lesions in urogenital tract was observed.

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

Epididymo-orchitis (EO) is infrequently reported in anorectal malformation (ARM) cases. Therefore, it is difficult to assess its risk factors. A total of 110 male patients who were operated on for ARM at the same Institution over a period of 13 years were contacted. Association was assessed between EO and the following: spinal dysraphism (SD), symptomatic VUR (VUR), and bowel management (BM) requiring enemas. The data were analyzed with the Chi-square test. A total of 89 patients were contacted. Ten cases of EO were found, and all occurred in patients with recto-urethral (RU) fistula after reconstruction. The patients' age at first episode ranged between 4 and 11 years. RU fistula patients experiencing EO (Group A, 10 patients) were compared with those without EO (Group B, 33 patients). VUR occurred in 9/10 cases in Group A and in 13/33 cases in group B (Chi-square 7.8658, p = 0.005038). SD was present in 4/10 cases in group A and in 13/33 cases in Group B (Chi-square 0.0434, p = 0.83491). A total of 8/10 cases in Group A and 12/33 cases in Group B were on BM (Chi-square 5.87, p = 0.0015). 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.

First evidence of Brucella ovis infection in rams in the Pirot Municipality, Serbia.

This paper describes a research on Brucella ovis infection in rams in the Pirot Municipality of South Serbia. A positive result with indirect immunoenzyme test (i-ELISA) was confirmed in 67 (29.8%) and suspicious in 31 (13.8%) out of 225 tested rams. Complement fixation test (CFT) was used as a confirmation test on 67 ELISA positive sera and gave positive reaction in 41 (61.2%) ram serum samples. Rams originated from 113 flocks with 4751 sheep, from 28 villages in the Pirot Municipality of southern Serbia. Clinical examination was performed on epididymis and testes of 12 rams from 7 seropositive flocks by inspection and palpation. The examination showed scrotum asymmetry and unilateral increase of the epididymistail in 5 (41.7%) out of 12 seropositive rams. Pathomorphological examination of testes and epididymis confirmed pathological changes in 7 (58.3%) of the 12 examined rams. Onesided epididymitis with pronounced hypertrophy of the epididymitis was also confirmed. Twelve rams were tested for the presence of bacteria, i.e. 21 epididymis, testes and lymph nodes samples. We isolated 20 Brucella strains from 11 (91.7%) of the 12 examined animals. All isolates were identified with bacteriological and molecular techniques as B. ovis. This is the first evidence of ovine epididymitis (B. ovis) in Republic of Serbia.

Animal models for genital tract infection with Ureaplasma urealyticum

Ureaplasma urealyticum (Uu) is a common pathogen of genital tract infection,and can cause pelvic inflammatory diseases,adverse pregnancy outcomes,non-gonococcal urethritis,epididymitis,and so on.Uu is classified into 2 biovars and 14 serotypes,while the difference in pathogenicity among these serotypes remains unanswered.Animal models have been built for intrauterine infection and lower genital tract infection in mice,chimpanzee,goats,etc.It has been found that Uu infection can cause an increase in multiple cytokines such as interleukin (IL)-1 and IL-6,as well as different degrees of inflammatory infiltration and degeneration in endometrium and spermary.The incidence and duration of Uu infection vary with anatomical sites. Key words: Ureaplasma urealyticum; Ureaplasma infections; Models, animal

AB147. Identification of different dendritic cell subpopulations in chronic epididymitis

Chronic inflammatory conditions of the male reproductive tract are thought to be a primary etiological factor in male infertility. The epididymis is considered to be the most common site of intrascrotal inflammation and a significant cause of male fertility disorders rather than the prostate or seminal vesicles. The purpose of the present study was to identify the distribution of DCs of various phenotypes in control and chronically inflamed human epididymis. Immunohistochemistry and immunofluorescence of double staining were performed at control and inflammatory group. The results showed that (I) normal human epididymis contained only immature intraepithelial LCs, interstitial CD11c, and CD209 DCs whereas CD123pDCs and CD83 mature DCs were virtually absent; (II) the number of both CD11cIL-23 mDCs and CD123IFN-αpDCs were significantly elevated in inflamed epididymis; (III) the mDC populations of CD1a, CD209 immature DCs and CD83mature DCs also increased in inflamed group; (IV) Th17 (CD4IL-17) cells were predominantly distributed under chronic inflammation of human epididymis. Our results indicate that, under inflammatory conditions, the modified actions of different DC subpopulation induce autoimmune response and promote Th17 cells polarization.

Epidemiological and clinical study of 172 cases of Brucellosis

Objective To summarize the clinical features of brucellosis and investigate the experience of diagnosis and treatment of the disease .Methods Data from epidemic reports and clinical characteristics from 172 ca-ses of patients with brucellosis were retrospectively analyzed .Results 130 out of 172 cases of were diagnosed as bru-cellosisaise.Of the misdiagnosed 42 cases,13 cases were misdiagnosed as lumbar spine ,10 cases as upper respiratory tract infection 8 cases as pancytopenia,5 cases as orchitis epididymitis,2 cases as hepatitis,1 case as prostatitis, 1 case as cervical disease ,1 case as myocarditis ,1 case as rheumatoid arthritis .And after treatment ,142 cases recov-ered completely,16 cases improved.The total efficiency was 100.0%.2 cases without standard treatment recurred ,an interval of 3 to 15 months.Conclusion So the clinical manifestation of brucellosis is lack of specificity that misdiag-nosis rate is high;The manipulation combined with standard antibiotic therapy may have certain effects on early -stage brucellosis . Key words: Brucellosis; Epidemiology

English

OBJECTIVE: To find out real incidence of TT in pediatric age group as against EO. BACKGROUND: Acute painful scrotum is one of the most challenging urological emergencies. The early and accurate diagnosis of testicular torsion remains a clinical challenge and it accounts for approximately 25% to 35% of patients presenting with acute scrotum1. To date, no single reliable clinical feature or examination can give 100% diagnostic accuracy2. Though these problems are rare in pediatric age group, they pose a serious risk of loss of vital functions of testis. Torsion (TT) is not uncommon - a fact unknown to most pediatricians & general practitioners. Testicular torsion has a lifetime incidence of approximately 1/4000 males younger than 25 years 3 . This disease affects a wide age range, and most commonly occurs between the ages of 12 and 18 years, after which the incidence slowly decreases 4. Early diagnosis leads to preservation & its endocrine function & fertility. Hence as it is very difficult to differentiate TT & Epididymo-orchitis (EO) clinically, all cases should be submitted for surgical exploration at the earliest. METHODS: A Total of 250 patients were observed. All cases in the concerned age group presenting with acute pain, swelling in the scrotum, fever, vomiting were examined. Those having inflammatory signs in scrotum or any other signs suggesting TT or EO were admitted & evaluated. CONCLUSION: As the loss of gonadal function occurs so rapidly in TT, surgical exploration should neither be delayed for sonography nor be denied because of negative imaging in all acute scrotal swelling cases.

Evaluation of acute scrotum in our consecutive operated cases: a one-center study

PurposeThe purpose of the present study was to evaluate the clinical history, demographic data, surgical exploration findings, and final diagnoses in all young males presenting with acute scrotum to our center.Materials and methodsThis was a descriptive–retrospective study in which all consecutive cases of acute scrotum treated in our department from March 2008 to March 2012 were evaluated.ResultsA total of 116 cases were included in the study. Out of these cases, 100 cases underwent surgical exploration, and the remaining 16 cases were managed conservatively. Our eligible cases were divided into three groups: the testicular torsion (TT) group (68%); the torsion of the appendix testis (AT) group (20%); and the epididymo-orchitis (EO) group (9%). Testicular preservation was achieved in 39 cases of the TT group, while due to delayed referral, orchiectomy was performed in 29 cases. Thus, our testicular salvage rate was 57.5% and missed testicular torsion rate was 42.5%.ConclusionIt was observed that our testicular salvage rate was lower than the expected figures published in the literature. This is may be attributed to different causes, including delayed referral or presentation of acute scrotum cases, inadequate knowledge of the general practitioners working in emergency departments, or poor knowledge of parents.

Neurovascular sparing vas clipping: last option for recurrent epididymo-orchitis in urethrovasal reflux due to urethral injury

Acute scrotum is a critical clinical entity in children. This report presents a 12-year-old boy presented with recurrent epididymo-orchitis (EO) with a history of pelvic trauma and urethral disruption 10 years ago. Antegrade and retrograde studies confirmed urethrovasal reflux. The patient did not respond to prophylactic antibiotics, clean intermittent catheterization and endoscopic injection of bulking agent at the junction of the ejaculatory duct and posterior urethra. As the last option, neurovascular sparing vas clipping was performed and the patient made a full recovery. This is the first report of this technique in the treatment for recurrent EO caused by traumatic injury.

Epididymo-orchitis – Are we managing these cases appropriately?

Epididymo-orchitis – Are we managing these cases appropriately?

Flomoxef in neonates and young infants; clinical efficacy, pharmacokinetic evaluation and effect on the intestinal bacterial flora

Forty-three newborn and young infants including 13 low-birth-weight (LBW) infants were treated with flomoxef (FMOX) and the clinical efficacy and side effect were evaluated. The ages of the patients ranged from 0 to 99 days, and their body weights from 797 to 9,000 g. Dose levels were 10.5 to 48.5 mg/kg every 6 to 8 hours for 3 to 12 days. Those patients who responded to the FMOX treatment included 8 infants with sepsis, 14 with suspected sepsis, 6 with intrauterine infection, 2 with meningitis, 7 with pneumonia, 1 with staphylococcal scalded skin syndrome, 1 with epididymitis and 4 with urinary tract infections. The results were excellent in 17 and good in 22 patients. The drug was well tolerated, although diarrhea occurred in 2, slightly elevated serum concentrations of transaminases in 2, and eosinophilia and thrombocytosis in 1 patient each. Pharmacokinetic studies on FMOX with 20 mg/kg dose were done in 19 patients including 8 LBW infants. Serum concentrations at 15 minutes after intravenous bolus injection in five 1- to 6-day-old LBW, five 1- to 6-day-old and four 8- to 19-day-old mature infants were 52.6, 52.7 and 58.0 micrograms/ml, respectively, and those at 4 hours were 22.1, 13.3 and 5.2 micrograms/ml, respectively. Serum half-lives of the drug were 3.93, 2.29 and 1.62 hours, respectively, and excretion rates of this drug into urine in the first 6 hours after administration were 30.4, 45.1 and 58.7%, respectively. Mean serum concentrations just after intravenous 1-hour drip infusion in three 8- to 54-day-old LBW and two 8- and 10-day-old mature infants, were 31.5 and 18.9 micrograms/ml, respectively, and those at 4 hours were 15.3 and 4.3 micrograms/ml, respectively. Serum half-lives of the drug were 2.88 and 1.75 hours, respectively, and excretion rates of the drug into urine in the first 6 hours were 22.6 and 47.5%, respectively. The cerebrospinal fluid level at 3 hours after a dose was 7.09 micrograms/ml on the second day of treatment in a patient with Staphylococcus aureus meningitis receiving 50 mg/kg of the drug every 6 hours per day. Its level at 1 hour after a dose was 3.52 micrograms/ml on the 8th day of treatment in the same patient. The influence of FMOX on the fecal flora was studied in 7 patients. The characteristic pattern observed during the drug administration was the disappearance of Bifidobacterium, the decrease or disappearance of Enterobacteriaceae and the preservation of Streptococcus.(ABSTRACT TRUNCATED AT 250 WORDS)

660 EPIDIDYMOORCHITIS IN PEDIATRIC PATIENTS: ARE ANTIBIOTICS NECESSARY?

You have accessJournal of UrologyPediatrics: Urinary Tract Infection/Vesicoureteral Reflux1 Apr 2013660 EPIDIDYMOORCHITIS IN PEDIATRIC PATIENTS: ARE ANTIBIOTICS NECESSARY? Evalynn Vasquez, Brendan Frainey, Michaella Prasad, Bruce Lindgren, and Earl Cheng Evalynn VasquezEvalynn Vasquez Chicago, IL More articles by this author , Brendan FraineyBrendan Frainey Chicago, IL More articles by this author , Michaella PrasadMichaella Prasad Chicago, IL More articles by this author , Bruce LindgrenBruce Lindgren Chicago, IL More articles by this author , and Earl ChengEarl Cheng Chicago, IL More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.213AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Traditionally, pediatric patients with epididymoorchitis (EO) are treated with antibiotic therapy despite negative results found on urinalysis and urine culture. The purpose of this study is to identify the relationship between urinalysis and urine culture results with treatment of these patients. METHODS A query was performed for males aged 0-12 years who presented to the Emergency Department from 2000-2010 in which an ICD9 code had been entered for EO, scrotal pain, torsion of testis or appendix epididymis/testis, or unspecified disorder of male genitalia in order to capture all patients with a final diagnosis of EO. Patients with hypervascularity of the epididymis/testis demonstrated on a scrotal ultrasound were included. Exclusion criterion was known congenital urologic abnormalities. Through a retrospective chart review, data was collected regarding patient history, physical examination, laboratory and radiology results, treatment, and follow up. Data was analyzed to determine the correlation between presentation, urinalysis/urine culture, and treatment. RESULTS 2412 patients were identified using the described ICD9 code query. 161 patients met inclusion criteria. Median age was 9.1 years (range 0.2-12 years). Urine was collected in 144 patients. 135 (94%) had a negative urinalysis and 9 (6%) had a positive urinalysis. Only 3 patients had both positive urinalysis and urine culture. All 3 patients were 6 months old or less, not circumcised, and had urine specimens obtained by catheterization. The remaining 6 patients with a positive urinalysis had negative urine cultures. A total of 74 (46%) patients were treated with antibiotics. 87 (54%) patients were treated with nonsteroidal anti-inflammatories, acetaminophen, and supportive measures. Urinalysis/culture results did not correlate with antibiotic treatment (p=0.23). Follow up was available on 59 patients. Median follow up was 3 weeks. 39 patients reported resolution of symptoms, 14 reported persistent symptoms, 5 reported worsening symptoms. There was no statistically significant difference between resolution, persistence, or worsening of symptoms and antibiotic treatment (p=0.92). CONCLUSIONS Our study found that sterile urine is exclusively found in boys greater than 1 year of age diagnosed with EO. This suggests, that in this population, EO is noninfectious in nature and implies an inflammatory response from sterile urine (chemical EO) that does not require antibiotic treatment. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e270 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Evalynn Vasquez Chicago, IL More articles by this author Brendan Frainey Chicago, IL More articles by this author Michaella Prasad Chicago, IL More articles by this author Bruce Lindgren Chicago, IL More articles by this author Earl Cheng Chicago, IL More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Epididymo-Orchitis in Pre-Pubertal Children. Epidemiology, Etiology, Management and Follow-Up Recommendations

Epididymo-Orchitis (EO) is a disease that may affect males in all ages. Neonates and elderly patients may suffer from bacterial infection due to congenital or aging processes affecting the urinary tract. In sexually active post pubertal and young males sexually transmitted organisms may cause EO. EO is also prevalent in pre pubertal healthy boys; however in this group the etiology, the needed imaging modalities and proper management are not clearly defined yet. This manuscript will systematically review the various etiologies causing EO in pre-pubertal boys, discus about the needed proper imaging, and image interpretation, will give treatment and follow-up recommendations.

Clinical value of scrotal ultrasonography for patients with azoospermia

Objective To investigate the clinical value of scrotal ultrasonography for patients with azoospermia.Methods Between January 2009 and march 2012,clinical data of 400 patients with azoospermia were analyzed retrospectively,to study the constinent ratio of the etiopathogenicis of azoospermia and the value of scrotal ultrasonography.Results In 400 cases with azoospermia,the diseases of the testis were found in 164 cases (41.0％),including 114(28.5％) hypogenesis of testicle,24 (6.0％) cryptorchidism,14(3.5％) testicular microlithiasis and 12 (3.0％) testitis; the obstruction of deferent duct in 204 cases(51.0％),including 80(20.0％) epididymitis,60(15.0％) vas deferens obstructions,44(11.0％) bilateral absence of vas deferens,and 20(5.0％) absence of epididymal body and tail; and the other etiopathogenicis in 32 cases(8.0％).Conclusion There are many etiopathogenicis for patients with azoospermia,the main etiopathogenicis are hypogenesis of testicle,epididymitis,bilateral absence of vas deferens and the obstruction of deferent duct.Scrotal ultrasonogaphy is an easy,repeatable,noninvasive method for the patients with azoospermia.It can provide credible ultrasonogaphy evidence for the treatment. Key words: Scrotal ultrasonography; Male infertility; Azoospermia

Autoimmune epididymoorchitis is essential to the pathogenesis of male‐specific spondylarthritis in HLA–B27–transgenic rats

Male rats transgenic for HLA-B27 and human β(2) -microglobulin (hβ(2) m) spontaneously develop epididymoorchitis (EO) preceding the development of spondylarthritis (SpA). In the specific B27/hβ(2) m-transgenic rat cross-strain (21-3 × 382-2)F(1) , only the males develop SpA, and neither sex develops gut inflammation. This study was undertaken to determine whether EO and SpA in male (21-3 × 382-2)F(1) rats are causally related. In addition, the primary characteristics of EO in this rat arthritis model were assessed. Male B27/hβ(2) m-transgenic (21-3 × 382-2)F(1) rats underwent bilateral, unilateral, or sham epididymoorchiectomy between ages 36 and 125 days. The castrated rats were given testosterone replacement. Alternatively, the 21-3 and 283-2 transgene loci were crossed with a transgene inducing aspermatogenesis. Rats were observed for the development of EO, arthritis, and spondylitis. In unmanipulated transgenic rats, inflammation was first evident in the ductuli efferentes (DE; ducts linking the rete testis to epididymis) as early as age 30 days. The inflammation was initially neutrophilic, and later became granulomatous. Antisperm and anti-testis cell antibodies appeared in the rat serum after age 70 days. Cells infiltrating the testes were predominantly CD4+ T cells and CD68+ or CD163+ macrophages. Quantitative polymerase chain reaction of the DE, epididymis, and testis showed elevations in the levels of interferon-γ, interleukin-10 (IL-10), and IL-17A. In addition, levels of IL-12A, IL-22, IL-23A, and IL-23 receptor were found to be elevated in the DE. Remarkably, castration of the rats before age 91 days completely prevented the subsequent onset of arthritis and spondylitis, as did transgene-induced azospermia. Autoimmune EO develops spontaneously in HLA-B27/hβ(2) m-transgenic (21-3 × 283-2)F(1) rats at age 30 days, the age when antigen-positive meiotic germ cells first exit the testis. Persistent testicular inflammation and/or antigenic stimulation are essential prerequisites for the subsequent development of SpA. Thus, dysregulated innate immunity at immune-privileged sites may be an essential mechanism triggering the onset of SpA.

Escherichia coliBacteremia, Epididymo-Orchitis, and Scrotal Abscess in a Neonate

Epididymo-orchitis (EO) is a rare but important cause of scrotal swelling in pediatric patients. EO is caused by bacteremia leading to hematogenous seeding or ascending infection of the urinary tract. EO can be associated with abscess, bacteremia, and other serious infections, and must be distinguished from other causes of scrotal swelling such as testicular torsion. We present a case of a 16-day-old male with EO, scrotal abscess, and bacteremia from Escherichia coli.

Comparison of Brucella and Non-specific epididymo–orchitis

Comparison of Brucella and Non-specific epididymo–orchitis

A five year review of epididymo-orchitis in Exeter: Category: Scientific free paper

A five year review of epididymo-orchitis in Exeter: Category: Scientific free paper