You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Prostate & Genitalia1 Apr 20131166 OUTCOMES OF INPATIENT TESTICULAR ABSCESSES COMPLICATING EPIDIDYMITIS AND ORCHITIS AMONG HOSPITALIZED PATIENTS Vidit Sharma, Puneet Masson, Jeremy T. Choy, Brian V. Le, James M. Dupree, and Robert E. Brannigan Vidit SharmaVidit Sharma Chicago, IL More articles by this author , Puneet MassonPuneet Masson Chicago, IL More articles by this author , Jeremy T. ChoyJeremy T. Choy Chicago, IL More articles by this author , Brian V. LeBrian V. Le Chicago, IL More articles by this author , James M. DupreeJames M. Dupree Chicago, IL More articles by this author , and Robert E. BranniganRobert E. Brannigan Chicago, IL More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.803AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Testicular abscess is an uncommon complication of epididymitis or orchitis, and there is considerable variability regarding its incidence and implications in a hospital setting. We used a large, national inpatient sample to characterize outcomes of testicular abscesses. METHODS Years 2004-2010 of the Nationwide Inpatient Sample were queried for the ICD-9-CM diagnosis code 604.0, “Orchitis, epididymitis, and epididymo-orchitis, with abscess”. We reviewed patient demographics and course of hospitalization, and then constructed a regression model to identify predictors of progression to orchiectomy. RESULTS From 2004-2010, 3365 inpatients with testicular abscesses were identified. 188 (5.6%) became septic, 78 (2.3%) developed severe sepsis, and 32 (1.0%) died during hospitalization. An organism was reported in only 27.4% of all cases, with the most common organisms being S. aureus (13.5%) and E. coli (8.2%). Among 1058 (31.4%) patients who underwent incision and drainage (I&D) of the abscess, 35.5% had an organism reported vs 23.7% when I&D was not performed (P < 0.001). 862 (25.6%) patients had a unilateral orchiectomy and were significantly older than those who did not (59.0 vs 51.6 years, P < 0.001). Upon regression analysis, risk factors for having an orchiectomy included older age (OR 1.022, 95% CI: 1.017 - 1.027, P < 0.001), testicular abscess as the primary admission diagnosis (OR 1.752, 95% CI: 1.390 - 2.209, P < 0.001), and a medium (OR 1.359, 95% CI: 1.009 - 1.831, P = 0.044) or large (OR 1.378, 95% CI: 1.053 - 1.804, P = 0.020) hospital by bed count. Black race significantly decreased the odds of having an orchiectomy (OR 0.622, 95% CI: 0.470 - 0.822, P = 0.001). Severity of illness, development of sepsis, I&D, identification of an organism, hospital teaching status, hospital region, and urban location were not associated with having an orchiectomy. Overall, patients with a testicular abscess had an average length of stay of 6.93 days and average hospital charges of $33,719. CONCLUSIONS Testicular abscess is a serious and expensive complication of urogenital infections that can lead to sepsis and even death. In this national cohort, an organism was not reported in the majority of cases. Orchiectomy was necessary in approximately one-fourth of inpatients, with older age and larger hospital size being associated with this outcome. Further studies must be performed to better characterize the subgroup progressing to orchiectomy. These patients may benefit from a more aggressive early management strategy to avoid this devastating morbidity. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e476 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Vidit Sharma Chicago, IL More articles by this author Puneet Masson Chicago, IL More articles by this author Jeremy T. Choy Chicago, IL More articles by this author Brian V. Le Chicago, IL More articles by this author James M. Dupree Chicago, IL More articles by this author Robert E. Brannigan Chicago, IL More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...