TY - JOUR
T1 - Is follow-up ultrasound necessary after acute epididymitis?
T2 - A retrospective analysis from a large university hospital
AU - Capet, J
AU - Sønsksen, J
AU - Bisbjerg, R
AU - Fode, M
PY - 2019/1/3
Y1 - 2019/1/3
N2 - OBJECTIVES: To evaluate the role of scrotal ultrasound in the follow-up after epididymitis for underlying serious testicular pathologies, which could be overseen in the acute phase.METHODS: Retrospective chart reviews were performed for patients diagnosed with acute epididymitis at Herlev-Gentofte Hospital between 2006 and 2013. Patients were included if they had received the diagnosis after a clinical evaluation in the emergency department and had subsequently undergone antibiotic treatment and a follow-up scrotal ultrasound at a later date.RESULTS: Overall, 118 patients fulfilled the inclusion criteria. The median age was 45 years (range = 18-80). The follow-up ultrasound scans showed no signs of significant pathology in 92/118. Incidental findings of hydroceles, spermatoceles, and varicoceles were made in eight, five and five of the 118, respectively. One patient had testicular tuberculosis and one had neglected testicular torsion. Six patients were diagnosed with suspicious testicular lesions and underwent surgery. Cancer was confirmed in four men (27, 32, 40, and 45 years old).CONCLUSIONS: Epididymitis can be diagnosed and treated correctly without scrotal ultrasound in the majority of cases. However, the risk of underlying testicular cancer should be kept in mind. Patients below 50 years of age without bacteriuria and patients with persistent symptoms after antibiotic treatment should be referred to an urologist for a re-evaluation or for a follow-up ultrasound.
AB - OBJECTIVES: To evaluate the role of scrotal ultrasound in the follow-up after epididymitis for underlying serious testicular pathologies, which could be overseen in the acute phase.METHODS: Retrospective chart reviews were performed for patients diagnosed with acute epididymitis at Herlev-Gentofte Hospital between 2006 and 2013. Patients were included if they had received the diagnosis after a clinical evaluation in the emergency department and had subsequently undergone antibiotic treatment and a follow-up scrotal ultrasound at a later date.RESULTS: Overall, 118 patients fulfilled the inclusion criteria. The median age was 45 years (range = 18-80). The follow-up ultrasound scans showed no signs of significant pathology in 92/118. Incidental findings of hydroceles, spermatoceles, and varicoceles were made in eight, five and five of the 118, respectively. One patient had testicular tuberculosis and one had neglected testicular torsion. Six patients were diagnosed with suspicious testicular lesions and underwent surgery. Cancer was confirmed in four men (27, 32, 40, and 45 years old).CONCLUSIONS: Epididymitis can be diagnosed and treated correctly without scrotal ultrasound in the majority of cases. However, the risk of underlying testicular cancer should be kept in mind. Patients below 50 years of age without bacteriuria and patients with persistent symptoms after antibiotic treatment should be referred to an urologist for a re-evaluation or for a follow-up ultrasound.
KW - Acute Disease
KW - Adolescent
KW - Adult
KW - Aftercare/methods
KW - Aged
KW - Aged, 80 and over
KW - Anti-Bacterial Agents/therapeutic use
KW - Azithromycin/therapeutic use
KW - Ciprofloxacin/therapeutic use
KW - Epididymitis/diagnostic imaging
KW - Genitalia, Male/diagnostic imaging
KW - Hospitals, University
KW - Humans
KW - Incidental Findings
KW - Male
KW - Middle Aged
KW - Retrospective Studies
KW - Spermatic Cord Torsion/diagnostic imaging
KW - Spermatocele/diagnostic imaging
KW - Testicular Hydrocele/diagnostic imaging
KW - Testicular Neoplasms/diagnostic imaging
KW - Testis/diagnostic imaging
KW - Tuberculosis, Male Genital/diagnostic imaging
KW - Ultrasonography
KW - Varicocele/diagnostic imaging
KW - Young Adult
U2 - 10.1080/21681805.2018.1545797
DO - 10.1080/21681805.2018.1545797
M3 - Journal article
C2 - 30600755
SN - 2168-1805
VL - 52
SP - 445
EP - 447
JO - Scandinavian Journal of Urology
JF - Scandinavian Journal of Urology
IS - 5-6
ER -