[Epididymitis after prostatic adenomectomy--24-years observations]

Area of Science:

• Urology
• Surgical Outcomes
• Infectious Disease

Context:

• Benign prostatic hyperplasia (BPH) is a common condition requiring surgical intervention.
• Postoperative epididymitis is a potential complication of BPH surgery.
• Evaluating trends and risk factors for postoperative epididymitis is crucial for improving patient care.

Purpose:

• To retrospectively analyze the incidence of postoperative epididymitis in patients undergoing suprapubic and transurethral adenomectomy for BPH.
• To identify factors associated with the development of postoperative epididymitis.
• To assess the historical trend of postoperative epididymitis and the role of prophylactic vasectomy.

Summary:

• A 24-year retrospective review of 6811 BPH patients revealed a low incidence of acute postoperative epididymitis (0.64%).
• Incidence varied by surgical approach: transvesical adenomectomy (1.53%), retropubic surgery (1.09%), and transurethral resection of the prostate (TURP) (0.11%).
• Postoperative epididymitis correlated with urinary tract infections (UTIs), predominantly caused by Gram-negative bacteria. No difference in incidence was observed between patients with and without prophylactic vasectomy.

Impact:

• Significant decrease in postoperative epididymitis incidence over two decades, linked to advancements in surgical techniques and reduced catheterization duration.
• Shorter catheterization periods minimize UTIs, thereby reducing the occurrence of postoperative epididymitis.
• Antibiotic therapy effectively treats most cases (70.45%), and routine prophylactic vasectomy is no longer indicated for BPH surgery.