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Urinalysis in children with epididymitis
L A Graumann1, H-G Dietz, M Stehr
1Department of Pediatric Surgery, University Hospital, Philipps University Marburg, Germany. graumann@med.uni-marburg.de
Summary
Urine tests show little value in diagnosing epididymitis in children. Most cases in prepubertal boys are idiopathic, with rare positive microbiological findings, suggesting antibiotics are often unnecessary.
Area of Science:
- Pediatric Urology
- Infectious Diseases
Background:
- Epididymitis in children, particularly prepubertal boys, is often treated empirically with antibiotics.
- Recent literature suggests limited diagnostic value of urine examinations for prepubertal epididymitis.
- The study addresses the discrepancy between clinical practice and evidence regarding urine testing in pediatric epididymitis.
Purpose of the Study:
- To evaluate the diagnostic and therapeutic utility of urine tests in pediatric epididymitis.
- To determine the frequency of positive microbiological findings in children with epididymitis.
- To inform antibiotic treatment guidelines for epididymitis in the pediatric population.
Main Methods:
- Retrospective analysis of 151 boys with a single episode of epididymitis over a 5-year period.
- Collection and review of laboratory test results, including urinalysis and urine cultures.
- Analysis of intraoperative cultures from surgical explorations when performed.
Main Results:
- Urine examination results were available for 62% of patients (93/151).
- Only one patient (1%) showed bacteriuria on urinalysis, with a sterile urine culture.
- All urine cultures (6/97) and intraoperative epididymal cultures (6/7) were sterile, indicating rare positive microbiological findings.
Conclusions:
- Urine tests (urinalysis and culture) are largely unrevealing in pediatric epididymitis.
- Epididymitis in prepubertal boys is predominantly idiopathic, with infrequent positive microbial identification.
- Antibiotic therapy for pediatric epididymitis should be reserved for cases with confirmed positive urine tests.
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