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Acute epididymitis and urinary tract anomalies in children
E Merlini1, F Rotundi, P L Seymandi
1Department of Pediatric Surgery, C Arrigo Children's Hospital, Alessandria, Italy.
Insights
Infants with acute epididymitis have a higher incidence of urinary tract infections (UTIs) and genitourinary malformations. Complete evaluation is recommended for infants, while older children require imaging based on clinical findings.
Area of Science:
- Pediatric Urology
- Pediatric Infectious Diseases
Background:
- Acute epididymitis in children can be associated with underlying urinary tract infections (UTIs) and genitourinary malformations.
- The incidence and relationship of these conditions vary by age group.
Purpose of the Study:
- To determine the incidence of UTIs and genitourinary malformations in children with acute epididymitis.
- To compare these incidences between infants and older children.
Main Methods:
- A cohort of 25 children (2 months–14 years) with acute epididymitis underwent urine culture, abdominal ultrasound, and voiding cystourethrography.
- Intravenous pyelography was performed in select cases.
- Fisher's exact test was used for age group comparisons.
Main Results:
- Infants (n=11) showed a higher rate of associated UTIs (p=0.049) and genitourinary malformations (p=0.017) compared to older children (n=14).
- Seven UTIs and eight malformations were found in infants; three UTIs and three malformations in older children.
Conclusions:
- Acute epididymitis in infants is closely linked to UTIs and genitourinary malformations.
- Complete evaluation including imaging is crucial for infants with epididymitis.
- Imaging in older children should be guided by clinical presentation.
Objectives:
To evaluate the incidence of urinary tract infection (UTI) and genitourinary malformations in children presenting with acute epididymitis.
Patients And Methods:
Twenty-five children between 2 months and 14 years of age presenting with acute epididymitis underwent urine culture, abdominal ultrasound, voiding cystourethrography and, in selected cases, intravenous pyelography. Eleven patients were infants and 14 were older than 1 year. UTIs and genitourinary malformations were recorded. Fisher's exact test was used to compare the incidence in two age groups. A p value of less than 0.05 was considered significant.
Results:
Seven UTIs and eight genitourinary malformations were diagnosed in infants, while in older children three UTIs and three malformations were discovered. Infants had a higher rate of associated UTI (p 0.049) and genitourinary malformations (p 0.017) than did older children.
Conclusions:
Our data show a close relationship between acute epididymitis in infants for both UTIs and genitourinary malformations. Every infant presenting with epididymitis would undergo a complete evaluation including abdominal ultrasound and voiding cystourethrography. In older children the need for imaging should be dictated by clinical history and physical findings.