Epididymo-Orchitis in Children: A Review of 35 Cases

Year 2018, Volume: 20 Issue: 1, 62 - 67, 30.04.2018

Hasan Rıza Aydın , Azam Demirel

https://doi.org/10.24938/kutfd.349886

Abstract

Objective: Epididymo-orchitis
is extremely rare in infants and children. The pathophysiologic mechanisms for
the development of Epididymo-orchitis are not well known in most of cases. This
retrospective review was undertaken to determine causes, management and long
term follow-up of this pathology.

Material and Methods: During a 13 years period (between January 1993 and December
2006), a total 35 children with Epididymo-orchitis were enrolled in this study.
Mean age of patients was 10.5 ± 3.7 (range: 1-14 years). Diagnosis of
epididymo-orchitis was made by patients’ history, physical examination and
scrotal Doppler ultrasonographic examination of testes. Urinary system
sonography, urinalysis, urine culture and in cases of doubt intravenous
urography were performed to detect the underlying abnormalities.

Results: The causes for Epididymo-orchitis were as follows: idiopathic
Epididymo-orchitis (n=22), mumps epididymo-orchitis (n=9), bacterial
epididymo-orchitis (n=1), tuberculous epididymo-orchitis (n=1) and
epididymo-orchitis resulting from Henoch-Schönlein purpura (n=2). In patient
with tuberculosis Epididymo-orchitis, no evidence of tuberculosis infection in
his urine. This case received aproppriate combination chemotherapy and
underwent orchiectomy. Of 35 cases 15 were followed up for long term periods.
Mean follow-up time was 49.0 ± 35.8 months (range: 13 months-13 years). Mean
volume of testis was significantly lower in testes with Epididymo-orchitis
compared to those of contralateral ones (p <0.01).

Conclusion: Differentiating
the causes of acute scrotum can sometimes be difficult if only the clinical
features or laboratory data are employed. Doppler ultrasound examination is the
most useful method in differential diagnosis especially for torsion of the
spermatic cord. 

Keywords

Epididymo-orchitis, testicular torsion, child

ÇOCUKLARDA EPİDİDİMO-ORŞİTLER: 35 OLGUNUN GÖZDEN GEÇİRİLMESİ

Abstract

Amaç: Epididimo-orşit infant ve
çocuklarda son derece nadir görülen bir patolojidir. Çoğu olguda epididimo-orşit gelişimindeki patofizyolojik mekanizma
anlaşılamamıştır. Bu retrospektif çalışmada bu patolojinin olası nedenleri,
tanı ve tedavisiyle uzun dönem takip sonuçlarını irdelemeyi amaçladık.

Gereç ve Yöntem: Ocak 1993 ile Aralık 2006 tarihleri
arasındaki 13 yıllık periyotat epididimo-orşit tanısı almış 35 olgu bu
çalışmaya kapsamına alındı. Hastaların yaş ortalaması 10.5 ± 3.7 yıl (1-14 yıl)
idi. Epididimo-orşit tanısı, öykü, fizik muayene ve skrotal doppler
ultrasonografi ile konuldu. Altta yatan patolojiyi ortaya koyabilmek için
üriner sistem ultrasonografisi, idrar tetkiki, idrar kültürü ve şüpheli
olgularda intravenöz ürografi yaptırıldı.

Bulgular: Epididimo-orşit’in nedenleri şu şekilde idi: idiopatik
Epididimo-orşit (n = 22), kabakulak Epididimo-orşit (n=9), bakteriyel
epididimo-orşit (n=1), tüberküloz epididimo-orşit (n=1) ve Henoch-Schönlein
purpurasına bağlı oluşmuş epididimo-orşit (n=2). Tüberküloz epididimo-orşit’i
olan hastanın idrarında tüberküloz enfeksiyonunu gösteren bir bulgu yoktu. Bu
olgu, uygun antitüberküloz ilaç tedavisi ve
orşiektomi ile tedavi edildi. Otuz beş olgunun 15’inde uzun dönem takip
yapılabildi. Ortalama takip süresi 49.0 ± 35.8 ay (13 ay-13 yıl) idi. Ortalama
testis volümleri karşı sağlam testisle karşılaştırıldığında epididimo-orşit
tarafında anlamlı derecede düşük bulundu (p <0.01).

Sonuç: Akut
skrotumun nedenlerinin ayırıcı tanısında sadece klinik özellikler ve
laboratuvar verileri kullanıldığında zorlanılmaktadır. Doppler ultrasonografi
ayırıcı tanıda, özellikle de spermatik kord torsiyonunun ayırımında en
kullanışlı metottur.

Keywords

Epididimo-orşit, testis torsiyonu, çocuk

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