Rezidü idrar miktarı ve tekrarlayan akut epididimit arasında sebep-sonuç ilişkisi var mı?

Öz

Amaç: Tekrarlayan idrar yolu enfeksiyonunun artmış rezidü idrar ile ilişkili olduğu biliniyor. Yetişkinlerde tekrarlayan akut epididimit için ise böyle bir durum henüz gösterilmemiş. Bildiğimiz kadarıyla bu konuyla ilgili çok fazla çalışma yok ve bu yapılan kısıtlı sayıdaki çalışmaların çoğunda etyolojide ejekülatör kanala retrograd idrar akışı üzerinde durulmuş. Bu çalışmada tekrarlayan akut epididimit ile artmış rezidü idrar (PVR) arasındaki olası nedensel ilişkiyi incelemeyi amaçladık.

Yöntemler: Çalışma retrospektif kohort olarak tasarlandı. 2015-2018 yılları arasında polikliniğimizde epididimit tedavisi gören 388 hastanın verileri retrospektif olarak incelendi. Bu hastaların 72'si aynı zamanda alt üriner sistem semptomları (AÜSS) açısından da incelenmişti. Yaş, PSA düzeyi, Qmax değeri, üroflowmetrik patern, işeme sonrası rezidüel hacim, IPSS Skorları ve prostat hacimleri kaydedildi. Hastalar, dahil edilme kriterlerine göre akut ve tekrarlayan akut epididimiti olanlar olarak iki gruba ayrıldı. Analiz için hastalar akut (n=38, Grup 1) ve rekürren akut (n=34, Grup 2) epididimit olarak iki gruba ayrıldı. Grup 2’deki hastalar epididimit için son altı ayda iki veya son bir yılda üç defa tedavi edildi. Grup 1’deki hastalar yılda sadece 1 kez tedavi edildi. Kategorik değişkenleri karşılaştırmak için ki-kare ( Fisher’s exact test ) ve Student t-testi kullanıldı. P<0,05 değeri istatistiksel anlamlılık eşiği olarak kabul edildi.

Bulgular: Yaş, PSA düzeyi, prostat hacmi, IPSS skoru ve pik akım iki grup arasında anlamlı farklılık göstermedi. Bununla birlikte, işeme sonrası rezidüel idrar hacimleri açısından anlamlı farklılıklar vardı (P=0,029). Akut ve rekürren akut epididimitli hastalarda ortalama işeme sonrası rezidüel hacimler sırasıyla 47,3 (16,2) ml ve 178,2 (23,6) ml idi.

Sonuç: Artan işeme sonrası rezidüel idrar hacmi ile tekrarlayan akut epididimit arasında bir sebep-sonuç ilişkisi vardır. Tekrarlayan akut epididimit ile başvuran hastalar, artmış PVR'ye neden olabilecek ürolojik patolojiler için taranmalıdır.

Anahtar Kelimeler

• Epididimit,Artmış rezidü idrar

Increased post-voiding residue and recurrent acute epididymitis: Are they causally related?

Abstract

Aim: It is known that recurrent urinary tract infection (rUTI) is associated with increased post-voiding residue (PVR), however, the same relationship is yet to be shown in adults for recurrent acute epididymitis. To the best of our knowledge, there are inadequate studies on this subject and they are mainly focused on the retrograde flow of the infected urine into the ejaculatory duct in terms of pathophysiology. In this study, we aimed to evaluate the causal relationship between recurrent acute epididymitis and increased post-voiding residue.

Methods: In this retrospective cohort study, the data of 388 patients who received treatment for epididymitis in our polyclinic between 2015 and 2018 were evaluated to determine that 72 were examined for lower urinary tract symptoms (LUTS). Age, PSA level, Qmax value, uroflowmetric pattern, post-voiding residual volume, International Prostate Symptom Scores (IPSS), and prostate volumes were recorded. Patients were divided into acute (n=38, Group 1) and recurrent acute (n=34, Group 2) epididymitis groups for analysis. The patients in Group 2 were treated for epididymitis at least two times in the last six months or thrice a year. The patients in Group 1 were treated only once in a year. Chi-square (Fisher’s exact test) and Student’s t-test were used to compare categorical variables. A value of P<0.05 was considered the threshold of statistical significance.

Results: Age, PSA level, prostate volume, IPSS score, and peak flow did not significantly differ between the two groups. However, there were significant differences in terms of post-voiding residual urine volumes (P=0.029). The mean post-voiding residual volumes in patients with acute and recurrent acute epididymitis were 47.3 (16.2) ml and 178.2 (23.6) ml, respectively.

Conclusion: There is a relationship between increased post-voiding residual urine volume and recurrent acute epididymitis. Patients who present with recurrent acute epididymitis should be scanned for urological pathologies which may cause increased PVR.

Keywords

• Epididymitis,Post-voiding residue

Kaynakça

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