The Relationship between Clinical Symptoms and Urine Culture in Adult Patients with Acute Epididymitis

다국어 초록 (Multilingual Abstract)

Purpose: We evaluated adult patients with acute epididymitis to identify the frequency of actual sexual contacts and the causative organism, and compared clinical examinations, degrees of manifested symptoms, and radiological test results.

Materials and Methods: We reviewed the medical records of 65 patients older than 18 years presenting with acute epididymitis who had been treated between 2002 and 2011. Scrotal ultrasonography, urinalysis, and urine culture were performed to diagnose the acute epididymitis. Patients were divided into negative (n=45) and positive (n=20) urine culture groups. Then the latter groups were subdivided into a sexually transmitted organism (STO) culture group (n=13) and a non-STO (n=7) culture group. Data on any history of sexual contact, scrotal pain and tenderness, symptoms of urethritis (discharge, dysuria, urethral burning, or irritation), and lower urinary tract symptoms (dysuria, frequency, and urgency of urination) were obtained from all of the subjects.

Results: Patients in the positive urine culture group were significantly younger than those in the other group (p=0.224) and were more likely to have a history of sexual contact at least two weeks prior to onset of epididymitis (p=0.012). They had also a significantly enlarged epididymal head and significantly more severe complaints of pain or tenderness than those of latter group (p=0.348, p=0.288). However, the difference in these measures between the STO and non-STO group was not significant, except in the case of age (p=0.044).

Conclusions: Patients of the positive urine culture group with acute epididymitis were significantly younger and more sexually active than the others. They also had severe pain or tenderness and an enlarged epididymal head. There was a close association between clinical symptoms, a positive urine culture, and ultrasonographic findings.

참고문헌 (Reference)

1 이상욱, "부고환의 투명 세포 유두상 낭선종 1례" 대한남성과학회 25 (25): 9-9, 2007

2 오동근, "급성음낭증 313례의 치험: 급성부고환염의 특징과 고환염전의 감별진단" 대한비뇨기과학회 43 (43): 624-630, 2002

3 지영환, "고환과 부고환 사이에 발생한 유선종" 대한남성과학회 26 (26): 240-243, 2008

4 De Jong Z, "The frequency of Chlamydia trachomatis in acute epididymitis" 62 : 76-78, 1988

5 Höppner W, "Surgical treatment of acute epididymitis and its underlying diseases" 22 : 218-221, 1992

6 Hoosen AA, "Microbiology of acute epididymitis in a developing community" 69 : 361-363, 1993

7 Hawkins DA, "Microbiological survey of acute epididymitis" 62 : 342-344, 1986

8 Lewis AG, "Evaluation of acute scrotum in the emergency department" 30 : 277-281, 1995

9 Melekos MD, "Epididymitis: aspects concerning etiology and treatment" 138 : 83-86, 1987

10 Geisler WM, "Epididymitis. Sexually transmitted diseases" McGraw-Hill Medical 1127-1145, 2008

11 Siegel A, "Epididymitis in infants and boys: underlying urogenital anomalies and efficacy of imaging modalities" 138 : 1100-1103, 1987

12 Park CH, "Clinical characteristics of acute epididymitis in children and adults" 40 : 674-676, 1999

13 "Clinical Effectiveness Group (Association of Genitourinary Medicine and the Medical Society for the Study of Venereal Diseases)" 75 (75): S51-S53, 1999

14 Berger RE, "Chlamydia trachomatis as a cause of acute "idiopathic" epididymitis" 298 : 301-304, 1978

15 Anthonisz M, "Assessing the impact: the National Chlamydia Screening Programme" 18 : 246-251, 2009

16 Park HC, "Adenomatoid tumor of the epididymis" 21 : 111-113, 2003

17 Hutson JM, "Acute epididymitis in boys: are antibiotics indicated?" 80 : 970-971, 1997