Ultrasonography and clinical findings in children with epididymitis, with and without associated lower urinary tract abnormalities.

Background: Epididymitis is most commonly idiopathic but can also be associated with urinary tract abnormalities (UTAs). The distinctive clinical and imaging findings of children with epididymitis and underlying UTAs are not known.

Objective: To describe clinical and imaging findings in children with epididymitis and the association with UTAs.

Material And Methods: The study group included all children evaluated for epididymitis confirmed by scrotal US in a 6-year period. The clinical and imaging findings and disease recurrence were compared between children with and without UTAs.

Results: A total of 47 boys (mean/SD 9.61/4.40 years, range 0.1 to 17.1 years) met the entry criteria, of whom 17 had UTAs. The most common UTAs were hypospadias, neurogenic bladder, and functional bladder abnormality (six each). Age at presentation and likelihood of testicular swelling or hydrocele was not different between children with and without UTAs. Marked epididymal swelling was more common in children with UTAs (9/17, 53%) than in those without UTAs (5/30, 17%; P=0.02), as was recurrent epididymitis (with UTAs, 9/17, 53%; without UTAs, 5/30, 17%; P=0.02). Chronic epididymitis (five children), presentation with scrotal mass (four), and epididymal abscess (two) occurred only in children with UTAs.

Conclusion: Children with epididymitis who have UTAs are more likely to present with marked epididymal swelling, develop recurrent disease, and have a more protracted course.