Pediatric epididymitis: A 20-year single-center experience of 61 cases.

Background: The etiology of acute epididymitis (AE) in children remains poorly understood. This study was performed to analyze the clinical and imaging findings in children with AE.

Methods: We retrospectively reviewed children with AE treated at our institute from 2003 to 2023. The patients' medical charts were reviewed to record their clinical features and radiological and laboratory data. Multiple acute episodes occurring in individual patients were also recorded.

Results: In total, 61 patients with AE were identified. Their median age at first presentation was 8 years (range, 0-22 years). The duration of pain ranged from 0 to 10 days. Accompanying genitourinary anomalies (GUA) were observed in 11 (18%) patients: hypospadias in 2, anorectal malformation in 9, neurogenic bladder in 3, undescended testis in 1, and surgery for contralateral testicular torsion in 1. One patient was diagnosed with Henoch-Schönlein purpura. Urine culture results were available in 41 patients and positive in 5 (11%). Eight patients had pre-existing infection (upper respiratory infection in four, enteritis in three, and posthitis in one). Eight (13%) patients experienced more than a second episode of epididymitis, and five (62%) of these eight patients had GUA. Testicular atrophy was present in five patients, detected 2-6 months after epididymitis.

Conclusion: Most cases of AE occurred in the prepubertal period, and most urine tests were negative. Recurrent epididymitis was associated with GUA. Because some patients showed signs of testicular atrophy, careful follow-up is necessary.