title: Isolated tuberculous epididymitis: a review of forty cases.
abstract: BACKGROUND
  Tuberculous epididymitis is one of the causes of chronic epididymal lesions. It is difficult to diagnose in the absence of renal involvement.
  
  
  OBJECTIVE
  To profile isolated tuberculous epididymitis and to assess our approach in the evaluation of this group of patients.
  
  
  METHODS
  Retrospective study done at Christian Medical College, Vellore, South India.
  
  
  METHODS
  Between 1992 and 2002, 156 fine needle aspiration cytology specimens and 108 epididymal biopsies were carried out in 187 men for evaluation of chronic epididymal nodules. Isolated epididymal tuberculosis was defined as "tuberculous infection affecting the epididymis without evidence of renal involvement as documented by the absence of acid fast bacilli in the urine sample and on imaging". The age, laterality, mode of presentation and method of histological diagnosis were studied with the objective of profiling isolated tuberculous epididymitis.
  
  
  RESULTS
  Fifty-four of the 187 men (median age 32 years; interquartile range: 21-37 years) had tuberculous epididymitis. Fourteen were excluded from the analysis (10 had associated urinary tract tuberculosis and 4 were lost to follow-up). None of the 40 men with isolated tuberculous epididymitis had urinary symptoms. Bilateral involvement was seen in five (12.5%) cases. The salient presenting features included painful swelling (16 subjects, 40%), scrotal sinus (4, 20%) and acute epididymitis (2, 10%). Past history or concomitant presence of tuberculosis was noted in three subjects each. Anti TB treatment resulted in a complete response in 10 and partial response in 18. Five subjects underwent epididymectomy. Tuberculous epididymitis was found incidentally in 5 (10%) cases on high orchiectomy specimen done for suspected testicular tumour.
  
  
  CONCLUSIONS
  Tuberculous epididymitis can be the sole presentation of genitourinary tuberculosis.
authors: Department of Urology, Christian Medical College, Vellore-632 004, India. uro2@cmcvellore.ac.in
authors: B S
authors: BS
authors: Viswaroop
authors: N
authors: N
authors: Kekre
authors: Ganesh
authors: G
authors: Gopalakrishnan
mesh_terms: D000328:Adult; D004823:Epididymitis / Q000382:microbiology*; D006801:Humans; D007194:India; D008297:Male; D012189:Retrospective Studies; D014376:Tuberculosis / Q000175:diagnosis*