Influence of bladder management on epididymo-orchitis in patients with spinal cord injury: clean intermittent catheterization is a risk factor for epididymo-orchitis.
METHODS
Retrospective study, based on cases of spinal cord injury (SCI).


OBJECTIVE
To establish hazard ratios for risk of epididymo-orchitis in SCI.


METHODS
South Korea.


METHODS
A total of 140 male patients injured before 1987 were eligible for this investigation and have been followed up on a yearly basis from January 1987 to December 2003.


RESULTS
The average age at which the lesion occurred was 24.8 years old (range, 18-53). The average time since SCI was 16.9 years (range, 1-37). A total of 34 lesions (24.3%) were complete and 106 (75.7%) were incomplete. Over the 17 years, 39 patients (27.9%) were diagnosed with epididymo-orchitis. Epididymo-orchitis was more common for patients with a history of urethral stricture (66.7 versus 25.2%, P=0.014). We also found that epididymo-orchitis was more common for patients on clean intermittent catheterization (CIC) than with indwelling urethral catheterization (42.2% versus 8.3%, P=0.030). In multivariate analysis, patients on CIC had a 7.0-fold higher risk (odds ratio, 6.96; 95% confidence interval, 1.26-38.53; P=0.026); however, a history of urethral stricture lost statistical significance (P=0.074). For other variables, no positive association with epididymo-orchitis was observed.


CONCLUSIONS
In this study, CIC was an independent risk factor for the development of epididymo-orchitis in patients with SCI. In addition, our findings suggest that urethral stricture may be a contributing factor for the development of epididymo-orchitis in these patients. Correct instructions about CIC are of utmost importance.
Ku
J H
JH
Department of Urology, Seoul Veterans Hospital, Seoul, Republic of Korea.
Jung
T Y
TY
Lee
J K
JK
Park
W H
WH
Shim
H B
HB
D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D004823:Epididymitis / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D007723:Korea; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009920:Orchitis / Q000453:epidemiology / Q000209:etiology*; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D012307:Risk Factors; D013119:Spinal Cord Injuries / Q000453:epidemiology / Q000534:rehabilitation*; D001743:Urinary Bladder / Q000503:physiopathology*; D001750:Urinary Bladder, Neurogenic / Q000209:etiology*; D014546:Urinary Catheterization / Q000009:adverse effects*