title: Acute epididymitis in children: the role of the urine test.
abstract: OBJECTIVE
  Acute epididymitis is considered to have an important role in children with scrotal pain. Recent reports have shown that urinalysis is not helpful for the diagnosis and treatment of acute epididymitis owing to negative microbiological findings. Therefore, we analyzed clinical and laboratory characteristics to examine the diagnostic yield of urinalysis in children.
  
  
  METHODS
  We retrospectively reviewed the medical records of 139 patients who were diagnosed with acute epididymitis from 2005 to 2011. Diagnosis was based on symptoms, physical findings, and color Doppler ultrasonography (DUS). To investigate the characteristics of epididymitis in children, the patients were divided into 3 groups: group A (aged less than 18 years, 76 patients), group B (18 to 35 years old, 19 patients), and group C (older than 35 years, 44 patients).
  
  
  RESULTS
  There were statistically significant differences in age, symptom duration, hospital stays, and lesion location in each group. White blood cell count and serum C-reactive protein levels, pyuria, and positive urine culture results were statistically higher in the older age group. The most common cause of acute epididymitis in children was idiopathic (96.1%).
  
  
  CONCLUSIONS
  In our group of children with epididymitis, 73 cases out of 76 (96.1%) resulted in negative pyuria in urinalysis. In addition, the most common cause of epididymitis was idiopathic. Because most urinalyses do not show pyuria, we believe that routine antibiotics may be not required in pediatric patients with epididymitis. If urinalysis shows pyuria with or without positive urine culture, antibiotics should be considered.
authors.affiliation: Department of Urology, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Jung Min
authors.initials: JM
authors.lastname: Joo
authors.forename: Seung Hoon
authors.initials: SH
authors.lastname: Yang
authors.forename: Tae Wook
authors.initials: TW
authors.lastname: Kang
authors.forename: Jae Hung
authors.initials: JH
authors.lastname: Jung
authors.forename: Sung Jin
authors.initials: SJ
authors.lastname: Kim
authors.forename: Kwang Jin
authors.initials: KJ
authors.lastname: Kim
keywords: Epididymitis; Pyuria; Urinalysis
references.citation: Urol Clin North Am. 2008 Feb;35(1):101-8; vii
references.pmid: 18061028
references.citation: Sex Transm Dis. 1981 Oct-Dec;8(4):286-9
references.pmid: 7330753
references.citation: Am J Dis Child. 1987 Jan;141(1):41-4
references.pmid: 3788880
references.citation: J Pediatr. 1972 Mar;80(3):476-9
references.pmid: 5060465
references.citation: J Infect Chemother. 2011 Feb;17(1):76-9
references.pmid: 20574697
references.citation: J Urol. 2004 Jan;171(1):391-4; discussion 394
references.pmid: 14665940
references.citation: J Urol. 1998 Aug;160(2):515-7
references.pmid: 9679920
references.citation: Pediatr Emerg Care. 2011 Mar;27(3):174-8
references.pmid: 21346680
references.citation: Urology. 2008 May;71(5):826-9; discussion 829
references.pmid: 18329081
references.citation: Eur J Pediatr Surg. 2005 Jun;15(3):180-6
references.pmid: 15999311
references.citation: J Urol. 1995 Aug;154(2 Pt 2):762-5
references.pmid: 7609173
references.citation: J Urol. 1992 Nov;148(5 Pt 2):1699-702
references.pmid: 1433591
references.citation: Eur J Pediatr. 2008 Jul;167(7):765-9
references.pmid: 17786475
references.citation: Eur J Pediatr Surg. 2010 Jul;20(4):247-9
references.pmid: 20440674
references.citation: Pediatr Surg Int. 2002 Sep;18(5-6):435-7
references.pmid: 12415374
references.citation: Int J Urol. 2012 Mar;19(3):234-8
references.pmid: 22142497
references.citation: J Urol. 1980 Oct;124(4):533-4
references.pmid: 7420597