title: The impact of color Doppler ultrasound on treatment patterns of epididymitis in a university-based healthcare system.
abstract: OBJECTIVE
  Evaluate the impact of scrotal color Doppler ultrasound (CDUS) on epididymitis treatment patterns in a university-based institution.
  
  
  METHODS
  From 1 January 1999 to 30 July 2005, 870 patients from a single institution were diagnosed with epididymitis. A total of 480 men met the inclusion criteria for acute epididymitis. Scrotal ultrasound was included as a part of the diagnostic evaluation in 42.7% of men. Ultrasound reports were available for review in 187 cases. Information regarding patient demographics, diagnostic evaluation, and treatment was reviewed.
  
  
  RESULTS
  Ultrasound findings consistent with epididymitis were identified in 69.3% of men. The four most commonly reported irregularities were scrotal wall thickening (84.2%), abnormal epididymal echotexture (74%), increased epididymal vascularity (72.9%), and an enlarged epididymis (71.5%). Scrotal ultrasound was performed in 67% men under age 20 compared to 36% men between ages 30 and 69. Patients presenting to the Emergency Department underwent sonographic evaluation 57% of the time versus 17.2% men presenting to primary care physicians (P < 0.001). Ninety-five per cent (194/204) of patients who underwent CDUS were treated with antibiotics compared to 96% (263/275) of those who did not receive an ultrasound (P = 0.78).
  
  
  CONCLUSIONS
  CDUS can be helpful in patients with a potential diagnosis of testicular torsion, however, the use of CDUS as a diagnostic adjunct in the evaluation of epididymitis is of limited value. Treatment patterns and antibiotic usage were not significantly altered by ultrasound findings at this institution.
authors.affiliation: Department of Urology, University of Virginia Health System, Charlottesville, VA, USA.
authors.forename: Ryan P
authors.initials: RP
authors.lastname: Smith
authors.forename: Chad R
authors.initials: CR
authors.lastname: Tracy
authors.forename: Parviz K
authors.initials: PK
authors.lastname: Kavoussi
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Witmer
authors.forename: Raymond A
authors.initials: RA
authors.lastname: Costabile
keywords: Doppler; epididymitis; epididymo-orchitis; ultrasonography; urinary tract infection