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Changes In the Etiology and Treatment Of Epididymitis From 1965 To 2005
Chad R Tracy, Raymond A Costabile
University of Virginia, Charlottesville, VA
Introduction: To review contemporary patterns in the etiology and treatment of epididymitis at a single institution and compare the results to similarly collected data from the 1960’s.
Methods: From 1999 to 2005, 870 patients from a single institution were diagnosed with epididymitis. Information regarding patient demographics, diagnostic evaluation, and treatment was reviewed on out-patients with newly diagnosed, non-traumatic epididymitis and comparisons were constructed with previously published series.
Results: 480 males between 3-88 years met the inclusion requirements. Unilateral disease was noted in 94% of patients, with both epididymides affected equally. Of the 161 urine cultures obtained (33% of all patients), 26.1% demonstrated bacterial growth. Eight of seventy-nine patients (10.1%) with urethral swab PCR for Chlamydia trachomatis had positive results, with all positive results being obtained in men between 16-26 years of age. A bacterial etiology for epididymitis was documented in 24.4% of patients who were tested by urine culture and/or urethral swab for C. trachomatis. Patients with complicated urinary tract infections accounted for 45% of all patients with infectious epididymitis. Patients were less likely to be admitted to the hospital and more likely to be treated with antibiotics than in previously published series (94% versus 75%).
Conclusions: Despite newer antibiotics, diagnostic methods and changes in health care delivery over the last forty years, including the discovery of C. trachomatis as an etiologic factor, the incidence of bacterial epididymitis remains unchanged. Twenty-four percent of patients have culture proven bacterial epididymitis, however 95% of patients continue to be treated with antibiotics.
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