Year 2020, Volume 4 , Issue 1, Pages 21 - 24 2020-01-02

Increased post-voiding residue and recurrent acute epididymitis: Are they causally related?
Rezidü idrar miktarı ve tekrarlayan akut epididimit arasında sebep-sonuç ilişkisi var mı?

Adem SANCI [1] , Evren SUER [2]


Aim: It is known that recurrent urinary tract infection (rUTI) is associated with increased post-voiding residue (PVR), however, the same relationship is yet to be shown in adults for recurrent acute epididymitis. To the best of our knowledge, there are inadequate studies on this subject and they are mainly focused on the retrograde flow of the infected urine into the ejaculatory duct in terms of pathophysiology. In this study, we aimed to evaluate the causal relationship between recurrent acute epididymitis and increased post-voiding residue.

Methods: In this retrospective cohort study, the data of 388 patients who received treatment for epididymitis in our polyclinic between 2015 and 2018 were evaluated to determine that 72 were examined for lower urinary tract symptoms (LUTS). Age, PSA level, Qmax value, uroflowmetric pattern, post-voiding residual volume, International Prostate Symptom Scores (IPSS), and prostate volumes were recorded. Patients were divided into acute (n=38, Group 1) and recurrent acute (n=34, Group 2) epididymitis groups for analysis. The patients in Group 2 were treated for epididymitis at least two times in the last six months or thrice a year. The patients in Group 1 were treated only once in a year. Chi-square (Fisher’s exact test) and Student’s t-test were used to compare categorical variables. A value of P<0.05 was considered the threshold of statistical significance.

Results: Age, PSA level, prostate volume, IPSS score, and peak flow did not significantly differ between the two groups. However, there were significant differences in terms of post-voiding residual urine volumes (P=0.029). The mean post-voiding residual volumes in patients with acute and recurrent acute epididymitis were 47.3 (16.2) ml and 178.2 (23.6) ml, respectively.

Conclusion: There is a relationship between increased post-voiding residual urine volume and recurrent acute epididymitis. Patients who present with recurrent acute epididymitis should be scanned for urological pathologies which may cause increased PVR.

Amaç: Tekrarlayan idrar yolu enfeksiyonunun artmış rezidü idrar ile ilişkili olduğu biliniyor. Yetişkinlerde tekrarlayan akut epididimit için ise böyle bir durum henüz gösterilmemiş. Bildiğimiz kadarıyla bu konuyla ilgili çok fazla çalışma yok ve bu yapılan kısıtlı sayıdaki çalışmaların çoğunda etyolojide ejekülatör kanala retrograd idrar akışı üzerinde durulmuş. Bu çalışmada tekrarlayan akut epididimit ile artmış rezidü idrar (PVR) arasındaki olası nedensel ilişkiyi incelemeyi amaçladık.

Yöntemler: Çalışma retrospektif kohort olarak tasarlandı. 2015-2018 yılları arasında polikliniğimizde epididimit tedavisi gören 388 hastanın verileri retrospektif olarak incelendi. Bu hastaların 72'si aynı zamanda alt üriner sistem semptomları (AÜSS) açısından da incelenmişti. Yaş, PSA düzeyi, Qmax değeri, üroflowmetrik patern, işeme sonrası rezidüel hacim, IPSS Skorları ve prostat hacimleri kaydedildi. Hastalar, dahil edilme kriterlerine göre akut ve tekrarlayan akut epididimiti olanlar olarak iki gruba ayrıldı. Analiz için hastalar akut (n=38, Grup 1) ve rekürren akut (n=34, Grup 2) epididimit olarak iki gruba ayrıldı. Grup 2’deki hastalar epididimit için son altı ayda iki veya son bir yılda üç defa tedavi edildi. Grup 1’deki hastalar yılda sadece 1 kez tedavi edildi. Kategorik değişkenleri karşılaştırmak için ki-kare ( Fisher’s exact test ) ve Student t-testi kullanıldı. P<0,05 değeri istatistiksel anlamlılık eşiği olarak kabul edildi.

Bulgular: Yaş, PSA düzeyi, prostat hacmi, IPSS skoru ve pik akım iki grup arasında anlamlı farklılık göstermedi. Bununla birlikte, işeme sonrası rezidüel idrar hacimleri açısından anlamlı farklılıklar vardı (P=0,029). Akut ve rekürren akut epididimitli hastalarda ortalama işeme sonrası rezidüel hacimler sırasıyla 47,3 (16,2) ml ve 178,2 (23,6) ml idi.

Sonuç: Artan işeme sonrası rezidüel idrar hacmi ile tekrarlayan akut epididimit arasında bir sebep-sonuç ilişkisi vardır. Tekrarlayan akut epididimit ile başvuran hastalar, artmış PVR'ye neden olabilecek ürolojik patolojiler için taranmalıdır.

  • 1. Cek M, Sturdza L, Pilatz A. Acute and chronic epididymitis. Eur Urol Suppl. 2017;16:124–31.
  • 2. Tracy CR, Steers WD, Costabile R. Diagnosis and management of epididymitis. Urol Clin North Am. 2008;35:101–8.
  • 3. Trojian TH, Lishnak TS, Heiman D. Epididymitis and orchitis: an overview. Am Fam Physician. 2009;79:583–7.
  • 4. Harnisch JP, Berger RE, Alexander ER, Monda G, Holmes KK. Aetiology of acute epididymitis. Lancet. 1977 Apr 16;1(8016):819-21.
  • 5. Street E, Joyce A, Wilson J. Clinical Effectiveness Group, British Association for Sexual Health and HIV. BASHH UK guideline for the management of epididymo-orchitis. 2010. Int J STD AIDS. 2011 Jul;22(7):361-5.
  • 6. Nicholson A, Rait G, Murray-Thomas T, Hughes G, Mercer CH, Cassell J. Management of epididymo-orchitis in primary care results from a large UK primary care database. Br J Gen Pract. 2010 Oct;60(579):e407-22.
  • 7. Weingartner K, Gerharz EW, Gillich M, Riedmiller H. Ectopic third ureter causing recurrent acute epididymitis. Br J Urol. 1998;81:164-5.
  • 8. Siegel A, Snyder H, Duckett JW. Epididymitis in infants and boys: Underlying urogenital anomalies and efficacy of imaging modalities. J Urol. 1987;138:1100-3.
  • 9. Kajbafzadeh AM, Shirazi M, Dianat S, Mehdizadeh M. Management of recurrent epididymitis in children: Application of neurovascular sparing vas clipping in refractory cases. J Ped Urol. 2011. Oct;7(5):552-8.
  • 10. Madani A, Rahimzadeh N, Esfahani ST, Ataei N, Mohseny P, Kajbafzadeh A, et al. Posterior urethral valve in a child presenting as recurrent epididymo-orchitis. Arch Iran Med. 2008 Nov;11(6):662-4.
  • 11. Banyra O, Shulyak A. Acute epididymo-orchitis: staging and treatment. Cent European J Urol. 2012;65(3):139-43.
  • 12. Luzzi GA, O'Brien TS. Acute epididymitis. BJU Int. 2001 May;87(8):747-55.
  • 13. Dason S, Dason JT, Kapoor A. Guidelines for the diagnosis and management of recurrent urinary tract infection in women. Can Urol Assoc J. 2011 Oct;5(5):316-22.
  • 14. Al-Badr A, Al-Shaikh G. Recurrent Urinary Tract Infections. Sultan Qaboos Univ Med J. 2013 Aug;13(3).
  • 15. Mittemeyer BT, Lennox KW, Borski AA: Epididymitis: a review of 610 cases. J Urol 1966;95:390-2.
  • 16. Höppner W, Strohmeyer T, Hartmann M, Lopez-Gamarra D, Dreikorn K. Surgical treatment of acute epididymitis and its underlying diseases. Eur Urol. 1992;22(3):218-21.
  • 17. Noguchi N, Chan L, Cumming RG, Blyth FM, Handelsman DJ, Waite LM, et al. Natural history of post-void residual urine volume over 5 years in community-dwelling older men: The Concord Health and Ageing in Men Project. Neurourol Urodyn. 2018 Mar;37(3):1068-73.
  • 18. Bergamin PA, Kiosoglous AJ. Non-surgical management of recurrent urinary tract infections in women. Transl Androl Urol. 2017;6(Suppl 2):S142-S152.
  • 19. José Carlos I. Truzzi, Flávio Mistreta R. Almeida, Eduardo Capati Nunes, Marcus V. Sadi. Residual Urinary Volume and Urinary Tract Infection—When are They Linked? J Urol. 2008 Jul;180(1):182-5.
  • 20. O'Grady F, Mackintosh IP, Greenwood D, Watson BW. Treatment of 'bacterial cystitis' in fully automatic mechanical modelsstimulating the conditions of bacterial growth in the urinary bladder. Br J Exp Pathol.1973;54:283-90.
  • 21. Özlülerden Y, Toktaş C, Zümrütbaş AE, Gülten MC, Başer A, Yapıcı O, et al. Can feeling of incomplete bladder emptying reflect significant postvoid residual urine? Is it reliable as a symptom solely? Investig Clin Urol. 2018 Jan;59(1):38-43.
  • 22. Caron F, Alexandre K, Pestel-Caron M, Chassagne P, Grise P, Etienne M. Highbacterial titers in urine are predictive of abnormal postvoid residual urine in patients with urinary tract infection. Diagn Microbiol Infect Dis. 2015;83(1):63-7.
  • 23. Dray E, Cameron AP, Clemens JQ, Qin Y, Covalschi D, Stoffel J. Does Post-Void Residual Volume Predict Worsening Urologic Symptoms in Patients with Multiple Sclerosis? J Urol. 2018 Oct;200(4):868-74.
  • 24. Sharma A, Garg G, Pandey S, Agarwal S, Sankhwar SN. Post Circumcision Meatal Stenosis Causing Renal Failure: A Preventable and Disastrous Complication. JOJ Case Stud. 2018;7(2):555708.
Primary Language en
Subjects Microbiology, Urology ve Nephrology
Journal Section Research article
Authors

Orcid: 0000-0003-2229-8234
Author: Adem SANCI (Primary Author)
Institution: ANKARA ÜNİVERSİTESİ, TIP FAKÜLTESİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, ÜROLOJİ ANABİLİM DALI
Country: Turkey


Orcid: 0000-0001-2349-6789
Author: Evren SUER
Institution: ANKARA ÜNİVERSİTESİ, TIP FAKÜLTESİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, ÜROLOJİ ANABİLİM DALI
Country: Turkey


Dates

Publication Date : January 2, 2020

Bibtex @research article { josam673237, journal = {Journal of Surgery and Medicine}, issn = {}, eissn = {2602-2079}, address = {jsurgmed@gmail.com}, publisher = {Fatih BAŞAK}, year = {2020}, volume = {4}, pages = {21 - 24}, doi = {10.28982/josam.673237}, title = {Increased post-voiding residue and recurrent acute epididymitis: Are they causally related?}, key = {cite}, author = {SANCI, Adem and SUER, Evren} }
APA SANCI, A , SUER, E . (2020). Increased post-voiding residue and recurrent acute epididymitis: Are they causally related?. Journal of Surgery and Medicine , 4 (1) , 21-24 . DOI: 10.28982/josam.673237
MLA SANCI, A , SUER, E . "Increased post-voiding residue and recurrent acute epididymitis: Are they causally related?". Journal of Surgery and Medicine 4 (2020 ): 21-24 <http://jsurgmed.com/en/issue/51597/673237>
Chicago SANCI, A , SUER, E . "Increased post-voiding residue and recurrent acute epididymitis: Are they causally related?". Journal of Surgery and Medicine 4 (2020 ): 21-24
RIS TY - JOUR T1 - Increased post-voiding residue and recurrent acute epididymitis: Are they causally related? AU - Adem SANCI , Evren SUER Y1 - 2020 PY - 2020 N1 - doi: 10.28982/josam.673237 DO - 10.28982/josam.673237 T2 - Journal of Surgery and Medicine JF - Journal JO - JOR SP - 21 EP - 24 VL - 4 IS - 1 SN - -2602-2079 M3 - doi: 10.28982/josam.673237 UR - https://doi.org/10.28982/josam.673237 Y2 - 2020 ER -
EndNote %0 Journal of Surgery and Medicine Increased post-voiding residue and recurrent acute epididymitis: Are they causally related? %A Adem SANCI , Evren SUER %T Increased post-voiding residue and recurrent acute epididymitis: Are they causally related? %D 2020 %J Journal of Surgery and Medicine %P -2602-2079 %V 4 %N 1 %R doi: 10.28982/josam.673237 %U 10.28982/josam.673237
ISNAD SANCI, Adem , SUER, Evren . "Increased post-voiding residue and recurrent acute epididymitis: Are they causally related?". Journal of Surgery and Medicine 4 / 1 (January 2020): 21-24 . https://doi.org/10.28982/josam.673237
AMA SANCI A , SUER E . Increased post-voiding residue and recurrent acute epididymitis: Are they causally related?. J Surg Med. 2020; 4(1): 21-24.
Vancouver SANCI A , SUER E . Increased post-voiding residue and recurrent acute epididymitis: Are they causally related?. Journal of Surgery and Medicine. 2020; 4(1): 24-21.