Urinalysis in Children with Epididymitis

Background: The aim of this study was to examine the diagnostic and therapeutic yield of urine tests in epididymitis in children. Recently, urine examination in prepubertal epididymitis has been described as having little value for diagnostic or treatment. Yet, although urine cultures are often sterile, in clinical practice prepubertal boys with epididymitis are often treated with antibiotics. Material and Methods: A retrospective analysis of all boys with 1-episode epididymitis presenting to a single institution over a 5-year-period was performed. Results of laboratory tests (blood, urine) were collected. Results: We found 151 consecutive patients. In 93 cases (62%), results of urine examinations were available. Only 1 patient (1 %) showed bacteriuria in urine sediment, while urine culture in this patient was sterile. Urine cultures were done in 6 of 97 patients treated in hospital (6%), and all cultures were sterile. Surgical exploration was performed in 7 patients (5 %); in 6 of them epididymal cultures were taken intraoperatively with negative microbiological results. Conclusion: In our group of children with epididymitis, almost all urine tests (urinalysis, urine culture) were negative. Epididymitis in prepubertal boys seems to be mostly idiopathic, and positive microbiological findings are rare. Antibiotic treatment in this age group should only be done in cases with positive urine tests.