How useful is a complete urinary tract ultrasound in orchiepididymitis ?

Article Article scientifique Article How useful is a complete urinary tract ultrasound in orchiepididymitis ? eng 2022-02-10 2022 author Aeschimann Eva 0000-0001-8251-4811 Pediatric Emergency Division, Department of Pediatrics, Gynecology, and Obstetrics, Geneva University Hospitals, University of Geneva, Geneva, Switzerland. 675250 author Sanchez Oliver Lope 0000-0003-0008-7436 Division of Child's and Adolescent's Surgery, Department of Pediatrics, Gynecology, and Obstetrics, University Center of Pediatric Surgery of Western Switzerland, Lausanne, Switzerland. 507229 author Birraux Jacques Maurice Division of Child's and Adolescent's Surgery, Department of Pediatrics, Gynecology, and Obstetrics, University Center of Pediatric Surgery of Western Switzerland, University of Geneva, Geneva, Switzerland. 36101 Département de Pédiatrie, Gynécologie et Obstétrique (PETRI) author Wildhaber Barbara Division of Child's and Adolescent's Surgery, Department of Pediatrics, Gynecology, and Obstetrics, University Center of Pediatric Surgery of Western Switzerland, University of Geneva, Geneva, Switzerland. 595596 Département de Pédiatrie, Gynécologie et Obstétrique (PETRI) author Manzano Sergio 0000-0001-9603-5520 Pediatric Emergency Division, Department of Pediatrics, Gynecology, and Obstetrics, Geneva University Hospitals, University of Geneva, Geneva, Switzerland. 88371 Département de Pédiatrie, Gynécologie et Obstétrique (PETRI) e0263934 10.1371/journal.pone.0263934 35143594 1932-6203 PMC8830649 https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0263934 Orchiepididymitis (OE) is a frequent cause of pediatric emergency department attendance in boys presenting with acute scrotum. The etiology of most episodes of OE remains unclear and there is no consensus regarding the correlation between OE and underlying genitourinary malformations. Whether imaging evaluation should comprise complete urinary tract ultrasonography (US) or voiding cystography is a subject of debate. The aim of this retrospective, single-center study was to analyze i) the number/type of urinary tract malformations detected by US following a first episode of OE in boys with no previously known malformation and ii) the frequency of associated urinary tract infection (UTI). We reviewed the records of 495 boys <16 years presenting to our pediatric emergency department with acute scrotum between January 2012 and December 2017. Patients with incomplete radiological data were excluded. Of 119 boys with a radiologically-confirmed first episode of OE, 99 had a complete urinary tract US and were included in the study. No genitourinary malformation was detected (0%). Urinary cultures showed UTI in 3/98 (3.1%) patients. Mean age at presentation was 9.7 years (standard deviation, 3.9) with a three-peak incidence of OE at 10-13 years, 4-5 years, and during infancy. Conclusion: Complete urinary tract US does not appear to be useful during a first episode of OE in countries with an antenatal US screening rate similar to Switzerland. The very low UTI rate suggests that a urinalysis is sufficient to investigate a first episode of OE and antibiotics should be reserved for positive urinalysis only. Adolescent Child Child, Preschool Cystography Epididymitis / diagnostic imaging Epididymitis / etiology Humans Infant Male Orchitis / diagnostic imaging Orchitis / etiology Retrospective Studies Switzerland / epidemiology Urinalysis Urinary Tract / abnormalities Urinary Tract / diagnostic imaging Urinary Tract Infections / complications Urinary Tract Infections / epidemiology Dewey 618 58 Département de pédiatrie, gynécologie et obstétrique 223 false 149 Etiologie des pneumonies et marqueurs inflammatoires chez l'enfant fébrile 183 https://yareta.unige.ch/archives/dcfe702a-76ca-4826-a9ac-d913fa3721b2 PloS one 17 2 b6114d17-434c-4bca-97de-0e32720ac80f Article (Published version) Public Article-scientifique-from-europePmc.pdf 670193 application/pdf CC BY-4.0 c618659952836fbc4a1affe2cb7de3f0a74e1342bc029950508223bb2e3d0b54 openAccess Faculté de médecine / Section de médecine clinique / Département de pédiatrie, gynécologie et obstétrique

Title	Published in	Year	Views	Downloads

How useful is a complete urinary tract ultrasound in orchiepididymitis ?	PloS one	2022	89	90
Intérêt de l'échographie rénale et des voies urinaires dans la prise en charge de l'orchi-épididymite chez l'enfant de moins de 16 ans		2020	712	1,170

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Aeschimann, Eva