Acute epididymitis in Vietnam: review of 52 cases
Shapiro, S.R.; Breschi, L.C.
Military Medicine 138(10): 643-645
1973
ISSN/ISBN: 0026-4075 PMID: 4206152 Document Number: 519542
The treatment experience of 52 military personnel in Viet Nam who had their 1st episode of acute epididymitis during a 9-month period in 1970-71 is reviewed. 75% of the patients were ages 18-30. The right side was involved in 48.1% of cases and the left in 44.2%; the remaining 7 cases showed bilateral involvement. Urine analysis revealed pyuria in 36 patients (69.2%). White blood cells in urine were too numerous to count in 20 patients (38.5%). Urine cultures were negative in all but 1 case. The patients were hospitalized a median number of 9 days. The therapeutic regimen consisted of absolute bed rest, elevation of the scrotum, and ice to the scrotum until tenderness disappeared. Tetracycline was generally administered. 28 patients showed no obvious factor related to the etiology or pathogenesis of the epididymitis; however, 3 had gonorrheal urethritis on admission, 7 had had gonorrhea within 8 weeks of admission, 4 had had nongonococcal urethritis within the prior 8 weeks, and 6 had acute or subacute prostatitis on admission. The paradox observed in this series between positive urinalasis and negative urine cultures may be explained by anaerobic and microaerophilic forms of the usual urinary pathogenic bacteria. The frequency of recovery of pathogenic bacteria has been shown to be enhanced when anaerobic and microaerophilic cultures are performed. Antibiotics thus assume an important role in the treatment of acute epididymitis, even if urine cultures are negative by the usual methods. Further research is needed to confirm this hypothesis.