A Retrospective Review of the Clinical Picture of Acute Epididymitis: With Special Attention to Testicular Atrophy

<p>Purpose: Acute epididymitis is a disease with a good prognosis for the testis, but recently, there have been reports of testicular atrophy after epididymitis, and we encountered a similar case in our hospital.</p><p>Methods: We retrospectively reviewed 77 cases of acute epididymitis (excluding recurrent cases) diagnosed and treated at our hospital from April 2008 to April 2022 on the basis of medical records.</p><p>Results: The age at onset was in the range from 1 month to 14 years (median 8 years). Acute epididymitis occurred on the right side in 36 patients, on the left side in 40, and bilaterally in one, and the median time from its onset to the consultation was 8 h (IQR, 5–14.5 h). Symptoms were scrotal pain in 75 patients (97%), scrotal swelling in 44 patients (57%), redness in 28 patients (36%), abdominal pain in eight patients (10%), and fever in five patients (7%). Post-treatment follow-up was as follows: 65 (84%) patients were reexamined and followed up, and 12 (16%) patients were reexamined only on occasion, with a median observation period of 40 days (IQR, 7–249 days). The prognosis of the testes was as follows: 33 patients (43%) were followed up for more than one month after treatment, and one patient developed testicular atrophy.</p><p>Conclusions: Acute epididymitis is a disease with a good prognosis for testicular disease, but in rare cases, it may lead to epididymitis and cause testicular atrophy, and long-term observation should be considered for patients with severe inflammation. Therefore, certain criteria for treatment and a follow-up period are required.</p>