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The impact of color Doppler ultrasound on treatment patterns of epididymitis in a university-based healthcare system
Journal article   Open access   Peer reviewed

The impact of color Doppler ultrasound on treatment patterns of epididymitis in a university-based healthcare system

Ryan P Smith, Chad R Tracy, Parviz K Kavoussi, Matthew T Witmer and Raymond A Costabile
Indian journal of urology, Vol.29(1), pp.22-26
01/2013
DOI: 10.4103/0970-1591.109979
PMCID: PMC3649595
PMID: 23671360
url
https://doi.org/10.4103/0970-1591.109979View
Published (Version of record) Open Access

Abstract

Evaluate the impact of scrotal color Doppler ultrasound (CDUS) on epididymitis treatment patterns in a university-based institution. From 1 January 1999 to 30 July 2005, 870 patients from a single institution were diagnosed with epididymitis. A total of 480 men met the inclusion criteria for acute epididymitis. Scrotal ultrasound was included as a part of the diagnostic evaluation in 42.7% of men. Ultrasound reports were available for review in 187 cases. Information regarding patient demographics, diagnostic evaluation, and treatment was reviewed. Ultrasound findings consistent with epididymitis were identified in 69.3% of men. The four most commonly reported irregularities were scrotal wall thickening (84.2%), abnormal epididymal echotexture (74%), increased epididymal vascularity (72.9%), and an enlarged epididymis (71.5%). Scrotal ultrasound was performed in 67% men under age 20 compared to 36% men between ages 30 and 69. Patients presenting to the Emergency Department underwent sonographic evaluation 57% of the time versus 17.2% men presenting to primary care physicians (P < 0.001). Ninety-five per cent (194/204) of patients who underwent CDUS were treated with antibiotics compared to 96% (263/275) of those who did not receive an ultrasound (P = 0.78). CDUS can be helpful in patients with a potential diagnosis of testicular torsion, however, the use of CDUS as a diagnostic adjunct in the evaluation of epididymitis is of limited value. Treatment patterns and antibiotic usage were not significantly altered by ultrasound findings at this institution.
epididymo-orchitis ultrasonography Doppler urinary tract infection epididymitis

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