EPIDIDYMITIS IN OLDER BOYS - DYSFUNCTIONAL VOIDING AS AN ETIOLOGY

Although male infants and young boys with epididymitis have a high inc idence of anatomical pathology, dysfunctional voiding is not a well es tablished cause of epididymitis. In our series 36 boys with epididymit is underwent noninvasive urodynamic studies to determine whether a phy siological defect could be assigned as an etiology. The 2 mechanisms p roposed are similar to that in children with vesicoureteral reflux ass ociated with dyssynergia or bladder instability and to a cause of recu rrent urinary tract infection in children (the infrequent voider syndr ome). Urinalysis and urine culture are recommended in all children wit h epididymitis and urethral swabs are obtained from those who are sexu ally active. We recommend renal/bladder ultrasound and voiding cystour ethrography in all infants and young children with epididymitis. In th e older child we advocate detailed questioning regarding voiding sympt oms and the performance of noninvasive urodynamic studies.