Indian Journal of Urology Users online:1002  
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Year : 2013  |  Volume : 29  |  Issue : 1  |  Page : 22-26

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

1 Department of Urology, University of Virginia Health System, Charlottesville, VA, USA
2 Department of Urology University of Iowa Healthcare System, Iowa City, IA, USA

Correspondence Address:
Ryan P Smith
P.O. Box 800422 Charlottesville, VA 22901
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0970-1591.109979

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Introduction and Objectives: Evaluate the impact of scrotal color Doppler ultrasound (CDUS) on epididymitis treatment patterns in a university-based institution. Materials and Methods: 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. Results: 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). Conclusions: 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.

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