青春期前附睾炎的病因及当前治疗方法
The aetiology and current management of prepubertal epididymitis.
作者信息
Gkentzis A, Lee L
机构信息
Bolton NHS Foundation Trust, UK.
出版信息
Ann R Coll Surg Engl. 2014 Apr;96(3):181-3. doi: 10.1308/003588414X13814021679311.
INTRODUCTION
The aim of this study was to review the published evidence on the pathogenesis and management of acute epididymitis (AE) in prepubertal boys after the authors encountered an unexpectedly large number of such cases in their institution.
METHODS
Using MEDLINE(®), a literature search was performed for articles in English with the words "pre-pubertal" OR "boys" OR "p(a)ediatric" OR "children" AND "epididymitis" OR "epididymo-orchitis".
RESULTS
The literature suggests that it is rare to find a bacterial infection or anatomical anomaly as a cause for AE in this population. A postviral infectious phenomenon is the most likely explanation. The management should be supportive and antibiotics reserved for those with pyuria or positive cultures. Urodynamic studies and renal tract ultrasonography have been advocated for those with recurrent epididymitis.
CONCLUSIONS
AE in prepubertal boys is more common than believed previously. A careful history for recent viral illnesses should be included. Antibiotics, urinary tract imaging and functional studies should be used in selected cases.
引言
在作者所在机构遇到数量意外众多的青春期前男孩急性附睾炎（AE）病例后，本研究旨在回顾已发表的关于青春期前男孩急性附睾炎发病机制及治疗的证据。
方法
使用MEDLINE（®）对英文文章进行文献检索，检索词为“青春期前”或“男孩”或“儿科”或“儿童”以及“附睾炎”或“附睾睾丸炎”。
结果
文献表明，在该人群中，很少发现细菌感染或解剖异常是AE的病因。病毒感染后现象是最可能的解释。治疗应采取支持性措施，抗生素仅用于脓尿或培养阳性的患者。对于复发性附睾炎患者，提倡进行尿动力学研究和泌尿系统超声检查。
结论
青春期前男孩的AE比之前认为的更为常见。应详细询问近期病毒感染病史。抗生素、泌尿系统影像学检查和功能研究应在特定病例中使用。
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