AUTHOR=Wenzel Mike , Deuker Marina , Welte Maria N. , Hoeh Benedikt , Preisser Felix , Homrich Till , Kempf Volkhard A. J. , Hogardt Michael , Mandel Philipp , Karakiewicz Pierre I. , Chun Felix K. H. , Kluth Luis A. 

TITLE=Catheter Management and Risk Stratification of Patients With in Inpatient Treatment Due to Acute Epididymitis

JOURNAL=Frontiers in Surgery

VOLUME=7

YEAR=2020

URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2020.609661

DOI=10.3389/fsurg.2020.609661

ISSN=2296-875X

ABSTRACT=<p><bold>Objective:</bold> This study aims to evaluate catheter management in acute epididymitis (AE) patients requiring inpatient treatment and risk factors predicting severity of disease.</p><p><bold>Material and Methods:</bold> Patients with diagnosed AE and inpatient treatment between 2004 and 2019 at the University Hospital Frankfurt were analyzed. A risk score, rating severity of AE, including residual urine &gt; 100 ml, fever &gt; 38.0°C, C-reactive protein (CRP) &gt; 5 mg/dl, and white blood count (WBC) &gt; 10/nl was introduced.</p><p><bold>Results:</bold> Of 334 patients, 107 (32%) received a catheter (transurethral (TC): <italic>n</italic> = 53, 16%, suprapubic (SPC): <italic>n</italic> = 54, 16%). Catheter patients were older, exhibited more comorbidities, and had higher CRP and WBC compared with the non-catheter group (NC). Median length of stay (LOS) was longer in the catheter group (7 vs. 6 days, <italic>p</italic> &lt; 0.001), whereas necessity of abscess surgery and recurrent epididymitis did not differ. No differences in those parameters were recorded between TC and SPC. According to our established risk score, 147 (44%) patients exhibited 0–1 (<italic>low-risk</italic>) and 187 (56%) 2–4 risk factors (<italic>high-risk</italic>). In the high-risk group, patients received a catheter significantly more often than with low-risk (TC: 22 vs. 9%; SPC: 19 vs. 12%, both <italic>p</italic> ≤ 0.01). Catheter or high-risk patients exhibited positive urine cultures more frequently than NC or low-risk patients. LOS was comparable between high-risk patients with catheter and low-risk NC patients.</p><p><bold>Conclusion:</bold> Patients with AE who received a catheter at admission were older, multimorbid, and exhibited more severe symptoms of disease compared with the NC patients. A protective effect of catheters might be attributable to patients with adverse risk constellations or high burden of comorbidities. The introduced risk score indicates a possibility for risk stratification.</p>