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Cysts of the ejaculatory system--a treatable cause of recurrent epididymo-orchitis in children.
Eur J Pediatr Surg. 2002 Aug; 12(4):281-5.EJ

Abstract

PURPOSE

The commonest causes of acutely painful scrotum are torsion (of appendix of the testis or the testis itself) and epididymo-orchitis. Exploration is the only way to prove the diagnosis and multiple such procedures are performed in patients with recurrent epididymo-orchitis. The purpose of our study was to investigate the cause of recurrent epididymo-orchitis in pre-pubertal children. Four children, aged three years or less, were investigated for recurrent left epididymo-orchitis. All four had cystic dilatation of the ejaculatory duct in the region of the prostatic utriculus, associated in two children with ectopic opening of the vas in the bladder. Initial ultrasound appeared to be normal in all four patients, a retrospective review of the sonographic films, however, revealed a retrovesical cyst in three of them. The diagnosis was established by a combination of urethroscopy with retrograde contrast study via the utriculus and open vasography. All four cases were treated operatively by a transtrigonal approach. The cyst was excised in each case. In one, a vasovasostomy was performed between the left and the normal right vas; in the other three the left vas was anastomosed to the blind end of the contralateral seminal vesicle. All four are symptom-free at one year follow-up. Cysts of the ejaculatory duct are a treatable cause of recurrent epididymo-orchitis. Pre-pubertal children with recurrent epididymo-orchitis and no obvious underlying cause should have a thorough sonographic examination of the retrovesical region for cystic lesions.

Authors+Show Affiliations

Pimpalwar A
Department of Paediatric Surgery, Birmingham Children Hospital, Birmingham, UK. ashwinpgi@hotmail.com
Chowdhary S
No affiliation info available
Huskisson J
No affiliation info available
Corkery JJ
No affiliation info available

MeSH

Child, PreschoolCystsEjaculatory DuctsEpididymitisHumansInfantMaleOrchitisRadiographyTreatment OutcomeUltrasonography

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

12369009

Citation

Pimpalwar, A, et al. "Cysts of the Ejaculatory System--a Treatable Cause of Recurrent Epididymo-orchitis in Children." European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [et Al] = Zeitschrift Fur Kinderchirurgie, vol. 12, no. 4, 2002, pp. 281-5.
Pimpalwar A, Chowdhary S, Huskisson J, et al. Cysts of the ejaculatory system--a treatable cause of recurrent epididymo-orchitis in children. Eur J Pediatr Surg. 2002;12(4):281-5.
Pimpalwar, A., Chowdhary, S., Huskisson, J., & Corkery, J. J. (2002). Cysts of the ejaculatory system--a treatable cause of recurrent epididymo-orchitis in children. European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [et Al] = Zeitschrift Fur Kinderchirurgie, 12(4), 281-5.
Pimpalwar A, et al. Cysts of the Ejaculatory System--a Treatable Cause of Recurrent Epididymo-orchitis in Children. Eur J Pediatr Surg. 2002;12(4):281-5. PubMed PMID: 12369009.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cysts of the ejaculatory system--a treatable cause of recurrent epididymo-orchitis in children. AU - Pimpalwar,A, AU - Chowdhary,S, AU - Huskisson,J, AU - Corkery,J J, PY - 2002/10/9/pubmed PY - 2003/1/15/medline PY - 2002/10/9/entrez SP - 281 EP - 5 JF - European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie JO - Eur J Pediatr Surg VL - 12 IS - 4 N2 - PURPOSE: The commonest causes of acutely painful scrotum are torsion (of appendix of the testis or the testis itself) and epididymo-orchitis. Exploration is the only way to prove the diagnosis and multiple such procedures are performed in patients with recurrent epididymo-orchitis. The purpose of our study was to investigate the cause of recurrent epididymo-orchitis in pre-pubertal children. Four children, aged three years or less, were investigated for recurrent left epididymo-orchitis. All four had cystic dilatation of the ejaculatory duct in the region of the prostatic utriculus, associated in two children with ectopic opening of the vas in the bladder. Initial ultrasound appeared to be normal in all four patients, a retrospective review of the sonographic films, however, revealed a retrovesical cyst in three of them. The diagnosis was established by a combination of urethroscopy with retrograde contrast study via the utriculus and open vasography. All four cases were treated operatively by a transtrigonal approach. The cyst was excised in each case. In one, a vasovasostomy was performed between the left and the normal right vas; in the other three the left vas was anastomosed to the blind end of the contralateral seminal vesicle. All four are symptom-free at one year follow-up. Cysts of the ejaculatory duct are a treatable cause of recurrent epididymo-orchitis. Pre-pubertal children with recurrent epididymo-orchitis and no obvious underlying cause should have a thorough sonographic examination of the retrovesical region for cystic lesions. SN - 0939-7248 UR - https://www.unboundmedicine.com/medline/citation/12369009/Cysts_of_the_ejaculatory_system__a_treatable_cause_of_recurrent_epididymo_orchitis_in_children_ DB - PRIME DP - Unbound Medicine ER -