Increased post-voiding residue and recurrent acute epididymitis: Are they causally related?

Aim: It is known that recurrent urinary tract infection (rUTI) is associated with increased post-voiding residue (PVR), however, the same relationship is yet to be shown in adults for recurrent acute epididymitis. To the best of our knowledge, there are inadequate studies on this subject and they are mainly focused on the retrograde flow of the infected urine into the ejaculatory duct in terms of pathophysiology. In this study, we aimed to evaluate the causal relationship between recurrent acute epididymitis and increased post-voiding residue. Methods: In this retrospective cohort study, the data of 388 patients who received treatment for epididymitis in our polyclinic between 2015 and 2018 were evaluated to determine that 72 were examined for lower urinary tract symptoms (LUTS). Age, PSA level, Qmax value, uroflowmetric pattern, post-voiding residual volume, International Prostate Symptom Scores (IPSS), and prostate volumes were recorded. Patients were divided into acute (n=38, Group 1) and recurrent acute (n=34, Group 2) epididymitis groups for analysis. The patients in Group 2 were treated for epididymitis at least two times in the last six months or thrice a year. The patients in Group 1 were treated only once in a year. Chi-square (Fisher’s exact test) and Student’s t-test were used to compare categorical variables. A value of P<0.05 was considered the threshold of statistical significance. Results: Age, PSA level, prostate volume, IPSS score, and peak flow did not significantly differ between the two groups. However, there were significant differences in terms of post-voiding residual urine volumes (P=0.029). The mean post-voiding residual volumes in patients with acute and recurrent acute epididymitis were 47.3 (16.2) ml and 178.2 (23.6) ml, respectively. Conclusion: There is a relationship between increased post-voiding residual urine volume and recurrent acute epididymitis. Patients who present with recurrent acute epididymitis should be scanned for urological pathologies which may cause increased PVR.