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P2 Epididymo-orchitis: urological condition best managed by sexual health clinicians?
  1. Ola Blach,
  2. Jan Nawrocki,
  3. Phil Thomas,
  4. Daniel Richardson
  1. Brighton and Sussex University Hospitals, Brighton, UK

Abstract

Background/introduction Epididymo-orchitis (EO) is a common urological problem: men frequently present to the Emergency Department (ED), Urology or Sexual Health (SH). EO is caused by STIs (chlamydia and gonorrhoea) and uropathogens.

Aim(s)/objectives The aim of this study was to audit the management of EO presenting to ED, Urology and SH locally.

Methods 127 patients with EO who attended ED, Urology and SH departments between January–June 2014 were reviewed.

Results 127 men were seen (median age: 33, range: 15–79). 44 attended ED (median age: 35), 30 Urology (median age: 37), and 53 SH (median age: 31). Sexual history was documented in 32/44(72.7%) of ED, 20/30(66.7%) of Urology and 53/53(100%) of SH patients. MSU was sent in 17/44(38.6%) of ED, 11/30(36.7%) of Urology, and 35/53(66%) of SH patients. 53/53(100%) presenting to SH had chlamydia and gonorrhoea NAAT-testing; 3 cases had chlamydia (5.7%) and none had gonorrhoea. 14/44(31.8%) of ED and 4/30(13.3%) of Urology patients were tested; none tested positive. 90.9% of ED, 93.3% of Urology and 100% of SH patients were prescribed antibiotics. 45/53(84.9%) seen in SH, 1/44(2.2%) in ED and 1/30(3.3%) in Urology were advised to abstain from sex. Partner notification was documented in 40/53(75.5%) of SH patients, but none in ED and Urology. 30/44(68.2%) of ED, 5/30(16.7%) of Urology, and 47/53(88.7%) of SH patients were followed up within 2 weeks post-treatment.

Discussion/conclusion In the absence of torsion or surgical complications requiring hospital admission it would appear to be preferable for patients to be referred to SH for management.

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