[Epididymitis after prostatic adenomectomy--24-years observations].

MATERIAL AND

METHODS

Authors have retrospectively reviewed records of 6811 patients with BPH treated during the last 24 years who underwent suprapubic and transurethral adenomectomy to evaluate the incidence of postoperative epididymitis.

RESULTS

Only in 44 cases was diagnosed acute postoperative epididymitis (0.64%). Most commonly the postoperative epididymitis was noted following transvesical adenomectomies (1.53%), less commonly following retropubic (Millin's) surgery (1.09%), and most rarely following transurethral resection of the prostate (TURP) (0.11%). It was observed that the postoperative epididymitis was closely associated with urinary tract infections (UTI). The most common pathogen isolated in the postoperative epididymitis were Gram negative bacteria. No difference was noted between two groups (our patients without prophylactic vasectomy compared with the data from literature with prophylactic vasectomy) in the incidence of postoperative epididymitis.

CONCLUSIONS

Incidence of postoperative epididymitis decreased significantly in the last two decades. Surgical techniques that allow for a shorter postoperative catheterization resulted in less frequent urinary tract infection which in turn led to decrease in the postoperative epididymitis. A course of suitable antibiotic therapy often permits to cure postoperative epididymitis without a need for surgery (70.45%). Vasectomy as the routine prophylactic intervention prior to prostatic surgery is no longer indicated.