1. ¹Department of Cardio-thoracic Surgery, Leeds General Infirmary, Leeds, UK
2. ²Department of Urology, Imam Reza University Hospital, Mashad, Iran
3. ³Janbazan Clinic for Spinal Cord Injuries, Mashad, Iran
4. ⁴Clinical Lecturer in Urology, Institute of Urology and Nephrology, University College London, London, UK

Correspondence: S Mirsadraee, Research Registrar, Department of Cardio-thoracic Surgery, Leeds General Infirmary, Leeds LS1 3EX, UK

Abstract

Study design: Retrospective audit and interview-based study of a traumatic spinal cord injured cohort, assessing the incidence and risk of epididymo-orchitis (E-O).

Objectives: Assess the potential risk factors for E-O in this cohort (spinal cord injured patients).

Setting: Janbazan Clinic for Spinal Cord Injuries, Mashad, Iran.

Methods: A retrospective notes audit of 169 male traumatic spinal cord injured (SCI) patients was performed. In addition, interviews were performed to confirm any equivocal data. The following risk factors were assessed: history of recurrent urinary tract infections (UTIs), urethral stricture, urethral diverticuli, urinary fistula, urinary calculi, spinal injury type, neurogenic bladder type, autonomic dysreflexia, vesico-ureteral reflux, sphincterotomy, vasectomy, marriage status, bladder residual and emptying method, ejaculation, spinal injury level, micturation control, and muscular spasm, which included detrusor, external sphincter or lower limb spasm.

Results: A total of 65 patients from our group (38.5%) had suffered E-O at least once. E-O presented on average, 3.9 years after the SCI. Patients with a history of muscular spasm appeared less likely to develop E-O (P<0.05). None of the vasectomised patients developed E-O. The relation between all the other factors and E-O were not significant.

Conclusions: Our study has shown that the presence of muscular spasm decreases the risk of E-O, although the mechanism remains unclear. Surprisingly, the other historical risk factors showed no clear relation with E-O occurrence.