Influence of bladder management on epididymo-orchitis in patients with spinal cord injury: clean intermittent catheterization is a risk factor for epididymo-orchitis

doi:doi:10.1038/sj.sc.3101825

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Abstract

Study design:

Retrospective study, based on cases of spinal cord injury (SCI).

Objectives:

To establish hazard ratios for risk of epididymo-orchitis in SCI.

Setting:

South Korea.

Methods:

A total of 140 male patients injured before 1987 were eligible for this investigation and have been followed up on a yearly basis from January 1987 to December 2003.

Results:

The average age at which the lesion occurred was 24.8 years old (range, 18–53). The average time since SCI was 16.9 years (range, 1–37). A total of 34 lesions (24.3%) were complete and 106 (75.7%) were incomplete. Over the 17 years, 39 patients (27.9%) were diagnosed with epididymo-orchitis. Epididymo-orchitis was more common for patients with a history of urethral stricture (66.7 versus 25.2%, P=0.014). We also found that epididymo-orchitis was more common for patients on clean intermittent catheterization (CIC) than with indwelling urethral catheterization (42.2% versus 8.3%, P=0.030). In multivariate analysis, patients on CIC had a 7.0-fold higher risk (odds ratio, 6.96; 95% confidence interval, 1.26–38.53; P=0.026); however, a history of urethral stricture lost statistical significance (P=0.074). For other variables, no positive association with epididymo-orchitis was observed.

Conclusions:

In this study, CIC was an independent risk factor for the development of epididymo-orchitis in patients with SCI. In addition, our findings suggest that urethral stricture may be a contributing factor for the development of epididymo-orchitis in these patients. Correct instructions about CIC are of utmost importance.

Keywords:

spinal cord injury, urinary catheterization, epididymo-orchitis, neurogenic bladder

Original Article