A five year review of the management of acutely presenting epididymo-orchitis in a single UK institution

SummaryIntroductionThis audit compared the management of epididymo-orchitis within our institution against the 2010 guidelines issued by the British Association of Sexual Health and HIV.MethodsA Retrospective casenote analysis was performed on all patients diagnosed with epididymo-orchitis between August 2004 and August 2009. Patients were identified using Hospital Episode Statistics (HES) data. Data analysed included patient's age, investigations performed, treatment given, and patient follow-up.ResultsIn total, 232 patients were identified (mean age 41 years, range 1–96). A mid-stream urine was performed in 105 (45%) patients, 12 (5%) had a urethral swab and 82 (35%) had an ultrasound scan. Twenty patients were surgically explored to exclude torsion. The mean length of stay was 1 night (range 0–9). Antibiotics were prescribed in 94% of patients. Sexual history and advice to attend a genito-urinary clinic was documented in 16% and 4% of cases respectively. Referral for follow-up in the urology outpatient clinic occurred for 24% of patients.ConclusionsThe management of epididymo-orchitis in patients referred for secondary care review is an area for significant improvement in clinical practice. Implementation and dissemination of clear local guidelines are essential to ensure appropriate patient management and minimise unnecessary in-patient admissions and outpatient follow-up.