COMPARATIVE STUDY OF EPIDIDYMAL CYST VERSUS URINARY TRACT INFECTION AS PREDOMINANT RISK FACTORS FOR DEVELOPING EPIDIDYMO-ORCHITIS IN PATIENTS PRESENTING TO A UROLOGY OUTPATIENT DEPARTMENT OF A TERTIARY CARE CENTRE: A CROSS SECTIONAL STUDY

Abstract

Background: Epididymo-orchitis (EO) is a common and potentially serious urological condition characterised by inflammation of the epididymis and testis. While urinary tract infection (UTI) and epididymal cysts are both individually recognised as predisposing factors for EO, a direct comparative evaluation of their relative contributions to disease development and severity in a tertiary care setting has not been performed. Aim: To compare the relative contribution of epididymal cysts and urinary tract infections as primary risk factors for the development of epididymo-orchitis in patients attending the urology outpatient department of a tertiary care centre, and to evaluate their impact on clinical presentation, laboratory parameters, and treatment outcomes. Methods: This analytical cross-sectional study enrolled 50 male patients diagnosed with EO, allocated equally into Group A (n=25, epididymal cyst as primary predisposing factor) and Group B (n=25, confirmed UTI as primary precipitant). Clinical, biochemical, microbiological, ultrasonographic, and outcome data were collected using a structured proforma. Chi-square test, independent samples t-test, Pearson's correlation, and binary logistic regression were used for analysis. Statistical significance was set at p<0.05. Results: The mean age was 42.3 ± 11.6 years in Group A and 38.7 ± 10.2 years in Group B (p=0.23). Fever at presentation was significantly more frequent in Group B (76.0% vs. 40.0%; p=0.006), as was dysuria (88.0% vs. 24.0%; p<0.001). Mean CRP was markedly elevated in Group B (67.4 ± 22.7 vs. 28.6 ± 14.3 mg/L; p<0.001) and urine culture positivity was substantially higher (84.0% vs. 16.0%; p<0.001). Recurrence at six months was numerically greater in Group A (28.0% vs. 16.0%; p=0.31). On binary logistic regression, UTI was the strongest independent predictor of EO (OR 8.42; 95% CI: 2.91–24.3; p<0.001), followed by epididymal cyst (OR 4.17; 95% CI: 1.58–11.0; p=0.004). Conclusion: Both UTI and epididymal cysts are significant and independent risk factors for EO. UTI constitutes the stronger acute precipitant with greater systemic inflammation and culture yield, while epididymal cysts function as a structural predisposing factor with higher recurrence rates. Early identification of both risk factors and tailored management strategies are essential in tertiary urological practice.