Testicular inflammation or orchitis is inflammation of one or both testicles. It is most often the result of infection with the mumps virus. This is a nasty problem. If left untreated, it can lead to many complications and even infertility.
The testes are the male reproductive glands that produce male gametes (sperm) and hormones. Sex cells first accumulate in the testes (tubes located above and behind each testicle). Of these, as part of sperm, they enter the vas deferens, and then come out, passing the prostate and urethra.
Causes of testicular inflammation
The content of the article
Men over 45 who have a urinary tract infection or who have a catheter are at increased risk.
Known causes of orchitis:
- Bacteria - most often Escherichia coli, staphylococcus, streptococcus and Klebsiella pneumoniae. Prostate infection and epididymitis (inflammation of the testicles) may occur.
- Viruses - in almost 70% of cases, the cause is mumps - this is an infectious viral inflammation of the parotid glands that swell on one or both sides of the face.
- Sexually transmitted diseases: gonorrhea, chlamydia.
Causes of orchitis
Infectious causes
- Infection due to mumps. This is the most common cause of orchitis in adolescent and adult men. According to statistics, an inflammatory process in the tissues of the testicle develops in every 3-4 patients with mumps. Infection occurs hematogenously: the paramyxovirus spreads through the blood throughout the body and affects various glands of the body (lacrimal, pancreas, mammary, testicles);
- Complication of other common infectious diseases, which include scarlet fever, influenza, chicken pox, etc. In exactly the same way as in the previous case, the virus reaches the testicles through the bloodstream and begins to actively multiply;
- Sexually transmitted diseases (STIs) also quite often provoke an inflammatory process in the testicles. Syphilis, chlamydia, gonorrhea, ureaplasmosis and mycoplasmosis;
- Bladder catheterization (placement of a catheter in the cavity of the bladder to remove urine) for a long period of time;
- Penetration of infection into the body of a newborn through the hematogenous route through the vessels of the umbilical cord.
Non-infectious causes
- Testicular injury;
- Surgery in the testicular area;
- Adenoma (hyperplasia) of the prostate gland;
- Systemic diseases (sarcoidosis, hemorrhagic vasculitis).
Symptoms of testicular inflammation
Signs of orchitis:
- pain in one or both testicles (inflammation of the right or left testicle), it can spread to the groin;
- sensitivity of the testicles to touch;
- edema (swelling) of the testicles;
- testicular erythema (redness);
- frequent urination;
- burning before, during and after urination;
- possible pain when urinating;
- discharge from the penis;
- painful ejaculation;
- blood in semen;
- heat;
- nausea;
- vomit;
- pain during intercourse.
Symptoms of acute orchitis and epididymitis
If the testicle and its appendage become inflamed for the first time, we are talking about an acute process. The symptoms of acute orchitis and epididymitis are similar. A man may experience:
- general malaise - weakness, loss of appetite, decreased ability to work;
- headache;
- increased body temperature, sometimes to very high values;
- pain in the perineum and scrotum, which can radiate to the tailbone, groin and lower back;
- redness and swelling on the side of the affected testicle.
It is the typical symptoms of scrotal diseases, that is, changes in size, redness and pain in the organ, that can become an indicator of orchitis and epididymitis. The remaining symptoms are not specific and may indicate other diseases.
Treatment of testicular inflammation
If these symptoms are noticeable, you should consult a urologist who will do a history, physical examination, urine culture, blood tests, and ultrasound.
If orchitis is bacterial in nature, treatment is carried out with antibiotics for 10 to 14 days.
On the other hand, if the cause is mumps (a virus), then analgesics and nonsteroidal pain relievers (ibuprofen, naproxen, or acetaminophen) are taken. The resulting inflammation will subside within 1 to 3 weeks.
If fever, nausea, and vomiting occur, the patient may be admitted to the hospital for intravenous antibiotics.
Diagnosis and treatment
Diagnosing diseases is not difficult. The doctor conducts a visual examination and palpates the scrotum. And just one examination is often enough to suggest an accurate diagnosis. But to confirm it, Doppler ultrasound is used; additional tests for infections, as well as general blood and urine tests, are prescribed.
Treatment of orchitis and epididymitis is conservative. A swab is taken from the man's urethra to determine the type of infection. You can also additionally analyze the sensitivity of pathogenic flora to antibiotics. Antibiotics are the main treatment in this case.
Since an acute process can easily develop into a chronic one, in no case should you prescribe treatment for yourself. An incorrectly selected antibiotic or incorrect dosage can lead to false relief and subsidence of symptoms. A man will think that he is completely healthy, but in fact, orchitis and epididymitis will simply turn into a chronic, blurred form. Constantly inflamed glands stop functioning normally, and sometimes a man may even develop infertility. In advanced cases, doctors have to resort to surgery, but this can be completely avoided. Therefore, at the first signs of illness you should consult a doctor. High-quality diagnostics and treatment can be obtained at the Dr. AkNer.
Treatment of orchitis
Treatment of orchitis is usually carried out at home. The patient is recommended:
- taking broad-spectrum antibiotics. The drugs are prescribed empirically, with therapy adjusted if necessary after receiving culture results;
- semi-alcohol compresses or compresses with Vishnevsky ointment;
- anti-inflammatory drugs;
- bed rest;
- wearing a suspensor - a special bandage that is used to support the scrotum and fix it in a certain position;
- a diet that involves excluding spicy foods and alcoholic beverages from the diet;
- consuming large amounts of fluid in order to quickly remove toxins from the body;
- physical therapy after the patient’s condition returns to normal (approximately 5 days after the onset of the disease). Methods such as electrophoresis, laser and magnetic therapy are effective.
Hospitalization and surgical treatment are required if purulent complications develop.
If you have any questions related to the diagnosis of orchitis, you can ask them to the doctors at Nova Clinic. You can make an appointment with a urologist-andrologist by calling the phone number listed on the website or using the booking button.
Diseases that cause symptoms
Enlargement of the scrotum occurs as a result of the following disorders:
Non-infectious
- Accumulation of serous fluid in the scrotum (hydrocele, or hydrocele). The swelling is soft to the touch and does not disappear when lying down. It cannot be pressed back into the abdominal cavity. When examining the scrotum with a bright light source, it evenly penetrates the fluid accumulated inside.
- Inguinal hernia. In the presence of a hernia, enlargement of the testicles is accompanied by a painless bulge in the groin, similar to a ball. It is soft to the touch and increases in size when standing, as well as when a man pushes or lifts weights. If the swelling does not push back into the abdominal cavity, pain may occur.
- Varicose veins that drain blood from the testicle (varicocele). Usually develops on the left side. Often accompanied by testicular atrophy, pain and a feeling of swelling when standing.
- Collection of blood in the scrotum (hematocele). With this disease, the swelling is painless. Typically, a hematocele develops against the background of testicular trauma.
- Epididymal cyst (spermatocele). Typically there is swelling at the top of the testicle. The edema is a round formation filled with fluid, with a small amount of sperm. Most often occurs in sexually active men after 25 years of age.
- Testicular cancer is characterized by a hard lump in the testicle. With testicular cancer, swelling may be accompanied by bleeding, aching or sharp pain. Men under 40 years of age are at high risk.
- Lymphedema occurs when lymph accumulates in the scrotum. Is congenital in nature or is a consequence of filariasis (an infectious disease caused by tropical insect bites). This is an elastic swelling in which pressing on the scrotum leaves no mark.
- Testicular torsion, which leads to pinching of the nerves and vessels of the spermatic cord and poor circulation. In this case, the swelling is painful, and the affected testicle is located above the healthy one. Typically, swelling due to testicular torsion develops only on one side. Testicular torsion is the most common non-infectious cause of testicular swelling.
- Fluid accumulation in the body (edema) associated with heart or kidney failure. In this case, the swelling is bilateral, spongy-like. After pressing on the scrotum, a depressed mark remains.
- Allergic swelling of the scrotum develops in boys under 7 years of age against the background of a general allergy.
- Postoperative swelling of the testicles due to surgery on the genitals.
Diagnosis of orchitis
Any changes in the testicular area (redness of the skin, swelling, pain) require an immediate visit to a consultation with a urologist-andrologist. This problem should be addressed to a urologist-andrologist. The doctor will prescribe the necessary examination, which may include various research methods.
Visual inspection
Visual examination, during which external pathological changes are revealed: an increase in the size of the scrotum on the side of the affected testicle, redness and a glossy sheen of the skin. On palpation, the vas deferens can be easily felt; the size of the epididymis most often remains normal. There is swelling along the spermatic cord.
If a purulent form of orchitis develops, upon palpation the doctor can identify a symptom such as fluctuation. What it is? When you press briefly on the testicle, the specialist feels that the surface is springy. This happens due to the fact that there is liquid content in a closed cavity with elastic walls.
Ultrasound
1. Ultrasound of the scrotum with Doppler ultrasound is an informative method for diagnosing orchitis, which makes it possible to differentiate this disease from other genitourinary pathologies.
Echo signs of orchitis
:
- thickening and hyperechogenicity of the tunica albuginea of the testicle
- increased echogenicity of testicular tissue
- increase in testicle volume and size
- significant increase in blood flow velocity in the testicular artery
- increased vascularization (formation of new blood vessels in the tissue)
- in some cases a hydrocele may be detected
2. Ultrasound of the prostate gland to exclude prostatic hyperplasia in older patients
Testicular biopsy
It may be necessary to remove a piece of testicular tissue for examination.
Analysis of urine
Urinalysis (general and bacteriological examination with determination of sensitivity to antibiotics). Markers of the inflammatory process are detected:
- leukocyturia (increased number of white blood cells)
- hematuria (presence of red blood cells)
- presence of cylinders.
Bacteriological culture allows you to identify the causative agent of infection and determine its sensitivity to certain antibacterial drugs.
Urethral swab
Examination of urethral discharge allows not only to find out which pathogenic microorganisms caused orchitis, but also to assess the stage of the inflammatory process.
Spermogram
A spermogram allows you to determine the degree of reproductive dysfunction, and also makes it possible to detect in the ejaculate:
- Leukocytes (leukospermia)
- Red blood cells (hemospermia)
- Pus (pyospermia)
Symptoms and forms of orchitis
Orchitis can occur in both acute and chronic forms. Depending on this, the clinical picture of the disease differs.
Symptoms of acute orchitis
Signs of general intoxication. When infectious agents penetrate, the body is poisoned with toxins - waste products and decay of pathogenic microorganisms. Depending on how reduced the patient’s immunity is, signs of intoxication may be expressed to a greater or lesser extent. The “classic” symptoms are:
- increase in body temperature to 38˚C and above;
- weakness;
- pain in muscles and joints;
- headaches, dizziness;
- nausea, vomiting;
- chills
Severe pain in the testicle, which can not only be localized where the inflammatory process occurs, but can also radiate to the lumbar, sacral and inguinal region. Patients indicate that the pain is of significant intensity and intensifies while walking and touching the affected testicle. Severe pain is due to the fact that with orchitis, swelling develops and, as a result, the tunica albuginea of the testicle, which contains a large number of nerve endings, stretches.
Increased pain is noted if a purulent form of orchitis develops. In this case, the patient requires immediate medical attention for surgical treatment. The purulent process is also dangerous due to its complications: melting of testicular tissue can cause secretory infertility.
On the affected side, the scrotum doubles in size or more. After a few days, the skin turns red and acquires a peculiar glossy shine.
Even in the absence of adequate therapy, in most cases the patient's condition with acute orchitis improves after 2-4 weeks, except in cases where an abscess forms.
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Features of orchitis resulting from mumps are:
- inflammatory process. It can develop in the testicle as early as the 3rd day from the onset of the disease (mumps). In some cases this happens later, up to 7 days after recovery;
- in approximately 30% of cases, the pathological process affects both testicles;
- Often a complication of orchitis, which is caused by paramyxovirus, is testicular atrophy.
Symptoms of chronic orchitis
As a rule, the development of chronic orchitis is facilitated by the lack of treatment for the acute form, as well as the presence of chronic inflammatory processes in the organs of the scrotum.
The course alternates between a sluggish inflammatory process and periodic exacerbations. Symptoms of general intoxication are not pronounced, but the size of the testicle is moderately enlarged, it feels firm to the touch, and the skin in the affected area is hyperemic.
Patients note that pain is present, but is of moderate intensity, increasing with exacerbation. Usually, pain outside of an exacerbation is practically not felt at rest.
Chronic orchitis is often accompanied by infertility. This is due to a pathological process that occurs over a long period of time in the tissues of the testicle. The secretory function of the organ suffers: the process of sperm formation (spermatogenesis) worsens.
If you have any questions related to the forms and symptoms of orchitis, as well as the treatment of orchitis, you can ask them to the doctors at Nova Clinic. You can make an appointment with a doctor by calling the number listed on the website or using the booking button.
