Overview
Understanding the disease
Risk Factors
Risk factors for developing orchitis include not being immunized against mumps, having recurring urinary tract infections, having surgery that involves the genitals or urinary tract, and being born with an abnormality in the urinary tract.
Development
Orchitis can develop due to bacterial or viral infections. Bacterial orchitis is often associated with or the result of epididymitis, which is caused by an infection that spreads from the urethra or bladder to the epididymis. The cause of the infection can be an STI or other factors such as birth abnormalities in the urinary tract or having had a catheter or medical instruments inserted into the penis. Viral orchitis, on the other hand, is typically caused by the mumps virus, which affects nearly one-third of males who contract the mumps after puberty. Risk factors for nonsexually transmitted orchitis include not being immunized against mumps, having recurring urinary tract infections, undergoing genital or urinary tract surgery, or being born with an abnormality in the urinary tract. Proper prevention measures include getting immunized against mumps and practicing safe sex to protect against STIs.
Assessment and Diagnosis
Triage
Orchitis is an inflammation of the testicles, which can be caused by various factors, including bacterial or viral infections. If orchitis is suspected, it's important to see a doctor for proper diagnosis and treatment. Some signs and symptoms that may warrant a visit to a healthcare provider for orchitis include:
- Sudden onset of severe scrotal pain or discomfort
- Swelling of the affected testicle or both testicles
- Fever
- Chills
- Nausea or vomiting
- Difficulty in urinating or painful urination
- Difficulty in achieving an erection or loss of libido
- Skin discoloration or changes in the appearance of the scrotum If you experience any of these symptoms, it's essential to seek medical attention promptly, as orchitis can lead to testicular torsion (twisting of the testicle) in some cases, which can result in loss of the affected testicle if not treated promptly.
Diagnosis
The most common way to diagnose orchitis is through a combination of medical history, physical examination, and diagnostic tests. Your doctor will likely start with a medical history and physical exam to check for enlarged lymph nodes and an enlarged testicle on the affected side. They may also perform a rectal examination and recommend STI screening, urine tests, or an ultrasound (with color Doppler) to further assess the situation.
Management and Treatment
Complications
Orchitis is inflammation of the testicles, which can be caused by various factors such as infections or trauma. Potential complications of orchitis may include:
- Testicular atrophy: Chronic orchitis can cause testicular shrinkage or atrophy due to damage to the testicular tissue.
- Infertility: In some cases, long-term orchitis can lead to fertility issues, as the inflammation and damage to the testicles can affect the production and quality of sperm.
- Chronic pain: Persistent orchitis may cause chronic pain in the affected testicle, which can impact daily life and overall quality of life.
- Epididymitis: Orchitis can sometimes be associated with epididymitis, which is inflammation of the epididymis, a structure located on the back of the testicle that helps in the storage and maturation of sperm.
- Systemic complications: In severe cases, orchitis can lead to systemic complications if the infection spreads beyond the testicles, potentially affecting other organs and systems in the body. Septicemia (bloodstream infection) and prostatitis (inflammation of the prostate gland) are examples of such complications. It is important to seek medical attention if you experience symptoms of orchitis, as prompt diagnosis and treatment can help prevent potential complications and promote recovery.
Prevention
orchitis can be prevented by getting immunized against mumps, which is the most common cause of viral orchitis. Practicing safe sex can also help protect against sexually transmitted infections (STIs) that can cause bacterial orchitis. Avoiding risk factors such as not being immunized against mumps, having recurring urinary tract infections, undergoing surgery involving the genitals or urinary tract, or being born with urinary tract abnormalities can also reduce the risk of developing orchitis.
Treatment
For treating orchitis, the approach depends on the underlying cause. If the orchitis is caused by a bacterial infection, antibiotics are necessary. The doctor will prescribe antibiotics to treat the infection. If the infection is caused by an STI, the sexual partner also requires treatment. It is important to complete the entire course of antibiotics prescribed, even if symptoms improve earlier, to ensure the infection is completely cured. Rest, scrotal support with an athletic strap, ice packs, and pain relief medication can help alleviate discomfort. For viral orchitis, the focus is on relieving symptoms. Treatment may involve nonsteroidal anti-inflammatory drugs (such as ibuprofen or naproxen sodium), bed rest, elevating the scrotum, and applying cold packs. Most people with viral orchitis start to feel better within 3 to 10 days, although scrotal tenderness may persist for several weeks. Remember to follow the recommended lifestyle and home remedies, such as rest, elevating the scrotum, and applying cold packs, to ease discomfort. Also, discuss any concerns or questions with your doctor during your appointment.