Orchitis: Symptoms, Causes, Treatment

What are the symptoms of orchitis?

Orchitis is inflammation of one or both testicles, often caused by an infection. It can be painful and lead to several symptoms, which may vary in severity. Here are the common symptoms associated with orchitis:

Symptoms of Orchitis:

• Testicular Pain:
• Sudden onset of pain in one or both testicles, which can range from mild to severe.
• Swelling:
• Swelling in one or both testicles.
• Tenderness:
• The affected testicle(s) may be tender to the touch.
• Fever:
• A high fever may accompany the inflammation, especially if the cause is an infection.
• Nausea or Vomiting:
• Some individuals may feel nauseous or vomit due to the intense pain or infection.
• Redness or Warmth:
• The skin of the scrotum may appear red or feel warm.
• Pain in Groin or Lower Abdomen:
• Pain may extend into the groin or lower abdomen.
• Painful Urination:
• Difficulty or pain during urination, especially if the infection is caused by a sexually transmitted infection (STI).
• Discharge from the Penis:
• This symptom can occur if the underlying cause is a sexually transmitted infection like gonorrhea or chlamydia.

If you suspect orchitis, especially if the symptoms are severe or persistent, it’s important to seek medical attention for proper diagnosis and treatment.

What are the causes of orchitis?

Orchitis, the inflammation of one or both testicles, can be caused by various factors, primarily infections or non-infectious conditions. Here are the main causes of orchitis:

1. Infectious Causes:

• Viral Infections:
  • Mumps Virus: Historically a common cause, particularly in unvaccinated individuals. Mumps orchitis often occurs after parotitis (swelling of the parotid glands).
  • Coxsackievirus: Can also lead to orchitis, typically associated with viral infections of the respiratory tract or gastrointestinal tract.
  • Other Viruses: Such as HIV, cytomegalovirus (CMV), or the varicella-zoster virus can also be responsible.
• Bacterial Infections:
  • Sexually Transmitted Infections (STIs): Common culprits include:
  • Chlamydia trachomatis
  • Neisseria gonorrhoeae
  • Urinary Tract Infections (UTIs): Especially in older men, bacteria can ascend from the urinary tract to the testicles.
  • E. coli and other Enterobacteriaceae: Particularly in cases related to urinary issues or conditions like epididymitis.

2. Non-Infectious Causes:

• Trauma or Injury: Physical trauma to the testicles can lead to inflammation.
• Autoimmune Disorders: Conditions where the immune system mistakenly attacks the testicular tissue.
• Other Medical Conditions: Such as testicular torsion (twisting of the spermatic cord) or hernias, which may also cause inflammation.
• Chemical Irritation: Exposure to certain chemicals can cause inflammation of the testicles.

3. Complications Related to Other Conditions:

• Epididymitis: Often accompanies orchitis; inflammation of the epididymis can lead to orchitis.
• Systemic Infections: Sometimes, general infections like viral meningitis can lead to orchitis.

Risk Factors:

Certain risk factors can increase the likelihood of developing orchitis:

• Being unvaccinated against mumps.
• Engaging in unprotected sexual activities.
• Having a history of STIs or UTIs.
• Being a prepubescent child (for viral causes like mumps) or an older adult (for bacterial cases).

Summary

Orchitis can result from viral or bacterial infections, trauma, autoimmune diseases, or other medical conditions. Understanding the underlying cause is important for appropriate treatment and management.

How is the diagnosis of orchitis made?

The diagnosis of orchitis typically involves a combination of a thorough medical history, physical examination, and various diagnostic tests. Here’s a breakdown of the steps commonly taken to diagnose orchitis:

1. Medical History:

• Symptom Inquiry: The healthcare provider will ask about the symptoms, including the onset, duration, and severity of pain, swelling, or other associated symptoms (e.g., fever, changes in urination, discharge).
• Recent Infections: History of recent viral or bacterial infections, particularly mumps, sexually transmitted infections (STIs), or urinary tract infections (UTIs) will be noted.
• Vaccination History: Vaccination status for mumps, rubella, and other relevant diseases may be assessed.
• Sexual History: Information regarding recent sexual activity, including unprotected sex or STIs, could be important.

2. Physical Examination:

• Exam of the Testicles: The physician will perform a physical examination to assess for tenderness, swelling, redness, or abnormal findings of the testicles and epididymis.
• Abdominal Exam: A general abdominal examination may also be performed to rule out associated gastrointestinal or urinary tract issues.

3. Diagnostic Tests:

• Ultrasound: A scrotal ultrasound is often used to visualize the testicles and surrounding structures. It can help assess for swelling, abscesses, or fluid collection and to differentiate between orchitis and other conditions like testicular torsion or tumors.
• Blood Tests: Blood tests can help identify signs of infection or inflammation. This includes:
• Complete Blood Count (CBC): May show elevated white blood cell counts, indicating infection.
• Serology Tests for Viruses: Blood tests may be conducted to detect viruses (e.g., mumps) or other pathogens.
• Urine Tests:
• Urinalysis: A urine sample may be collected to check for signs of infection or the presence of blood or protein.
• Urine Culture: If a urinary tract infection is suspected, a culture may be done to identify the causative organism.
• Sexually Transmitted Infection (STI) Testing: If STIs are suspected as a cause of orchitis, specific tests may be performed for pathogens like Chlamydia and Gonorrhea.
• Swabs: If there is discharge from the urethra, a swab may be taken for culture and sensitivity testing.

4. Differential Diagnosis:

The physician will also consider other conditions that might present with similar symptoms, such as:

• Epididymitis (inflammation of the epididymis)
• Testicular torsion (twisting of the spermatic cord)
• Testicular tumors
• Hernias

Summary:

Diagnosing orchitis involves a systematic approach, starting with a detailed medical history and physical examination, followed by imaging studies like ultrasound and laboratory tests. All these steps help confirm the diagnosis, identify the underlying cause, and guide appropriate treatment. If you suspect orchitis or are experiencing relevant symptoms, it is essential to consult a healthcare professional for evaluation and care.

What is the treatment for orchitis?

The treatment for orchitis depends on the underlying cause, whether it is viral or bacterial, and the severity of the symptoms. Here’s an overview of the treatment strategies for orchitis:

1. Bacterial Orchitis:

• Antibiotics: If orchitis is caused by a bacterial infection, appropriate antibiotics will be prescribed. The choice of antibiotic depends on the causative bacteria, which may be determined through cultures.
• Supportive Care: Along with antibiotics, supportive measures such as rest, scrotal elevation, and applying ice packs can help alleviate pain and swelling.

2. Viral Orchitis:

• Symptomatic Treatment: There is no specific antiviral treatment for viral orchitis (e.g., caused by the mumps virus). Treatment typically focuses on relieving symptoms:
• Pain Relief: Over-the-counter pain medications such as ibuprofen or acetaminophen can help reduce pain and inflammation.
• Rest and Support: Resting and supporting the scrotum with an athletic supporter can help minimize discomfort.
• Ice Therapy: Applying ice packs to the affected area for 15-20 minutes at a time can help reduce swelling and relieve pain.

3. Non-Infectious Orchitis:

• Anti-inflammatory Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) can help manage inflammation and pain.
• Treatment of Underlying Conditions: If orchitis is due to another condition (e.g., traumatic injury or autoimmune disorders), appropriate treatment for that condition will be necessary.

4. Follow-up Care:

• Monitoring Symptoms: Patients should be advised to follow up with their healthcare provider if symptoms do not improve, if they worsen, or if new symptoms appear.
• Post-recovery Precautions: In cases related to STIs, patients might be advised regarding safe sexual practices and the importance of informing sexual partners.

5. Surgical Considerations:

In rare cases, if complications arise, such as abscess formation or severe persistent symptoms due to an underlying condition, surgical intervention may be necessary.

Summary:

While the treatment of orchitis is tailored to the underlying cause (bacterial, viral, or non-infectious), the emphasis is usually on relieving symptoms and preventing complications. It’s essential for individuals experiencing symptoms of orchitis to seek medical attention for an accurate diagnosis and appropriate management.