Orchitis

Orchitis is an inflammation of one or both testicles, most often associated with the virus that causes mumps. About 1/3 of men who contract mumps after puberty also develop this disease.

Other possible causes are bacterial infections such as the sexually transmitted diseases gonorrhea or chlamydia. The bacterial form of the disease is often the result of epididymitis, which is an inflammation of the epididymis, where sperm are stored. In such a case, the disease is referred to as epididymo-orchitis.

What are the symptoms?

The manifestations of the disease most often appear suddenly and are most often:

• Swelling of one or both testicles;
• Pain, which in different cases varies from very strong to milder;
• Discomfort in sitting;
• Tenderness of one or both testicles that may last for weeks;
• Nausea and increased body temperature;
• Unusual discharge from the penis;

The terms testicular pain and groin pain are sometimes used interchangeably. But groin pain is located in the skinfold of the thigh and abdomen, not the testicle, and the causes of the two conditions are different.

What are the causes?

The disease is most often caused by a bacterial or viral infection.
Most often, the bacterial form of the clinical condition results from epididymitis – inflammation of the coiled tube that connects the vas deferens and the testicle. The vas deferens carries the sperm out of the testicles during ejaculation.

Other causes of infection may be congenital abnormalities of the urinary tract or from the placement of a catheter or other medical instruments that are inserted into the penis.

The viral form of the disease is a result of the mumps virus. Inflammation of the testicles usually about 4-7 days after the initial symptoms of mumps appear.

What are the risk factors?

• Non-immunization against mumps;
• Recurrent urinary tract infections;
• Surgical intervention involving the genitals and urinary tract, due to the increased risk of infection;
• Congenital anomaly of the urinary tract;
High risky sexual behavior, due to which it is possible to contract a sexually transmitted disease, also increases the risk of inflammation of the testicles. Such risky behaviors are:
• Multiple sexual partners;
• Sex with a partner who has sexually transmitted diseases;
• Sex without a condom;
• History of sexually transmitted diseases;

Treatment of orchitis

The method of treatment depends on the cause of inflammation of the testicles. In addition to supportive care, which includes rest and ice to relieve pain, bacterial infection and epididymo-orchitis require antibiotic treatment. If the cause of the infection is a sexually transmitted disease, your sexual partner must also need treatment.

The antibiotics most commonly used are ceftriaxone, ciprofloxacin, doxycycline, azithromycin, trimethoprim and combined sulfamethoxazole. Tell your doctor about all other medicines you are taking and possibly if you are allergic to certain medications. This information, as well as whether the infection is sexually transmitted, will help your doctor prescribe the most appropriate therapy for you.

Remember to take the antibiotics as prescribed. Even if symptoms resolve early, do not stop treatment prematurely to ensure that the infection is completely cured. It may take several weeks for the tenderness in your testicles to go away.

For viral orchitis, treatment is aimed at relieving symptoms. Your doctor may prescribe pain relievers such as ibuprofen or naproxen, as well as recommend bed rest with the scrotum elevated and the application of cold compresses.

If you have viral orchitis you will start to feel better in about 3 to 10 days, although it may take a few weeks after that for the scrotal tenderness to go away.