What Is Orchitis?

Orchitis is usually caused by bacteria and viruses. Bacterial infections rarely occur in the testes themselves. Because the testes have a rich supply of blood and lymph fluid, they are more resistant to bacterial infections. Bacterial orchitis is mostly caused by inflammation of the adjacent epididymis, so it is also called epididymis-orchitis. Common pathogenic bacteria are Staphylococcus, Streptococcus, E. coli and so on. The virus can directly invade the testes, the most common being mumps virus, which mainly invades children's parotid glands. However, this virus also invades the testes, so viral orchitis often occurs shortly after the onset of mumps.

Basic Information

English name: orchitis
Visiting department: Urology

Common causes: Infection, trauma, tumor, etc.
Common symptoms: High fever, chills, testicular pain, swelling, radiation pain, tenderness
Contagious: no

Causes of orchitis

Orchitis is a common disease in andrology. It is mainly divided into two types: acute suppurative orchitis and mumps orchitis. Among them, acute suppurative orchitis is most common. There are many causes of orchitis, such as infections, trauma, and tumors.

Orchitis classification

Chronic nonspecific orchitis

Chronic orchitis is usually caused by incomplete treatment of non-specific acute orchitis, and can also be caused by mold, spirochaete, and parasitic infections, such as testicular syphilis. Patients with previous testicular trauma may develop granulomatous orchitis. Testicular local or systemic radioisotope phosphorus exposure can also cause testicular inflammation and damage testicular tissue.

2. Acute nonspecific orchitis

Acute nonspecific orchitis usually occurs in patients with urethritis, cystitis, prostatitis, prostatic hyperplasia, and long-term indwelling catheters. The infection spreads to the epididymis via lymph or vas deferens, causing epididymis orchitis. Common pathogenic bacteria are E. coli, Proteus, Staphylococcus and Pseudomonas aeruginosa. Bacteria can spread to the testes through blood, causing simple orchitis. However, the testis is rich in blood flow and has strong resistance to infection, so this situation is rare.

3. Acute mumps orchitis

Mumps is the most common cause of orchitis. About 20% of patients with mumps have orchitis, which is more common in late adolescence. The naked eye can see that the testicles are highly enlarged and purple-blue.

Orchiditis clinical manifestations

1. High fever and chills.

2. Testicular pain and radiating pain in the scrotum, thigh roots and groin area.

3. Swelling and tenderness of the affected testicles, and if there is suppuration, palpation has a fluctuating feeling of pus.

4. Often accompanied by scrotal skin swelling and scrotal effusion.

5. Viral orchitis occurs in children, and parotid enlargement and pain are sometimes seen.

Orchitis test

Testicular self-examination

Relax the scrotum so that you can feel lumps and abnormalities. During the test, stand on both feet and feel for lumps or other abnormalities. Normal testes are oval in shape, with a smooth surface and medium hardness.

2. Local inspection

After bilateral scrotal masses, benign and malignant lesions can be roughly distinguished. After a testicular tumor is suspected, a local biopsy of the testicular tumor should not be performed, as it is more likely to cause tumor metastasis. The diagnosis of testicular tumors depends on the pathological report after surgery.

3.B-ultrasound

It can more accurately determine the size, morphology, and presence of tumors in the testes. For patients with cryptorchidism, you can understand the testicular development and whether it is enlarged or malignant.

4. Blood test

Tumor markers human chorionic gonadotropin (HCG, normal value <5 micrograms / liter) and alpha-fetoprotein (normal AFP normal value <25 micrograms / liter) are more than normal and should be further examined.

5. Chest X-ray examination

Including fluoroscopy or chest radiography.

6.Computed tomography (CT) and magnetic resonance imaging (MRI)

It can be more accurate to know whether there is metastasis to the peritoneum, which is especially beneficial for patients who have not undergone cryptorchidism and may have malignant changes.

Orchitis complications

1. Inducing serious diseases, such as varicocele, static cord inflammation, prostatitis, endocrine diseases, kidney diseases such as nephritis, urinary infection diseases, malignant tumors, etc.

2. Lead to male sexual function decline, or even completely lose sexual function.

3. Lead to dead sperm, azoospermia, loss of fertility, and transmission of inflammatory germs to spouses, causing gynecological diseases.

4. Testicular disease is not cured for a long time.

Orchitis Treatment

Bacterial orchitis

Rest in bed, hold up the scrotum, and apply local heat. Swelling of the scrotum skin is obvious, apply 50% magnesium sulfate solution to heat and compress, in order to ease inflammation. When pain is severe, the effect of analgesics is not good, and it can be used to close the spermatic cord of the affected side. Systemic medication should be selected from broad-spectrum or gram-negative bacteria, such as penicillin, gentamicin, and various cephalosporins.

2. Chronic non-specific orchitis

Chronic orchitis on both sides can often cause infertility. Treatment is mainly aimed at the etiology of chronic orchitis.

3. Mumps orchitis

(1) Antibiotics are not effective for this disease, and symptomatic treatment is the main.

(2) The use of adrenal corticosteroids has a clear effect on patients during recovery.

(3) 1% lidocaine low spermatic cord closure can improve testicular blood flow and protect spermatogenesis.

(4) In addition to having a good curative effect on acute mumps orchitis, interferon also has a significant effect on preventing testicular atrophy.

4. Treatment of testicular pain

Symptomatic treatment should be performed on the basis of determining its cause. If the cause cannot be found for a while, symptomatic treatment of sedation and analgesia can be done. If necessary, procaine blocking therapy can be used.

Orchitis prevention

1. Middle-aged men should pay attention to their testicle maintenance. Testicular maintenance is an important means to solve men's sexual dysfunction.

2. If you feel pain during massage, it may be orchitis or epididymitis, please go to the hospital for examination in time.

3. Acute mumps and orchitis bilateral lesions can cause irreversible destruction of spermatogenic activity, and even testicular atrophy, which can cause male infertility.

4. Should eat more fresh vegetables and fruits, increase intake of vitamin C and other ingredients to improve the body's anti-inflammatory ability.

5. Avoid spicy food, smoking, drinking, sedentary, excessive sex, frequent masturbation, etc.