Orchitis
Epididymo - orchitis; Testis infection
Orchitis is swelling (inflammation) of one or both of the testicles .
Testicles
The testes are 2 egg-shaped male reproductive organs located in the scrotum. They produce sperm and the male hormone, testosterone.
Causes
Orchitis may be caused by an infection. Many types of bacteria and viruses can cause this condition.
The most common virus that causes orchitis is mumps . It most often occurs in boys after puberty. Orchitis most often develops 4 to 6 days after the mumps begins. Mumps is now rare in the United States due to childhood vaccinations.
Mumps
Mumps is a contagious disease that leads to painful swelling of the salivary glands. The salivary glands produce saliva, a liquid that moistens food...
Orchitis may also occur along with infections of the prostate or epididymis.
Orchitis may be caused by a sexually transmitted infection (STI) such as gonorrhea or chlamydia . The rate of sexually transmitted orchitis or epididymitis is higher in men ages 19 to 35.
Gonorrhea
Gonorrhea is a common sexually transmitted infection (STI).
Chlamydia
Chlamydia is an infection. It is caused by the bacteria Chlamydia trachomatis. It is most often spread through sexual contact.
Risk factors for sexually transmitted orchitis include:
- High-risk sexual behaviors
- Multiple sexual partners
- Personal history of gonorrhea or another STI
- Sexual partner with a diagnosed STI
Risk factors for orchitis not due to an STI include:
- Being older than age 45
-
Long-term use of a
Foley catheter
Foley catheter
A urinary catheter is a tube placed in the body to drain and collect urine from the bladder.
- Not being vaccinated against the mumps
- Problems of the urinary tract that were present at birth (congenital)
-
Repeated
urinary tract infections
Urinary tract infections
A urinary tract infection, or UTI, is an infection of the urinary tract. The infection can occur at different points in the urinary tract, including...
- Surgery of the urinary tract (genitourinary surgery)
Symptoms
Symptoms include:
-
Pain in the testicle
Pain in the testicle
Testicle pain is discomfort in one or both testicles. The pain can spread into the lower abdomen.
- Blood in the semen
- Discharge from penis
-
Fever
Fever
Fever is the temporary increase in the body's temperature in response to a disease or illness. A child has a fever when the temperature is at or abov...
-
Groin pain
Groin pain
Groin pain refers to discomfort in the area where the abdomen ends and the legs begin. This article focuses on groin pain in men. The terms "groin"...
- Pain with intercourse or ejaculation
-
Pain with urination
(dysuria)
Pain with urination
Painful urination is any pain, discomfort, or burning sensation when passing urine.
-
Scrotal swelling
Scrotal swelling
Scrotal swelling is abnormal enlargement of the scrotum. This is the name for the sac surrounding the testicles.
- Tender, swollen groin area on affected side
- Tender, swollen, heavy feeling in the testicle
Exams and Tests
A physical exam may show:
- Enlarged or tender prostate gland
-
Tender and
enlarged lymph nodes
in the groin (inguinal) area on the affected side
Enlarged lymph nodes
Lymph nodes are present throughout your body. They are an important part of your immune system. Lymph nodes help your body recognize and fight germ...
- Tender and enlarged testicle on the affected side
Tests may include:
-
Complete blood count (
CBC
)
CBC
A complete blood count (CBC) test measures the following:The number of red blood cells (RBC count)The number of white blood cells (WBC count)The tota...
-
Testicular ultrasound
Testicular ultrasound
Scrotal ultrasound is an imaging test that looks at the scrotum. It is the flesh-covered sac that hangs between the legs at the base of the penis an...
- Tests to screen for chlamydia and gonorrhea (urethral smear)
-
Urinalysis
Urinalysis
Urinalysis is the physical, chemical, and microscopic examination of urine. It involves a number of tests to detect and measure various compounds th...
-
Urine culture (clean catch)
-- may need several samples, including initial stream, midstream, and after prostate massage
Urine culture (clean catch)
A urine culture is a lab test to check for bacteria or other germs in a urine sample. It can be used to check for a urinary tract infection in adults...
Treatment
Treatment may include:
- Antibiotics, if the infection is caused by bacteria. (In the case of gonorrhea or chlamydia, sexual partners must also be treated.)
- Anti-inflammatory medicines
- Pain medicines
- Bed rest with the scrotum elevated and ice packs applied to the area
Outlook (Prognosis)
Getting the right diagnosis and treatment for orchitis caused by bacteria can most often allow the testicle to recover normally.
You will need further testing to rule out testicular cancer if the testicle does not completely return to normal after treatment.
Mumps orchitis cannot be treated, and the outcome can vary. Men who have had mumps orchitis can become sterile.
Possible Complications
Some boys who get orchitis caused by mumps will have shrinking of the testicles (testicular atrophy).
Orchitis may also cause infertility.
Other potential complications include:
- Chronic epididymitis
- Death of testicle tissue (testicular infarction)
-
Fistula
on the skin of the scrotum (cutaneous scrotal fistula)
Fistula
A fistula is an abnormal connection between 2 body parts, such as an organ or blood vessel and another structure. Fistulas are usually the result of...
-
Scrotal
abscess
Abscess
An abscess is a collection of pus in any part of the body. In most cases, the area around an abscess is swollen and inflamed.
Acute pain in the scrotum or testicles can be caused by twisting of the testicular blood vessels (torsion). This is a medical emergency that requires immediate surgery.
Acute
Acute means sudden or severe. Acute symptoms appear, change, or worsen rapidly. It is the opposite of chronic.
A swollen testicle with little or no pain may be a sign of testicular cancer. If this is the case, you should have a testicular ultrasound.
When to Contact a Medical Professional
See your health care provider for an exam if you have testicle problems.
Get emergency medical help if you have sudden pain in the testicle.
Prevention
Things you can do to prevent the problem include:
- Get vaccinated against mumps.
- Practice safer sex behaviors to decrease your risk of STIs.
References
Mason WH. Mumps. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics . 19th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 240.
McGowan CC, Krieger J. Prostatitis, epididymitis, and orchitis. In: Bennett JE, ed . Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases . 8th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2015:chap 112.
Nickel JC. Prostatitis and related conditions, orchitis, and epididymitis. In: Wein AJ, ed. Campbell-Walsh Urology . 10th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 11.
-
Male reproductive anatomy - illustration
The male reproductive structures include the penis, the scrotum, the seminal vesicles and the prostate.
Male reproductive anatomy
illustration
-
Male reproductive system - illustration
The male reproductive system, viewed from a sagittal section.
Male reproductive system
illustration
-
Male reproductive anatomy - illustration
The male reproductive structures include the penis, the scrotum, the seminal vesicles and the prostate.
Male reproductive anatomy
illustration
-
Male reproductive system - illustration
The male reproductive system, viewed from a sagittal section.
Male reproductive system
illustration
Review Date: 1/21/2015
Reviewed By: Scott Miller, MD, urologist in private practice in Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.