Orchitis: What Is It, Causes, Symptoms & Treatment

Orchitis or the inflammation of one or both testicles is a serious condition. If left untreated, it can lead to shrinkage of testicles and even infertility in men. As such, orchitis must be treated at the earliest and with proper care.

This article explores everything you need to know about orchitis, including its symptoms, treatment plan, diagnostic tests, and more.

Orchitis Meaning

Orchitis is a medical condition in which one or both testicles are swollen and inflamed. This usually happens due to an infection by a bacterium or a virus. In some cases, the exact cause of orchitis can't be determined with accuracy.

A man can suffer from orchitis due to the spread of bacteria through the bloodstream from other parts of the body. The condition can also be caused by epididymitis, an infection of the tube that acts as the carrier of semen from the testicles. This condition is called epididymo-orchitis. The treatment for this disease is a two-step process that involves diagnosis and orchitis medication.

Orchitis Causes

As mentioned earlier, orchitis can be of two types. The causes for each of these are described below:

• 1. Causes of Bacterial Orchitis Bacterial orchitis can be caused by various bacteria, including Escherichia coli, Streptococcus, and Staphylococcus. Prostate infection may appear in combination with orchitis. In several cases, epididymitis also becomes one of the bacterial orchitis causes. Epididymitis is the condition in which the epididymis or the long, coiled tube located at the back of the testicles becomes swollen, inflamed, and painful. This tube is responsible for carrying sperm from the testicles.   
  Bacteria that are responsible for causing sexually transmitted diseases (STD), such as syphilis, chlamydia, and gonorrhea, can become the reason for orchitis in sexually active men.
• 2. Causes of Viral Orchitis The most common cause of viral orchitis is the virus that causes mumps. Almost one-third of the adolescent boys who suffer from mumps after puberty can also get orchitis. The condition develops about four to seven days after the mumps infection sets in. In many such cases, orchitis leads to the development of testicular atrophy. Testicular atrophy is the condition in which shrinkage of the testicles takes place along with a loss of functions.

Symptoms of Orchitis

There are several orchitis symptoms. In most cases, the signs and symptoms of this medical condition develop suddenly. Sudden pain in one or both the testicles that may spread to the groin is the primary identifying symptom of this condition.

Other common orchitis signs and symptoms include the following:

• One or both the testicles appear swollen and tender, along with redness
• Visible swelling of the inguinal lymph nodes in the groin
• There appears to be a heavy feeling in the inflamed or swollen testicle
• Painful ejaculation and presence of blood in ejaculatory output or semen, which is known as hematospermia
• Painful urination and presence of blood in the urine, which is known as hematuria
• Nausea and vomiting
• High fever
• Painful bowel movement
• Pain during intercourse
• Enlarged prostate

In the case of epididymo-orchitis, the signs and symptoms are similar. The onset of symptoms may occur rapidly, or the progression may be more gradual, marked by the following:

• There may appear pain or swelling in a localised area of the testicle for one or more days
• The infection increases to impact the whole testicle
• There may be pain or a burning sensation before or after urination or even during penile discharge

Orchitis requires proper medical care. If you suspect that you are suffering from this condition, make sure to consult a doctor immediately.

Orchitis Diagnosis and Testing

There are several diagnostic tests that are performed to confirm the diagnosis of orchitis. The standard procedure for diagnosing orchitis includes a thorough rundown of your medical history and the following tests:

• Physical examination: Your doctor may perform your physical examination to examine the severity of the infection. They might insert a finger into your rectum to physically examine your prostate to check whether it is inflamed or not.
• Ultrasound: An ultrasound of the inflamed testicle is done to determine whether the inflammation and pain are due to orchitis or any other medical condition. It can rule out testicular torsion.
• Rectal examination: A rectal examination is done to determine if there is any prostate infection. This is an essential part of orchitis treatment guidelines because if the infection involves the prostate, the antibiotic treatment will have to continue for a long duration of time.
• Urinalysis or urine test: A urine sample is tested to check for STD's or other bacteria that may be the cause behind the infection.
• Blood test: A blood test is done to test for syphilis and HIV if there is any suspicion of a sexually transmitted disease.

Since the symptoms of orchitis resemble symptoms of other conditions like testicular torsion, it is extremely important for your doctor to perform a differential diagnosis and exclude the possibility of other conditions with similar symptoms.

Orchitis Treatment Options

Yet, doctors haven’t found a cure for orchitis, but the infection usually goes away on its own. But treatment in most cases of orchitis requires administering antibiotics along with anti-inflammatory medications and cold packs. Complete recovery from orchitis may take several weeks, regardless of the cause of inflammation.

Antibiotics for orchitis are taken for about 10-14 days orally and meant to help with the bacterial infection that causes orchitis; however, they are rendered ineffective in case your orchitis infection was caused due to a virus. Thus, supportive care is used to supplement the orchitis treatment antibiotics and help with your recovery. Ice packs, rest, and pain relievers play an important role in the recovery from an orchitis infection.

In most cases, doctors advise patients suffering from this condition against indulging in sexual intercourse and lifting heavy objects while they are taking orchitis medicines and recovering from the infection.

Generally, full recovery from orchitis is possible if the treatment starts before the condition reaches an extreme stage. The doctor may also ask the patient to undergo a re-evaluation at the end of the treatment to be sure that you have healed completely and there is no possibility of the infection to return.

You are recommended to do the following to aid your recovery process:

• Application of ice packs and a heating pad in alternate sequence
• Give your body proper rest
• Take medicine for orchitis recommended by your doctor according to the instructions
• Wear supportive underwear or a jockstrap to support the scrotal area and restrict unnecessary movement

Orchitis Prevention and Risk Factors

Prevention of orchitis is not possible in some cases; for example, if you have congenital urinary tract problems. However, there are a few things you can do to lower your chance of getting an orchitis infection. Getting the vaccination for mumps and engaging in protected sexual intercourse can help in preventing orchitis. Additionally, seeking treatment for urethral stricture or benign prostatic hyperplasia (BPH) is also helpful in preventing this disease.

There are several factors that can lead to orchitis. For example, a male with many sexual partners, engaging in unprotected sex or having sex with a partner suffering from STI or with a history of STI is at high risk of contracting bacterial orchitis. A person may also be at the risk of developing non-sexually transmitted orchitis if he hadn't had proper immunisation against mumps.

Bacterial or viral infections aren't the only things that can cause the condition. The risk for orchitis also increases if a person is born with congenital urinary tract abnormalities. A person who has undergone surgery that involves the urinary tract or the genitals, or has a catheter placed into the bladder frequently also has a high risk of developing orchitis.

Possible Complications of Orchitis

Generally, men who have orchitis recover completely with no lasting effects from the condition. Orchitis rarely causes complications, but the following can occur in some cases:

• Chronic inflammation of the epididymis
• Testicular atrophy or shrinking of the affected testicle
• Necrosis or death of the testicular tissue
• A blister or abscess within the scrotum
• Infertility

FAQs About Orchitis

Q. What is the relation between orchitis and infertility?

A. Orchitis can cause infertility or lead to inadequate production of testosterone (hypogonadism) in some cases. Thus, it is important to consult your doctor if you notice any of the orchitis symptoms. However, orchitis usually doesn’t lead to infertility or hypogonadism if it affects only one testicle.

Q. Is infertility caused by orchitis reversible?

A. If you get right medical attention early on before orchitis causes irreversible damage to spermatogenesis and a decline in the ejaculate quality, you can expect to get decent results from a fertility treatment.

Q. What is the difference between orchitis and testicular torsion?

A. Orchitis is caused by a bacterial or viral infection, whereas testicular torsion occurs when the testicle rotates on the spermatic cord. The symptoms of these two conditions can appear to be similar, but the cause and treatment plan are quite different. However, both these conditions can cause infertility if left untreated.