Orchitis is the medical term for testicular inflammation. Orchids are viral or bacterial infections of the testes. Viral testicular inflammation occurs especially in boys. Bacterial inflammation of the testicles, however, are especially common in men.
Regardless of the cause are the extremely unpleasant symptoms: In a testicle inflammation swell one or both testicles strongly. Even the slightest touch or movement causes severe pain. In the case of a complicated course, the testes may even die or be damaged so severely that the fertility is endangered.
Bacterial testicular inflammation usually occurs in combination with epididymitis. Detailed information on this disease can be read here: Epididymitis. Viral testicular inflammation in boys is usually the result of a mumps infection. But there are other infectious diseases as a cause in question (see Causes).
Bacterial testicular inflammation is treated with antibiotics. The treatment of viral orchitis, on the other hand, must be limited to relieving pain and fighting inflammation.
The best protection against testicular inflammation is provided by vaccinations (for example against mumps) and the use of condoms during sexual intercourse (see Prevention).
Exact numbers about the frequency of orchids do not exist.
Testicular inflammations in boys are considered very rare. Painful testicular swelling in children is usually caused by a testicular torsion (twisting of the testicles).
When men get mumps after puberty, up to 30 percent develop testicular inflammation. In about one third of these cases, both testicles are inflamed.
In testicular inflammation, one or both testicles swell rapidly. The testicular swelling is associated with severe pain. The testes are extremely sensitive to pressure. As a rule, the scrotum is clearly reddened and shiny. Traces of blood in the urine or seminal fluid are other symptoms of orchitis. In addition, there is often pain when urinating or even urinary retention.
In addition to these specific symptoms of testicular inflammation, general symptoms such as a marked malaise with fever, chills, fatigue and body aches may occur.
In viral testicular inflammation, the symptoms usually begin 4 to 5 days after the onset of the underlying disease. The same applies after bacterial urinary tract infections. Testicular inflammations also occur without previous diseases and as a result of autoimmune diseases (see Causes).
Probably the most dreaded consequence of testicular inflammation is impaired fertility. These occur especially when it comes to complications in the course of the disease.
Complications of testicular inflammation are rare. Sometimes an orchitis attacks the epididymis. In general, however, it is the other way around: epididymitis is a common cause of orchitis.
In the course of bacterial scrotum inflammation (especially as a result of sexually transmitted diseases such as syphilis and gonorrhea), it rarely occurs in the testicular envelopes to form pus encapsulations (abscesses). These abscesses press the swollen testicles, increasing the risk of testicular tissue dying. As a result, it can also lead to a reduction of the gonads (testicular atrophy). And that in turn can permanently affect fertility. This is even more so if both testes are affected by the testicle inflammation.
A correlation between testicular inflammation and an increased risk of testicular cancer has not been proven so far.
Testicular inflammation is caused by infections. The cause of the infection are viruses or bacteria, rarely also fungi and parasites (for example, plasmodia as a trigger of malaria). Secondary epithelial infections are most commonly transmitted to the testicles. For detailed information on this disease read the guide on epididymitis.
Cause of viral testicular inflammation
In most cases, simple testicular inflammation is caused by mumps viruses. This applies to both boys and men. But other viral infections come into consideration. These are mainly flu (influenza virus), glandular fever (Epstein-Barr virus) or chicken pox and shingles (varicella virus).
Cause of bacterial scrotum inflammation
Bacterial inflammations of the testicles are usually caused by bacteria, which ascend through the urinary tract to the testes. This applies, for example, to the bacterial pathogens of urethritis (prostatitis) or prostate inflammation. Another major cause is sexually transmitted diseases such as syphilis or gonorrhea (gonorrhea).
In children, the causes of scarlet fever (A-streptococci) and pneumococci or salmonella are sometimes the cause of testicular inflammation.
Pathogens are not always responsible for orchitis. The non-infectious causes of testicular inflammation include injuries, bruises and accidents (traumatic orchitis) and an excessive immune system (autoimmune orchitis). In rare cases no cause is found. Physicians then speak of idiopathic orchitis.
The diagnosis of testicular inflammation is made by pediatricians or urologists on the basis of visible and palpable swellings and pain.
A positive Prehn sign can corroborate the suspected diagnosis. The patient lies relaxed on the examination table and the doctor raises the affected testicles. If the pain decreases when the testicle is raised, the Prehn sign is positive. It is most likely a testicular or epididymitis. If the pain increases or does not change when the testicle is raised, the Prehn sign is negative. A negative Prehn sign indicates a testicular torsion.
Reliable digestion usually brings an ultrasound examination. Sonography (usually color Doppler sonography) can be used to detect testicular inflammation and at the same time rule out testicular torsion as the cause of the symptoms. Blood and urine tests are mainly used to determine bacterial pathogens.
Viral-related testicular inflammation can not be causally treated with medication. There are no drugs that could effectively fight the triggering viruses. In bacterial orchitis, however, a causal therapy with antibiotics is possible and useful. Depending on the type of bacterium, a variety of drugs come into consideration. Frequently, however, broadband antibiotics such as ceftriaxone and doxycycline are also used without determining the pathogens.
Testicular inflammations usually resolve within 7 to 8 days. Especially in the first few days, the treatment aims to relieve the symptoms. Simple anti-inflammatory drugs with diclofenac or ibuprofen help. In cases of pronounced inflammation, meloxicam and phenylbutazone are also considered. Painkillers like acetaminophen and metamizole can complement the symptomatic therapy.
Above all, it is important to protect and protect the extremely pressure-sensitive testicles. In order to store the testicles high, there are suspensions in the sanitary trade. Many men also find it very pain-relieving to cool the genital area. Ice packs should never be placed directly on the skin, but wrapped in a cloth. In the first few days, bed rest may be useful for severe testicular inflammation, especially fever and chills.
In very rare cases, such as large abscesses, surgery can not be avoided.
Overall, the chances of recovery after a testicular inflammation are very good. In most cases, orchids are over within a week. The complication rate with limitations or loss of fertility is - apart from the mumps orchitis - very low. But if it comes to a testicular atrophy, that is irreversible.
The most common causes of testicular inflammation are easy to prevent. The biggest benefit is the mumps vaccination. It reliably protects both boys and men from one of the most common viral agents of the testicle inflammation, the mumps virus.
Sexually active men can use condoms to protect themselves effectively from urinary tract infections and sexually transmitted diseases such as gonorrhea (gonorrhea) or syphilis (syphilis) - thus significantly reducing the risk of testicular inflammation.
Finally, the prevention of prostate inflammation contributes to the protection against orchitis. Therefore, men should be examined at the latest from the 40th Age of the prostate every 2 to 3 years.