Definition
Orchitis is a type of infection or inflammation that affects one or both testicles. Testicles or testicles are an important part of the male reproductive system. The function of this organ is to produce sperm and the hormone testosterone. The exact cause of some cases of orchitis remains unknown. Bacterial infections, including the sexually transmitted disease chlamydia and urinary tract infections, are the most common causes of orchitis. Mumps may sometimes cause orchitis.
Orchitis is commonly associated with epididymitis. The most common diagnosis in this condition is epididymo-orchitis. Orchitis can cause pain and have an impact on fertility, but effective treatment can help minimize the signs and symptoms. However, it typically takes weeks for the swelling in the testicles to subside completely.
Causes
Orchitis is commonly associated with other diseases. Orchitis often develops 4 to 6 days after the testicles become infected, whether with viruses or bacteria. Urinary tract infections and sexually transmitted diseases are common causes of orchitis. Sexually transmitted illnesses such as chlamydia, gonorrhea, and syphilis are common causes of orchitis. Escheria coli, Staphylococcus, and Streptococcus are three species of bacteria that frequently cause orchitis. Viral infections that induce orchitis include the mumps virus or paramyxovirus, smallpox or varicella, cytomegalovirus (CMV), hand, foot, and mouth disease (coxsackie virus), and rubella.
Risk Factor
Orchitis is a risk at any age. However, the incidence of orchitis increases in patients with the following conditions:
- Autoimmune conditions
- The obstruction of the bladder, such as those with Benign Prostate Hyperplasia
- Foley catheter users
- Have multiple sexual partners and engage in casual sex
- Previous history of epididymitis
- Having a partner with a history of sexually transmitted diseases
- History of sexually transmitted infections.
- Not vaccinated against MMR (measles, mumps, rubella)
Symptoms
Symptoms of orchitis are:
- Swelling in one or both testicles
- Mild to severe pain
- Fever
- Nausea and vomiting
- Muscle pain
- Blood in the semen
- Groin pain
- Heart pounding
- Fluid leaking from the penis
- Pain during sexual activity, ejaculation, or urination
Diagnosis
The doctor will conduct a question-and-answer session in which he or she will inquire about the patient's primary complaint, any accompanied complaints, vaccination history, sexual behavior, history of previous diseases, and family history of disease.
The doctor will then perform a physical examination, which will include an assessment of the patient's general health as well as vital indicators such as blood pressure, breathing rate, pulse, and body temperature. The doctor will then perform a local examination, focusing on the testicles and groin. If the patient has a history of sexually transmitted infections, the doctor will inspect and touch the testicles gently to look for changes in shape, swelling, pain, and temperature changes caused by inflammation, as well as do an evaluation for sexually transmitted infections. The examination will be conducted hygienically and with the patient's agreement first.
Aside from these examinations, the doctor will recommend several further tests. Supporting examinations that can help confirm the diagnosis of orchitis include:
- Blood tests: Blood laboratory tests may be used to detect bacterial or viral infection
- Venereal disease examination: If the patient has a history of changing sexual partners or is prone to sexually transmitted infections, the doctor will collect genital fluid samples
- Urinalysis examination: This test seeks to take a urine sample and look for bacteria in the urine to determine if there is a risk of a urinary tract infection
- Ultrasound examination: The doctor may order an ultrasound to determine if there is an increase or reduction in blood flow to the testicles
Management
There are two types of treatment: home-based treatment and medical treatment.
Patients can manage their symptoms at home, beginning by compressing the testicles with ice or cold water to relieve pain and swelling. Patients may also use testicular guards similar to those worn by athletes to protect them from harm. Aside from that, taking medicines like paracetamol can help relieve pain briefly. Patients should also use a condom during sexual intercourse.
Meanwhile, medical treatment is based on the cause of orchitis. If bacteria cause orchitis, the doctor will prescribe antibiotics to the patient, who will take them under the care of a doctor. If the cause of orchitis is a sexually transmitted disease, the doctor may additionally prescribe several medications for the patient and partner to help avoid recurrence and severity of the disease.
Recovery from viral orchitis infections often takes 3 to 10 days until completely recovered. The doctor will prescribe a number of nonsteroidal anti-inflammatory medicines (NSAIDs). Viral orchitis does not always require antiviral medicine; the most important thing is to get enough rest and live a healthy lifestyle so that the body can fight the virus effectively and the orchitis will recover much faster.
Complications
Despite the fact that orchitis rarely results in serious complications, the following issues can occur:
- Testicular atrophy: Orchitis can cause the testicles to gradually diminish, a disease known as testicular atrophy
- Scrotal abscess: An untreated infection can worsen the tissue surrounding the testicles, resulting in a pus-filled mass on the testicles
- Male infertility: Although extremely rare, orchitis can impair fertility due to insufficient testosterone production. This is quite rare, especially if the orchitis affects only one testicle
Prevention
To prevent orchitis, you can take the following steps:
- Avoid risky sexual behaviors, such as changing sexual partners
- Use condoms to lower the risk of acquiring a sexually transmitted infection
- Ensure that you have received the MR/MMR immunization
- If you are more than 50 years old, have your prostate health evaluated
- Maintain a healthy lifestyle by not smoking
- Consume a well-balanced diet to keep the body's immune system healthy and invulnerable to viruses and bacteria
When to See a Doctor?
If you have redness, heat, swelling, pain, or discharge from your penis, see a doctor immediately to get it examined out. You can take this complaint to a urologist. Similar complaints could indicate the presence of an emergency condition known as testicular torsion. Early therapy will result in better results and prevent complications.
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- dr. Alvidiani Agustina Damanik
Cleveland Clinic - Orchitis. (2021). Retrieved 29 August 2022, from https://my.clevelandclinic.org/health/diseases/21658-orchitis
Azmat CE., Vaitla P., (2022). Orchitis. Retrieved 29 August 2022, from https://www.ncbi.nlm.nih.gov/books/NBK553165/
Mayo Clinic - Orchitis. (2020). Retrieved 29 August 2022, from https://www.mayoclinic.org/diseases-conditions/orchitis/symptoms-causes/syc-20375860