Symptoms of orchitis and the main forms of inflammatory disease

Orchitis is a disease of the genitourinary system, during which inflammation of the testicle occurs in men. The cause of its development may be infection, injury, or the transfer of the inflammatory process from other organs. As a rule, one testicle is affected (left-sided or right-sided orchitis); bilateral inflammation is rare. There are acute and chronic forms of the disease.

Types of pathology

Based on the course of the disease, there are:

• Acute orchitis lasts an average of 2-4 weeks.
• Chronic orchitis – lasts more than 4 weeks.
• Recurrent orchitis - occurs some time after recovery.

1. Granulomatous.
2. Traumatic.
3. Congestive orchitis

Causes

Doctors identify many causes of orchitis. The most common of them are:

• Infections that are specific and nonspecific. They can enter the testicle not only from organs located in the immediate vicinity, but also from distant ones. Often the disease occurs due to sexually transmitted infections entering the body. Specific infections include: syphilis, gonorrhea, typhus, tuberculosis, etc. Among nonspecific infections, one can distinguish: bacteria (staphylococcus, E. coli, etc.), viruses (influenza, measles, mumps, herpes, etc.) , fungi (candida, etc.) and urogenital infection (Trichomonas, chlamydia, etc.).
• Injury or other mechanical impact on the organ (impact, consequences of surgery, medical procedures).
• Stagnant processes in the pelvic area associated with poor circulation, prolonged sexual abstinence, the practice of coitus interruptus, etc.

Immunologist Ermakov Georgy Aleksandrovich will tell you about the causes of development, signs and consequences of the disease:

Risk factors for the development of pathology are:

1. Sedentary lifestyle and frequent sitting.
2. Too active or, conversely, irregular sex life.
3. Decreased body defenses or chronic fatigue syndrome.
4. Hypothermia or significant overheating of the genital area.

Normal and inflamed prostate with prostatitis

1. Impaired urine outflow (with adenoma, prostatitis, etc.).
2. The presence of chronic foci of infection in a man’s body (chronic bronchitis, sinusitis, etc.).
3. The presence of concomitant pathologies of the genitourinary system (cystitis, pyelonephritis, etc.).

Symptoms

Symptoms of orchitis depend on its form and the cause of the disease. Acute orchitis is characterized by the following symptoms:

• Increased body temperature.
• Acute pain in the area of ​​the affected testicle, which can radiate to the lower abdomen, back, sacrum or groin. It intensifies significantly when moving. Painful sensations are associated with the fact that the membrane of the organ, which contains many nerve endings, is stretched.
• The testicle significantly increases in size, becomes painful and tense.

• Tightness of the skin of the scrotum is noted. It becomes glossy and bright red.
• Symptoms of general intoxication of the body appear (headache, chills, nausea, muscle weakness).

If you do not start treatment for testicular inflammation in a man at this stage, then after 2 weeks, the symptoms will disappear on their own, but there is a risk of the disease becoming chronic and developing irreversible infertility.

Chronic orchitis is rare and usually results from an untreated acute process. The disease has the following manifestations:

1. Periodic aching pain that intensifies after hypothermia, high physical activity or long walking.
2. There is a slight enlargement and hardening of the testicle.
3. Fever and signs of intoxication are rare.

Urologist-andrologist Nikolai Konstantinovich Soloviev will talk about the symptoms of inflammation of the testicle and its appendages in men:

Due to the fact that inflammation of the testicles in men, which has become chronic, practically does not manifest itself in any way, many patients do not consult a doctor.

But at the same time, irreversible changes occur in the testes, as a result of which their secretory function suffers, which often leads to male infertility.

Diagnostics

Any urologist can diagnose testicular orchitis immediately after examination. But to find out why the inflammation occurred, additional examinations will be required:

• A blood and urine test will confirm the presence of inflammation and determine its severity.
• Bacterial urine analysis allows you to identify pathogens and assess their sensitivity to antibiotics.
• A smear from the urethra makes it possible to identify the causative agent of the infection and assess the nature of the inflammation.

Ultrasound of the scrotum. The picture shows a purulent focus in the left testicle

• A spermogram allows you to identify pathogens and assess the condition of sperm.
• Ultrasound shows the degree, shape and size of the inflammatory process, the presence of fluid and lesions.
• Magnetic resonance imaging helps not only to assess the development of the disease, but also to identify the smallest foci of infection.

Treatment

Your doctor will tell you how to treat orchitis after a comprehensive examination. The main therapy is aimed at eliminating the symptoms and the source of infection.

Conservative therapy

Treatment of orchitis involves:

1. Elimination of the main causes that led to the development of the disease. If tests show the presence of pathogenic microflora, then the patient is prescribed antibiotic treatment. For this purpose, broad-spectrum drugs are used. The results of bacteriological examination help to select them. Doctors usually recommend taking:

• Fluoroquinolones (“Ofloxacin”, “Ciprofloxacin”, etc.).
• Drugs of the tetracycline group (“Doxycilline”, “Metacycline”, etc.).
• Macrolides (“Sumamed”, “Erythromycin”, etc.).

• Cephalosporins (“Cefepime”, etc.).
• Nitrofurans (“Furungin”, etc.).
• Trimethoprim with sulfonamides (Biseptol, etc.).

1. Impact on the mechanisms of pathology. During the disease, inflammatory processes occur in the testicular tissues, the intensity of which increases over time and leads to damage to the organ. To eliminate them, the doctor will prescribe drugs that have an anti-inflammatory effect (Ibuprofen, Indomethacin, etc.).
2. Elimination of the main symptoms. Orchitis in a child or adult man is always accompanied by pain. To rid the patient of them, analgesics are used (Analgin, Ketoprofen, etc.). In some cases, novocaine blockade is necessary.

What means to treat the disease? Urologist Sergey Gennadievich Lenkin will tell you:

1. Creating the necessary conditions for the patient. Treatment of orchitis in the acute phase involves bed rest. The patient is recommended to use a suspensor - a special bandage that helps improve blood circulation in the appendage area. In order to reduce congestion, it is recommended to take angioprotectors. The doctor will advise you on the names of the medications. As a rule, Escusan, Agopurin, etc. are used for orchitis.
2. Additional treatment methods that reduce the intensity of the inflammatory process, activate local immunity, prevent the spread of infection and speed up recovery. Such methods include physiotherapy (UHF, mud baths, electrotherapy, etc.) and exercise therapy.

Treatment can be carried out at home. But if the patient’s temperature rises significantly and signs of intoxication appear, the doctor may decide to hospitalize the patient.

Surgery

In difficult cases, the patient needs surgical intervention. Indications for surgery are:

• Acute post-traumatic orchitis.
• Abscess (suppuration) of the testicle.
• Ineffectiveness of conservative therapy.
• A severe course of the pathology, which is accompanied by a significant deterioration in the patient’s condition.
• The presence of lumps in the testicle that cause acute pain and do not resolve after conservative therapy.
• Frequent exacerbations of the disease.
• Tuberculous nature of the disease.

There are several types of surgery:

1. Resection of the testicle with removal of part of it. This makes it possible to preserve the basic functions of the organ. Resection is performed under local anesthesia. The prognosis after surgery is favorable, but in some cases a re-exacerbation of the pathology is possible.
2. Orchiectomy (complete removal of the damaged testicle with epididymis). In case of severe purulent orchitis, such an operation is considered vital. This way the spread of infection can be avoided. It is performed under local anesthesia. The prognosis for the patient's life is favorable. However, in the case of bilateral orchitis and removal of two testicles, the man becomes infertile. At the same time, the process of synthesis of male sex hormones is disrupted.

Orchiectomy - surgery to remove a damaged testicle

1. Making notches. This intervention allows you to identify small foci of suppuration and get rid of them. The procedure has a diagnostic rather than a therapeutic effect.
2. Scrotal puncture can significantly reduce the number of operations that may become unnecessary. Through puncture it is possible to reduce pain and pressure in the scrotum area. Local anesthesia is used for the operation.

Traditional methods

Orchitis in men is a fairly serious disease, so in most cases the use of traditional methods of treatment is ineffective.

But supplementing the main (drug) treatment with them helps speed up the healing process. Before using any product, it is important to consult with your doctor.

This is especially true in cases where orchitis in children is to be treated.

For this purpose, lotions and infusions of medicinal herbs are used. Such remedies help relieve inflammation and swelling, speed up the process of tissue regeneration, strengthen local immunity and speed up the healing process.

Flax seed compress. Ground flax seed is boiled in boiling water for 10 minutes, filtered and placed in cheesecloth. After cooling, the product is applied to the diseased organ and kept there for at least 20 minutes. Repeat three times a day

Sex should be excluded for the entire period of treatment. If the cause of testicular inflammation is a sexually transmitted infection, then the partner also needs appropriate treatment.

Orchitis in a child

The disease can occur not only in an adult man, but also in a boy. In children, orchitis can become a complication of an infectious disease (ARVI, mumps, pneumonia, etc.) or result from injury. Symptoms, diagnosis and treatment of the disease are the same as in adults.

Consequences

This pathology is considered quite serious, therefore, when the first signs appear in a man or child, you should immediately consult a doctor. This is due to the fact that sometimes the disease can have unpleasant consequences:

• An incorrect approach to treatment or its absence can cause the development of chronic orchitis.
• Possible accumulation of fluid (hydroxy testis). Usually, after treatment of orchitis, dropsy goes away on its own.
• Epididymitis is inflammation of the epididymis in men. If the inflammatory process is not stopped in time, it will soon spread to the entire surface of the appendages. Therefore, it is believed that orchitis and epididymitis are always interrelated.

• Suppuration (abscess) of testicular tissue.
• Testicular atrophy (reduction in size).
• The development of infertility due to impaired secretory function, damage to the structures or pathways along which sperm move, or exposure to infectious factors on the organ.
• In rare cases, erectile function is impaired or libido is reduced.

Prevention

To prevent orchitis from occurring, it is important to avoid:

1. Hypothermia and overheating of the groin area.
2. Physical or psychological fatigue.
3. Promiscuity and unprotected sex.
4. Sexual excesses and the practice of coitus interruptus.
5. Sedentary lifestyle.
6. Bad habits and poor nutrition.
7. Injury to the scrotum.

It is necessary to use contraception to avoid infection in the body

Other preventive rules include:

• Timely treatment of any infectious diseases and inflammatory processes in the body.
• Elimination of any source of infection (sinusitis, proctitis, bronchitis, prostatitis, etc.).
• Sexual life should be regular, and sex with a casual partner should be protected.
• In the case of sexual abstinence, it is necessary to prevent the occurrence of congestive processes in the pelvic area (do yoga, exercise regularly, etc.).
• Lead a healthy and active lifestyle.
• When playing sports (hockey, football, martial arts, etc.), use protective equipment.
• Provide yourself with proper nutrition with sufficient amounts of protein, microelements and vitamins in your diet.

Orchitis is one of those diseases that do not pose a threat to the patient’s life. However, if left untreated, it can lead to unpleasant consequences for a man, including impaired potency and complete infertility. To prevent this, it is important to consult a doctor at the first sign of it.

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Source: https://VashUrolog.com/bolezni/orhit-simptomy-i-lechenie.html

Pathology of orchitis: symptoms and treatment

• Orchitis , the symptoms and treatment of which depend on the individual characteristics of the course, is a disease of the male genital organs with the presence of an inflammatory process in the testicles.
• It can occur as a result of an infectious disease or other factors: a passive lifestyle and bad habits.
• If therapy is incorrect or ignored, infertility occurs as a complication.
• For various reasons, the disease can occur in both older men and boys.
• It can occur in chronic and acute forms.

Causes of the disease

Several negative factors that are often found in modern life can lead to the appearance of orchitis in men.

These need to include:

• sedentary lifestyle;
• severe overwork;
• overheating or hypothermia;
• problems with regular sex life;
• chronic inflammatory processes in the body;
• presence of diabetes, hepatitis or AIDS;
• inflammation in the genitourinary system.

All this is only a small number of negative factors that can provoke the development of the disease.

Acute orchitis also occurs in newborn boys. This is due to the presence of viral diseases that have a negative effect on the reproductive system. For example, mumps or injury to the testicles can lead to the disease.

As for adults, orchitis in men appears after infectious diseases , especially if they were not treated properly.

Most often, the pathology is considered a consequence of the inflammatory process in the bladder. However, it can also occur due to diagnoses such as pneumonia, sinusitis or bronchitis.

Sexual intercourse can be one of the factors that can provoke testicular orchitis.

Both parts of the paired organ are most often affected only in mumps; usually on the 3rd or 10th day you can understand the degree of damage to the reproductive system. If a man suffered from the disease during puberty, then the likelihood of infertility is quite high. If the mumps has been treated properly, the threat is minimized.

In addition to mumps, the development of testicular inflammation can be influenced by diseases such as measles, influenza, and herpes. Pathology can be caused by stagnant processes, poor outflow of sperm and urine, as a result of which bacteria accumulate in the canals.

During diagnosis, a specialist often identifies a number of negative factors that could lead to inflammation of the testicles. With weak immunity and improper treatment, the disease can develop into a chronic disease.

Video: “Orchitis”

Symptoms and diagnosis

Acute orchitis is characterized by severe pain and elevated body temperature.

You need to pay attention to the pain syndrome, which is usually located in one of the testicles, and only intensifies with movement. The pain can radiate to the groin area, lower back, or sacrum. Sometimes it becomes unbearable and the person simply cannot move; with an increased sensitivity threshold, fainting is possible.

From the right or left testicle, depending on the location of the source of inflammation, the scrotum enlarges . Natural folds are smoothed out and acquire a glossy red color. If you ignore the symptoms, they will go away in about 14 days (sometimes they disappear completely after 30), and the disease develops into a chronic form.

But as the inflammatory process progresses, sooner or later an abscess of the left or right testicle occurs.

What is an abscess? This term refers to an inflammatory phenomenon in which suppuration is accompanied by skin hyperemia and acute pain on palpation. There is a decrease in sperm production, which leads to infertility.

Symptoms of chronic orchitis may be mild or not appear at all. It is noted that the recurrent form is accompanied by aching pain, which intensifies with changes in temperature, during active activities and physical impact. There is an increase and hardening of the testicle.

With chronic orchitis, symptoms can be expressed in elevated body temperature, constant discomfort in the genitals, dysfunction of the organ, which entails the inability to have children.

In most cases, a specialist can immediately diagnose testicular inflammation in men. To do this, he must conduct an examination and also ask a few questions to the patient. Taken together, these actions give a clear picture of the disease.

How to diagnose orchitis?

It is necessary to conduct a number of studies that will help determine the degree of the inflammatory process and establish the reason why it occurred.

Studies usually consist of:

• taking a blood test to identify the inflammatory process in the body;
• general urine test to detect bacteria;
• urethral smear;
• spermograms.

Sometimes it is necessary to additionally undergo an ultrasound examination of the genitals and bladder. It is also possible to conduct magnetic resonance imaging, which will assess the inflammatory process, identify foci of infection, and see the disease over time.

Video: “causes of orchitis and how to treat it”

Treatment

Treatment with folk remedies

Traditional medicine is famous for its recipes for male illness. With an accurate diagnosis, you can consult with a specialist about the use of ancient recipes. Most likely, he will advise using them as an addition to the main treatment. Traditional medicine methods can be quite effective if used correctly.

How to treat orchitis using alternative medicine?

So, there are a lot of recipes for oral and external use. Traditional medicine refers to the use of various tinctures, decoctions, compresses and lotions.

Of course, their action is not as fast as that of medicines, but they are able to alleviate a person’s condition, relieve the manifestations of the disease, and prevent the organ from becoming inflamed again.

Due to the use of traditional medicine, even symptoms disappear if acute orchitis occurs.

A horsetail compress works well. To prepare, you will need to take dry crushed grass, make a cake from natural material, and then apply it to the sore spot.

Treatment can be carried out using a special medicinal ointment prepared from herbs. To create the drug you will need propolis, chicory, barberry, sorrel, wheatgrass, calamus, dandelion and elecampane. All components must be taken in an amount of 3 g and filled with 120 ml of melted bee glue. Place the mixture in the refrigerator until completely hardened.

It is necessary to lubricate the affected area several times a day. The ointment has a strong antiseptic effect, relieves pain, kills pathogenic microflora, and helps the affected areas recover.

For a comprehensive effect, especially if acute orchitis is being treated, it is necessary to take herbal remedies that will help influence the problem from the inside.

Treatment can be carried out with the following fees:

• St. John's wort, lingonberry, chamomile and elderberry;
• wintergreen, knotweed, sweet clover, lingonberry, birch, chamomile, dried grass, rose hips.

If the inflammatory process has just begun, then folk remedies will help to quickly eliminate it, prevent the development of infertility and damage to the tissues of the genital organ.

Inflammation of the epididymis in men can be treated with traditional medicine only in combination with traditional medications , which will be prescribed by a doctor after a full examination. With timely diagnosis and proper treatment, infertility can be avoided.

Traditional medicine and surgery

Treatment of orchitis is impossible to imagine without medications. In order for it to be successful, it is necessary to create favorable conditions.

First of all, acute orchitis requires bed rest. It is necessary to minimize mechanical impact on the scrotum. To do this, the specialist applies a special bandage, which ensures complete rest for the organ .

It is imperative to take medications that remove congestion. Most often prescribed are Aescusan , Venoruton , Agopurin , Dartilin .

For orchitis, treatment should be carried out strictly according to a specific scheme:

• Getting rid of the reason why the disease occurred. For this purpose, drugs with a specific or broad spectrum of action are prescribed. If necessary, they are selected individually.
• With the help of painkillers, pain relief therapy is carried out , especially if the organ is already severely damaged.
• Anti-inflammatory drugs are necessarily used to stop the disease process and the spread of bacteria.

The result of an untreated disease is usually infertility, therefore it is necessary to approach this process with full responsibility and strictly follow the recommendations of a specialist. Otherwise, complications may arise.

Epididymitis is an inflammation of the appendage of the testis and a violation of its patency. It is a complication as a result of improper treatment or its neglect in orchitis. That is why in the early stages it is necessary to take Prednisolone by injection.

Physiotherapy is sometimes used for treatment , which reduces the inflammatory process, slows the spread of infections, and helps the body fight the disease. With the help of physical therapy, it is possible to speed up the recovery process.

For chronic orchitis it is recommended:

• take mud baths;
• engage in exercise therapy;
• do electrotherapy.

If this treatment for orchitis does not help, then surgery is necessary.

Surgery is necessary if:

• the tuberculous nature of the disease is present;
• frequent exacerbations occur in the chronic form;
• organ injury is observed;
• a severe form of the disease was diagnosed.

If there are such factors, then you should definitely go for an operation, which can be performed using resection or removal of the ovary and appendage. If both testicles are damaged, then the question arises about the man’s hormonal background and his reproductive function. With such serious complications, we can talk about complete infertility.

Consequences and prevention

Orchitis is a rather serious disease and cannot be ignored.

In order to avoid complications in the chronic form, it is necessary to beware of genitourinary infections , be careful about sexual relations, and use barrier contraception methods. It is imperative to be examined after suffering from infectious diseases, severe viruses and colds.

If an injury to the pelvis or the genital organ itself occurs, it is necessary to immediately undergo an ultrasound to determine the condition of the testicles.

Damage to both testicles occurs in half of the cases of the disease ; with this factor, we can talk about a complete lack of possibility of conception. That is, there is not only inflammation of the testicles, but also male infertility. If only one side is affected, it is possible to preserve reproductive functions.

If treated incorrectly, the following may occur:

• drying of the testicle;
• spread of the inflammatory process;
• suppuration;
• atrophy of the tissues of the genital organ;
• accumulation of fluid in the scrotum.

Timely medical care can preserve men's health, prevent loss of reproductive function and problems with potency . After the examination, it is necessary to follow all the specialist’s recommendations and carry out therapy only in accordance with the developed scheme. Traditional medicine can be used as an additional treatment.

Conclusion

If you follow all stages of therapy, you can get a positive result quite quickly. It is important to get checked regularly for sexually transmitted infections to stay healthy.

Source: https://kakbyk.com/bolezni/invektsionnye-i-vospalitelnye-zabolevaniya/patologiya-orkhit-simptomy-i-lechenie.html

Orchitis

Orchitis is an inflammatory process of testicular tissue caused by bacterial or viral pathogens and testicular injuries. Symptoms include scrotal enlargement, pain, swelling, flushing and fever. The pathological process often involves the epididymis, which is expressed by pain in the groin area. The diagnosis is confirmed by ultrasound of the scrotum. PCR diagnostics are carried out to exclude the sexually transmitted nature of the disease. Treatment involves prescribing an antibiotic taking into account sensitivity to the drug, NSAIDs, and physical therapy. In case of purulent tissue melting or necrosis, surgery is performed.

Males at any age experience testicular inflammation. Orchitis is often diagnosed in men at the peak of sexual activity (18-35 years), who are at greatest risk of contracting STDs, and in patients over 50 years of age with prostatic hyperplasia and concomitant obstruction.

In 80-90% of cases, orchitis occurs in combination with epididymitis, in 9% the lesion is bilateral. The most common venereal pathogens are gonococci and chlamydia, and nonspecific microflora are Escherichia coli and Pseudomonas aeruginosa, Proteus, staphylococci and streptococci. In boys, the viral nature of orchitis predominates.

In a number of observations, Koch's bacillus can initiate the development of genitourinary tuberculosis involving the testicles.

Orchitis

Testicular inflammation is a multifactorial disease. It develops when infected with pathogens of a viral nature, specific or nonspecific bacterial microflora.

In some patients, the cause cannot be determined - then they speak of the idiopathic form, which is the most difficult to treat.

A connection between orchitis (orchiepididymitis) and the use of certain medications and some systemic diseases has been described.

In children, bacterial orchitis is most often caused by congenital anomalies (ectopic ureter or vas deferens, congenital valves, diverticulum, etc.

) or functional disorders associated with the presence of residual urine (bladder sphincter dyssynergia).

These changes are accompanied by recurrent urinary tract infections, which, under appropriate conditions, spread to the testicular tissues. The main etiofactors leading to orchitis are:

• Viral infections. Viral infection often provokes orchitis in children under 15 years of age; in approximately 20% of cases, testicular inflammation is complicated by mumps; in adults this figure is 10-15%. There is some evidence of the development of orchitis after immunization for mumps, measles and rubella. Less common causes include varicella-zoster and Coxsackie viruses, cytomegalovirus, and adenoviruses.
• Urological diseases. Orchitis can be caused by a bacterial infection, which often spreads from adjacent inflamed structures of the urogenital tract: prostate, vesicles, appendages. Bacterial microflora can enter the testicular tissue through the bloodstream from any source of inflammation in the body. In older patients, due to an enlarged prostate or urethral stricture, adequate urine outflow is disrupted, which is complicated by the formation of urethrovesical reflux with the development of epididymitis, and then orchitis. A testicular tumor leads to reactive tissue inflammation.
• Trauma and iatrogenic damage . Infection of testicular tissue is facilitated by surgical interventions (TURP, open surgery, lithotripsy), urological manipulations (bougienage, catheterization), diagnostic procedures (urethrocystoscopy, pyeloscopy), which disrupt the integrity of the mucous membranes. Orchitis often develops after an animal or insect bite, due to injury. Initially, aseptic inflammation with the addition of a secondary bacterial infection turns into purulent orchitis.
• Venereal infections . Sexually transmitted diseases can cause orchitis in sexually active men. The route of infection is ascending contact; initially, specific inflammation develops in the urethra. Without the necessary therapy, gonococci, chlamydia, mycoplasma, trichomonas affect the prostate, appendages, testicles and other organs.

The main predisposing factor includes immunosuppression of any origin (HIV infection, diabetes mellitus, severe infectious diseases, etc.). Men receiving chemoradiotherapy or taking hormones or immunosuppressants are at higher risk of developing orchitis. In these patients, the initiators of testicular inflammation can be candida albicans, Toxoplasma gondii, cryptococci, etc.

Orchitis is mainly considered as a complication of acute epididymitis, caused by the spread of the pathological process in the testicular tissue through the perivasal and interstitial route. Inflammation is supported by impaired blood and lymph flow, tissue compression due to the accumulation of exudate, and increased pressure in the ducts and seminiferous tubules.

If untreated, serous inflammation turns into a purulent form, microabscesses form, which can self-resolve to form a fibrous scar or, if fused, form a testicular abscess. Focal or diffuse sclerosis of testicular tissue leads to impaired spermatogenesis, as functioning structures are lost.

Clinical symptoms are variable and depend on the severity of the pathological process and the nature of the pathogen. General symptoms may include weakness, fever with chills, headache, and muscle aches. The disease can be acute, which is typical for men with gonorrhea, or develop over several days - it depends on the characteristics of the immune status.

The affected testicle is enlarged in size, sharply painful, the skin over it is hyperemic. Swelling due to inflammation can be so severe that it is not possible to palpate any structures in the scrotum on the affected side. In the lying position, the pain is less pronounced.

Discharge from the urethra can be pronounced: the secretion is usually profuse, whitish or yellowish-green, with an unpleasant odor, which raises suspicion of the venereal nature of the disease. The inguinal lymph nodes may be enlarged. Urinary disorders are present in 35% of patients; symptoms of dysuria include pain, frequent urge, and discomfort in the perineum.

Chronic orchitis has less severe symptoms. The temperature rises only during exacerbation, the pain is nagging, aching, intensified after physical activity, during and after sexual intercourse, and during bowel movements. Localization of painful sensations - testicle, groin area, perineum. The appearance of blood in the sperm may indicate the involvement of vesicles in the process.

With mumps, orchitis is often preceded by general weakness, enlargement of the salivary glands (swelling in the parotid area), fever, chills, and difficulty swallowing. In 20% of patients, testicular inflammation occurs on days 4-7. In 70% of cases, the lesion is unilateral, contralateral involvement of the second sex gland occurs on days 1-9.

Complications when visiting a urologist in a timely manner and following all recommendations are rare.

After suffering bilateral orchitis, spermatogenesis is disrupted in 87% of patients, azoospermia occurs in 3-5% of cases. Within 12 months, improvement in ejaculate parameters occurs in 90% of men.

Chronicity of the process can also be considered as a complication of acute inflammation, while sclerotic and dystrophic changes are the cause of obstructive and/or secretory infertility.

In 60% of men who have had orchitis, a slight decrease in testicular size is diagnosed - atrophy, which is not always accompanied by changes in the spermogram.

Sepsis is a potential consequence of severe infection.

A preliminary diagnosis can be established on the basis of anamnesis and physical examination; a number of instrumental and laboratory tests are required to determine the genesis of the inflammatory process.

It is mandatory for a urologist to conduct a digital rectal examination of the prostate gland, since orchitis and prostatitis often occur in combination. The patient can be referred for consultation to a phthisiourologist, oncologist, or surgeon.

Examination algorithm for orchitis:

• Laboratory diagnostics . To exclude/confirm STIs, PCR tests for Neisser's gonococci and chlamydia trachomatis are prescribed. The study is necessary if, with conventional microscopy of a urethral smear, a large number of leukocytes are visualized. Conduct cultural studies aimed at identifying bacterial pathogens and drug sensitivity. Orchitis against the background of viral mumps is confirmed by detecting antibodies using ELISA. Changes in the general blood test are nonspecific; with severe inflammation, there is a shift in the leukocyte count to the left and an increased ESR.
• Instrumental diagnostics . Ultrasound of the scrotum with Doppler allows you to assess the condition of the affected testicle and exclude concomitant pathologies, for example, tumor, testicular torsion, abscess. In doubtful cases (if tumor genesis of reactive orchitis is suspected), magnetic resonance imaging of the scrotum and pelvic organs is performed. Diaphanoscopy demonstrates the heterogeneity of testicular tissue, but the information content of this method remains low.

Differential diagnosis is carried out with testicular torsion. It is characterized by a sudden onset of pain; there is no prodromal period with an increase in temperature.

The diagnosis is confirmed by Doppler ultrasound scanning, which clearly shows the rotation of the gonad relative to the normal anatomical location, compression of the vessels and nerves of the spermatic cord. The testicle itself is often of normal size.

Similar clinical symptoms are present with strangulated inguinal-scrotal hernia. A consultation with a surgeon and an ultrasound scan of the scrotum are sufficient to establish a diagnosis.

Bed rest; wearing a suspensor is recommended to relieve symptoms. Spicy foods and alcohol are excluded from the diet.

An increased drinking regimen is prescribed to relieve intoxication and increase diuresis, which helps accelerate the elimination of pathogens from the body.

Treatment begins empirically, without waiting for the results of culture and PCR diagnostics. In case of viral orchitis, the prescription of antibiotics is considered inappropriate. Inflammation caused by any sexually transmitted infection requires immediate treatment of the sexual partner. Complex therapy for bacterial inflammation of the testicle includes:

• Taking medications. Antibiotics with the widest possible spectrum of action are prescribed. The duration of the course is determined individually; for concomitant prostatitis, medications are taken for up to 4 weeks. After receiving the culture results, if necessary, the treatment regimen is adjusted. Nonsteroidal anti-inflammatory drugs are used to reduce pain and reduce temperature. NSAIDs and antibacterial drugs enhance each other's effects.
• Local impact. In the first hours, cold is applied to reduce swelling (a cold heating pad wrapped in a cloth), then absorbable compresses are used on the affected side. Physiotherapy is not carried out in the acute period, but as the inflammation subsides, after 3-5 days, UHF therapy, electrophoresis, and laser-magnetic effects are possible. For chronic inflammation, physiotherapy helps prevent exacerbation.
• Surgical treatment . With the development of purulent-destructive complications, they resort to orchiectomy. Some practitioners consider early surgical intervention to be justified, which consists of applying incisions to the tunica albuginea, which reduce compression and allow purulent contents to drain. Despite the fact that the operation is organ-preserving, undesirable consequences are possible in the form of the formation of areas of fibrosis with impaired spermatogenesis.

With adequate therapy, most cases of orchitis proceed without complications, and the prognosis for life is favorable. When spermatogenesis is suppressed, timely consultation with an andrologist is important.

If therapy for infertility is unsuccessful, it is possible to turn to assisted reproductive technologies.

Sometimes recurrent orchitis is a consequence of incomplete diagnosis, which requires a comprehensive examination and adequate treatment.

Preventive measures include commitment to monogamous relationships and the use of protective equipment when playing traumatic sports.

Timely contact with a urologist at the first symptoms of problems with the genitourinary organs, periodic examination of patients suffering from chronic urological pathology, and preventive treatment minimize the risk of orchitis.

Men who have not had mumps as a child and have not received vaccinations should avoid contact with people who have mumps.

Source: https://www.KrasotaiMedicina.ru/diseases/zabolevanija_urology/orchitis

Orchitis

Orchitis is an inflammation of one or both testicles that develops against the background of infectious and inflammatory diseases. As an independent disease, orchitis occurs in extremely rare cases.

Orchitis can occur in acute or chronic form.

Reasons for the development of the disease

Most often, orchitis is caused by a virus that causes mumps. In addition, the causes of testicular inflammation are:

• Infectious and inflammatory diseases (influenza, chicken pox, pneumonia, typhoid fever, scarlet fever, brucellosis);
• Bacterial sexually transmitted infections (gonorrhea or chlamydia);
• Inflammatory processes localized in the area of ​​the genitourinary system (vesiculitis, urethritis, prostatitis, epididymitis);
• Injuries to the testicle, scrotum, pelvis, perineum;
• Factors causing blood stagnation in the pelvis;
• Infection entering the testicle through inflamed umbilical vessels (in newborns);
• Long-term catheterization.

Factors such as hypothermia, physical activity, and decreased immunity can also play a significant role.

In most cases, inflammation of the testicular tissue is also accompanied by inflammation of the epididymis (epididymitis). In this case, they talk about orchiepididymitis.

Depending on the duration of the disease, orchitis can be acute or chronic:

2. Chronic orchitis occurs as a result of improper treatment of acute orchitis or as a side effect of inflammatory diseases of the genitourinary system that occur in a chronic form (for example, urethritis, vesiculitis, cystitis, prostatitis).

Symptoms of acute orchitis in some cases appear gradually, but sometimes patients may experience sharp pain radiating to the groin, perineum, sacrum or lower back, as well as swelling of the scrotum, which doubles in size. Due to swelling, the skin of the scrotum becomes smooth, all folds are smoothed out. A few days after the onset of the inflammatory process, it turns red (sometimes acquiring a glossy tint) and becomes hot.

The main symptoms of acute orchitis include:

• Swelling and enlargement of one or both testicles;
• Redness of one or both testicles;
• Pain of varying severity;
• Discomfort when sitting;
• Discharge from the penis;
• Sharp pain in the testicle when touched;
• Swelling and increased temperature of the scrotum;
• Pain along the spermatic cord.

Pain in the scrotum and swelling are also accompanied by general symptoms, including:

• Fever and chills at a temperature of 38-40°C;
• Weakness;
• Headache;
• Nausea;
• Loss of appetite;
• Signs of inflammation of the salivary glands.

Even without treatment, acute orchitis usually goes away on its own within 2-4 weeks. However, in some cases, the inflammatory process is complicated by testicular suppuration, epididymitis, the formation of fistulas or festering hernia, and the development of an abscess. The consequence of this is often a secretory form of infertility.

With orchiepididymitis, symptoms usually appear and develop gradually. Epididymitis initially results in localized pain and swelling in the back of the testicle. As the infection progresses, pain and swelling spread to the entire testicle. The process may be accompanied by pain or burning before or after urination.

Chronic orchitis is rarely accompanied by pronounced symptoms. Most often, the only sign of the inflammatory process is some pain when touching the testicle. Moreover, during periods of exacerbation, pain may intensify when walking.

Chronic orchitis, much more often than the acute form of the disease, leads to the development of secretory infertility in men.

Diagnosis of orchitis

To diagnose the disease, laboratory and instrumental research methods are used.

In laboratory conditions, a microscopic examination of a smear from the urethra, a general analysis of urine and blood, and culture of urine and ejaculate for sensitivity to antibiotics are performed. The instrumental method is ultrasound examination of the scrotum.

For uncomplicated acute orchitis, treatment is carried out on an outpatient basis. The patient is prescribed bed rest and a diet that excludes the consumption of spicy foods.

As a rule, these are antibiotics, vitamins, enzymes, as well as absorbable drugs.

If there is a threat of testicular suppuration, the patient is hospitalized.

After the symptoms of the inflammatory process have been relieved, physiotherapeutic procedures are prescribed.

When an abscess develops in the testicle, it is opened surgically, and then the purulent focus is drained. In particularly difficult cases, when purulent melting of the testicle occurs, its removal (orchiectomy) is required.

For the treatment of chronic orchitis, the following methods are used:

• Therapy using antibacterial drugs;
• Thermal procedures;
• Physiotherapeutic procedures.

In cases where the use of conservative methods of treating orchitis does not produce the desired effect, surgery is performed to remove the testicle.

The complexity of the chronic form of the disease lies in the fact that the symptoms of orchitis in this case are not expressed. As a result, most patients may not suspect that they have orchitis for a long time.

Prevention of orchitis

Preventive measures to prevent the development of inflammatory processes in the testicles include:

• Timely treatment of diseases of the genitourinary system;
• Timely vaccination against mumps;
• Timely treatment of infectious diseases;
• Prevention of injury to the testicle and scrotum.

Predictions regarding reproductive function

With early diagnosis and proper treatment of the acute form of the disease, the prognosis for reproductive function is favorable for the patient.

In the chronic course of the disease (especially if the orchitis is bilateral), a man most often develops infertility.

Source: https://zdorovi.net/bolezni/orhit.html