October 16, 2023 Author : Carlos Guimarães Orchitis is an inflammation of the testicles . In most cases is related with another infection and not an isolated problem; It can affect one or both testicles, that is, it can be unilateral or bilateral; It is usually painful; When not treated correctly, it can lead to organ loss or affect fertility; It usually affects the epididymis to a greater extent than the testicle. Causes and risk factors Orchitis can bacterial or viral. Orchitis caused by bacterial infections may be related to: Urinary tract infections, being often preceded by prostatitis and usually leading to epididymitis. A sexually transmitted infection, for example chlamydia, gonorrhea or syphilis. Viral orchitis is mainly due to the mumps virus, especially after puberty, affecting about 30% of men. However, other viral infections can cause orchitis, such as: Chickenpox Cytomegalovirus infections Rubeola The following are risk factors for orchitis : Not having been vaccinated against mumps (it is part of the Portuguese national vaccination program ); Recurrent urinary tract infections; Bladder catheter; Malformations of the urinary tract; Stenosis of the urethra or other blockage to urinary flow, for example due to benign prostatic hyperplasia; Previous history of epididymitis; Risky sexual behaviors. Symptoms and diagnosis of orchitis The signs and symptoms of orchitis are usually sudden . They can affect just one testicle and then affect both, or not. The main symptoms are: Swelling of the affected testicle; Redness of the scrotum; Pain of varying intensity in the affected testicle with inguinal irradiation. The following symptoms may also be present: Sensitivity of the testicles to touch; Fever; Headache and muscle pain; Nausea and vomiting; Urinary symptoms such as pain, burning, increased urinary frequency, bloody urine; Fatigue and general malaise. The diagnosis is based on the signs, complaints and history reported by the patient, results of the physical examination performed and results of diagnostic tests, which are, most frequently, blood and urine tests and/or of the urethral discharge that may be present, and testicles ultrasound. Treatment, complications and prevention The treatment of orchitis depends on its cause. It typically involves symptom relief actions , such as: Rest lying down with the scrotum elevated; Medication for pain and fever when necessary; Avoid sexual relations; Use of a support device to immobilize the testicles and relieve pain. When it is a bacterial infection, treatment also includes antibiotics and may involve sexual partners. If the origin is viral, treatment is aimed only at relieving symptoms. After starting treatment, symptoms begin to alleviate within a few days, but complete resolution of orchitis symptoms may take weeks or even months. Bilateral orchitis after puberty can reduce sperm concentration but only rarely is cause of infertility. Vaccination against mumps, protective measures against sexually transmitted infections and good hygiene practices reduce the risk of orchitis. For greater effectiveness of treatment and resolution of symptoms, it must be instituted as early as possible, so, in case of suspicion, medical care should be sought . Meet the urology clinical team from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
