Orchitis: Causes, Symptoms and Treatment

Man with orchitis holding groin in pain.

What Is Orchitis?

Orchitis is a condition causing inflammation to one or both of the testicles. Most often, orchitis develops due to a bacterial or viral infection, although it is possible for the exact cause to be unknown.

Orchitis can be painful and can potentially affect fertility. Although the causes of bacterial and viral orchitis can be treated with medication, it may take a number of weeks before any discomfort of the testicles fully disappears.

Symptoms

The symptoms and signs of orchitis can appear suddenly, and often include the following:

  • Mild to severe pain or soreness in the testicles
  • Pain when urinating
  • Pain when ejaculating
  • Swelling of one or both testicles
  • Blood in the semen
  • Unusual discharge
  • Enlarged prostate
  • Swelling of the lymph nodes in the groin area
  • Elevated body temperature
  • Nausea and/or vomiting

When Should You See A Doctor?

You should seek immediate medical attention if you feel any pain or swelling in the scrotum.

Testicular pain can be caused by a variety of conditions, some of which require immediate treatment. One example is testicular torsion, which can cause pain similar to orchitis, and is caused by the spermatic cord becoming twisted.

Your doctor will first want to ask you questions about the symptoms you are experiencing and review your medical history. A physical exam will then be performed to determine if there are any swollen lymph nodes in the groin area, or any swelling of the testicles.

A rectal exam may also be performed to check for tenderness or enlargement of the prostate. Additionally, your doctor may also suggest the following tests:

  • Screening for STIs – If there is discharge coming from the penis, a small swab is used to obtain a sample of it. The sample will then be tested for chlamydia and gonorrhea. A urinalysis is used for some STI screenings.
  • Testicular Ultrasound – An ultrasound is the most common imaging test used to evaluate testicular pain. This type of test is able to determine if blood flow to your testicles has reduced (a sign of torsion) or increased, which could indicate orchitis.
  • Urinalysis – Your urine sample will be examined to determine if there are any abnormalities present.

Orchitis Causes

Bacterial Orchitis

Bacterial orchitis is most frequently associated with or caused by epididymitis, an inflammation of a tube that transports sperm (epididymis). Epididymitis is typically caused by a bladder or urethra infection that spreads to epididymis.

STIs (sexually transmitted infections) are another common cause for orchitis. Being born with a urinary tract abnormality or having had a catheter or other medical instrument inserted into the penis are other potential causes.

Viral Orchitis

Viral orchitis is usually caused by the mumps virus. Nearly 1 out of 3 males who become infected with the mumps virus after puberty will develop orchitis. This typically occurs within the first week following the onset of the symptoms.

Who Is At Risk?

Orchitis may be more common in those who engage in high-risk sexual behaviors. These behaviors include:

  • Having unprotected sex
  • Having multiple sexual partners
  • Previously having an STI
  • Having sex with an STI-infected partner

These are also some risk factors for orchitis that are not sexually transmitted, including:

  • Not having received mumps immunization
  • Recurring UTIs
  • Surgery involving the reproductive or urinary tract
  • Congenital abnormality of the bladder or urinary tract

Secondary Conditions

The majority of men who develop orchitis recover fully and experience no long-lasting effects. Infertility is rare in cases of orchitis.

Other complications that can also occur (but are rare) include:

  • Chronic inflammation of the epididymis
  • Puss-filled blister in the scrotum (abscess)
  • Death of testicular tissue (infarction)
  • Testicular atrophy, or shrinking of the affected testicle
  • Low testosterone production (more common when both testicles are affected)

Orchitis Prevention

Orchitis can sometimes be difficult to prevent, particularly for those with congenital problems in the urinary tract. You can still help to prevent certain types of viral orchitis, however, by getting yourself and your children vaccinated against the mumps virus.

Safe sex practices will help to prevent getting bacterial orchitis. Talk to your partner about their sexual history and use a condom when having sex.

Treatment

Although there is no cure for the viral form of orchitis, the condition will typically resolve on its own. Until the condition clears up, you can manage your symptoms at home by using over-the-counter pain medication and ice packs, and by keeping your testicles elevated whenever possible.

In the case of bacterial orchitis, antibiotics, anti-inflammatory medication and cold packs are typically used for treatment.

Whatever the cause of the inflammation, it can take up to several weeks to recover fully.

While you are recovering from orchitis, it is important to avoid having sex or lifting anything heavy. Additionally, your partner will also need to be treated if you have an STI.

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