Orchitis: Symptoms, Causes, Diagnosis

The testicles form part of the male reproductive system and play a critical role in male reproduction.

The testicles are also called the male gonads. They are the primary part of the reproductive organs and provide two primary functions.

The first function is to produce sperm, also known as gametes1. The sperm is a critical element in reproduction. Secondly, testicles are also responsible for producing certain hormones, such as testosterone.

Some conditions can affect the testicles. When this happens, a man may experience problems with the functions of the testes. This may include issues with infertility. There may also be a decline in testosterone production.

Orchitis is one condition that affects the testicles. It is often mentioned alongside epididymitis. Among men with epididymitis, an estimated 58% will experience orchitis as a complication2.

It is often caused by viral infections. We take a closer look at what orchitis is. The post also focuses on causes, symptoms, and treatment options for the condition.

What Is Orchitis?

Orchitis is a condition that refers to inflammation that affects the testicles. The condition is not exceptionally common in the male population. Still, it poses a concern.

There are various reasons why orchitis can develop. Generally, the condition has a strong association with the mumps. This is not the only reason why orchitis can occur, however.

In most cases, a virus or bacteria is the reason behind orchitis. This is the case with the mumps too. Most men will find that only a single testicle is affected by orchitis. However, there are a few scenarios where both testicles can also be affected.

What Are The Symptoms Of Orchitis?

Most men with orchitis will experience pain, which will be present in the testicle that is affected.

Pain is not the only symptom that has been associated with the condition. There are a few other symptoms that men can experience too.

Some of the symptoms that men should look out for include:

  • The prostate may also become enlarged if a man has orchitis.

  • Lymph nodes located in the grown area may become swollen.

  • Some men will develop a fever.

  • Some men will also experience painful urination.

  • It is possible for the pain to be experienced when the man ejaculates too.

  • Some men may experience scrotal tenderness when they develop orchitis.

  • Sometimes, blood may be present in semen when a man ejaculates.

  • The scrotum may also be affected by inflammation.

When a man experiences these symptoms, they are advised to seek medical assistance. They can indicate the presence of orchitis. The symptoms may also sometimes indicate another problem with the prostate or testicles.

What Complications Can Orchitis Cause?

Treatment is vital for orchitis. This can help to ease the symptoms that the man experience. When treatment is initiated, it also helps to ensure the man does not experience long-lasting complications.

In most cases, the outlook is positive. A man will receive treatment and recover from the condition.

There are rare cases where orchitis causes infertility in the male patient. This usually happens when certain parts of the testicles are damaged. The testicles are responsible for the production of sperm. This is the primary ingredient in semen, which is used for reproduction. When the testicles are unable to make healthy sperm, fertility is adversely affected.

There are a few other complications that have also been associated with orchitis. Again, these are also rare complications. Still, men should acknowledge the risks associated with the condition.

Some of the complications that men should know about include:

  • The testicle affected by orchitis may shrink post-treatment. It may be smaller than it was before the man was affected by the condition.

  • Sometimes, testicular tissue may die. This can cause problems with the functions that the testicles perform. When testicle tissue dies, it may lead to problems with sperm and testosterone production.

  • A blister can sometimes develop in the scrotum. In some men, an abscess can also form in this area.

There are also cases where orchitis leads to chronic epididymitis. Epididymitis and orchitis seem to have a link. This is a condition that causes the epididymis to be affected by inflammation3.

The epididymis allows sperm to travel from the testicles to the vas deferens. When inflamed, it may affect the movement of sperm from the man’s testes.

What Causes Orchitis?

The primary causes behind orchitis include pathogenic microbes. In particular, the condition can be caused by either a bacterium or a virus.

Mumps is the most common reason why a man may experience orchitis. This is a viral disease.

Mumps is generally considered a childhood disease. Teenagers who catch the mumps may develop orchitis. In fact, according to one report, about one in three teenagers who have the mumps will experience orchitis4.

It is important to note that adult men can also be affected by orchitis. In such a case, it will usually not be the mumps that causes the condition. Several other types of infectious diseases can lead to orchitis.

A man with a urinary tract infection is at risk for orchitis. A urinary tract infection is often caused by invading bacteria. When the bacteria travel to the testicles, it may lead to an infection in the area. The presence of the infection would trigger an inflammatory response. In turn, orchitis can develop.

Some sexually transmitted diseases may also contribute to orchitis. Bacteria cause both chlamydia and gonorrhea. Sometimes, the bacteria that cause these STIs can travel to the testicles too. When this happens, inflammation is going to develop in the testicles. In turn, the man is likely to develop orchitis.

There is another possible cause of orchitis. The condition is known as epididymitis. It is important to note a complex association here. Orchitis can contribute to the development of chronic or acute epididymitis. A man with epididymitis, however, is also at risk of developing orchitis. The man can develop acute epididymal-orchitis.

What Are The Risk Factors For Orchitis?

In addition to understanding the causes of orchitis, men should also realize that there are certain risk factors. These risk factors increase the man’s likeliness of being affected by orchitis. A few risk factors have been established through scientific research.

Men should consider these risk factors if they wish to learn how likely they might be to develop the condition. When symptoms develop, it may also be useful to examine risk factors affecting the man. This makes it easier to determine if the symptoms are related to orchitis.

High-risk sexual behavior is considered the primary risk factor for this condition. Men who have sex without using condoms are more likely to catch certain sexually transmitted infections. When the man catches gonorrhea or chlamydia, they have an increased risk of experiencing orchitis.

Men who sleep with a partner that has one of these sexually transmitted infections would also be at a higher risk for orchitis. The sexually transmitted infection can carry over to the male patient.

Even though treatable, it can still cause orchitis before treatment is initiated. Congenital abnormalities with the urinary tract also seem to be a risk factor for orchitis. These abnormalities are present at birth. It may include structural problems with the urethra or the bladder.

How Is Orchitis Diagnosed?

An official diagnosis for orchitis is needed before treatment can be provided to the patient. This is important since symptoms associated with the condition can also signal another underlying problem.

A doctor will need to see a patient and conduct a full examination to make a diagnosis.

The first step is for the doctor to analyze the patient’s medical history. The doctor will look if the patient has a history of sexually transmitted infections. A history of urinary tract infections will also be taken into consideration.

The doctor will ask the man about their most recent sexual activities – mainly if protection was used. Furthermore, the doctor is likely to ask the man if he had a test for chlamydia and gonorrhea recently.

The man will be asked to explain the symptoms experienced to the doctor. This will help the doctor determine if orchitis is suspected. The doctor will also be able to determine if there might be a more serious underlying problem.

Certain tests may be requested to help the doctor with the diagnosis. A urine sample is often asked by the patient. A swab may also be taken if the man experiences a discharge through the tip of their penis.

The urine sample or swab will be sent to a laboratory. The laboratory will analyze the sample. This ensures infections can be recognized. The lab can also identify the presence of certain sexually transmitted infections through these samples.

Imaging tests are often ordered too. The doctor will need to rule out a few possible caused by testicular pain. An ultrasound imaging test is very common. This allows the doctor to rule out a condition known as testicular torsion5. A color doppler ultrasonography may be ordered.

Testicular torsion is known to cause significant pain in the testicles. It is a condition where the spermatic cord becomes twisted. The condition also causes pain in the groin. Sometimes, the symptoms of testicular torsion and those caused by orchitis are confused.

Once these factors have been ruled out, the doctor may diagnose the patient with orchitis. Only when such a diagnosis is made will appropriate treatment be provided to the patient.

Treatment Options?

It is important that men seek out appropriate treatment for orchitis. The condition is highly treatable. At the same time, it is important to consider the fact that it is generally considered a symptom rather than a condition itself.

For this reason, seeing a doctor when signs of orchitis develop is critical. The doctor needs to diagnose the patient before they consider implementing any type of treatment.

The doctor will also look at the reason why the patient is experiencing orchitis. The cause behind the condition needs to be addressed through a treatment strategy.

Thus, treatment may differ from one patient to the next.
It should be noted that no cure is available when orchitis is caused by a virus. In such a case, the condition is referred to as viral orchitis.

Most men will find that viral orchitis will go away without any medical treatment.

There are a few options that can help to ease symptoms in the meantime.

  • When possible, the testicles should also be elevated. This might be able to reduce the discomfort that the condition causes.

  • Pain medication can also be used to help reduce symptoms. Several pain medications can be utilized. Many over-the-counter drugs would help reduce testicular pain. Anti-inflammatory medications may also be used. This could help to reduce the inflammation in the testicles.

  • When bacterial orchitis is diagnosed, then medical treatment is necessary. The doctor will prescribe antibiotics. The antibiotics are important to assist in the treatment of the bacterial infection that affects the patient’s testicles.

  • The doctor may also advise the patient to apply cold packs to their testicles. This can help keep inflammation to a minimum. The cold pack may help alleviate the pain symptoms too.

  • Anti-inflammatory drugs are often provided alongside the antibiotics. These drugs bring down the swelling of the testicles. The drugs can also help reduce the amount of pain experienced.

Preventing Orchitis

There are scenarios where it is not possible to prevent orchitis from developing. For example, a congenital problem with the urinary tract can usually not be fixed. This is considered a fixed risk factor that will apply to the patient regardless of his actions.

There are, however, other risk factors that can be controlled. When these risk factors are controlled, the likeliness of the patient developing orchitis will be reduced.

  • Avoiding irresponsible and high-risk sexual behavior would be considered the primary preventative strategy for orchitis. In adult men, sexually transmitted infections are often the reason behind orchitis. The risk of being affected by a sexually transmitted infection is greatly increased with such behaviors.

  • Thus, to reduce the risk of orchitis, men should ensure they participate in safer sexual activities. This would mean wearing a condom when the man has sexual intercourse. While a condom is not 100% effective, it does offer a significant reduction in the risk of transmitting STIs. It helps to reduce the risk of transmitting bacteria like Neisseria gonorrhoeae.

  • Men and teenagers should also be vaccinated against the mumps viral infection. There is a highly effective vaccination available6. This helps to protect the person against the mumps. In turn, it also reduces the risk of experiencing orchitis as a complication of the mumps.

Conclusion

Testicles produce sperm and testosterone hormones. Both of these are crucial reproductive roles. Testosterone also helps with other functions in the body. Orchitis is a condition that causes the testicles to become inflamed. It can also lead to chronic epididymitis.

While most commonly associated with the mumps, there are other reasons why orchitis can develop too. Treatment should be initiated to avoid complications. Men should also understand what they can do to prevent the condition from developing.

Sources

  1. LiveScience. (2017) Testicles: Facts, Function & Diseases. [online] Available at: https://www.livescience.com/58838-testicle-facts.html
  2.  American Family Physician. (2009) Epididymitis and Orchitis: An Overview. [online] Available at: https://www.aafp.org/afp/2009/0401/p583.html
  3. Centers for Disease Control and Prevention. Vaccines and Preventable Diseases: Mumps. [online] Available at: https://www.cdc.gov/vaccines/vpd/mumps/index.html

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