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Orchitis - Causes, Symptoms, Diagnosis, and Treatment

What is orchitis?

Orchitis is an inflammation of one or both testicles, most commonly associated with the virus that causes mumps. At least one-third of males who contract mumps after puberty develop orchitis.

What are orchitis causes?

Orchitis may be caused by an infection from many different types of bacteria and viruses.

The most common virus that causes orchitis is mumps. It most often occurs in boys after puberty. Orchitis usually develops 4 - 6 days after the mumps begins. Because of childhood vaccinations, mumps is now rare in the United States.

Orchitis may also occur along with infections of the prostate or epididymis.

Orchitis may be caused by sexually transmitted infection (STI) such as gonorrhea or chlamydia. The rate of sexually transmitted orchitis or epididymitis is higher in men ages 19 - 35.

Risk factors for sexually transmitted orchitis include:
- High-risk sexual behaviors
- Multiple sexual partners
- Personal history of gonorrhea or another STD
- Sexual partner with a diagnosed STD

Risk factors for orchitis not due to an STD include:
- Being older than age 45
- Long-term use of a Foley catheter
- Not being vaccinated against the mumps
- Problems of the urinary tract that occurred at birth (congenital)
- Regular urinary tract infections
- Surgery of the urinary tract (genitourinary surgery)

What are orchitis symptoms?

- Orchitis symptoms include:
- Blood in the semen
- Discharge from penis
- Fever
- Groin pain
- Pain with intercourse or ejaculation
- Pain with urination (dysuria)
- Scrotal swelling
- Tender, swollen groin area on affected side
- Tender, swollen, heavy feeling in the testicle
- Testicle pain that is made worse by a bowel movement or straining

How is orchitis diagnosed?

Tests that your doctor may use to diagnose orchitis and to rule out other causes of your testicle pain include:

A physical exam. A physical exam may reveal enlarged lymph nodes in your groin and an enlarged testicle on the affected side; both may be tender to the touch. Your doctor also may do a rectal examination to check for prostate enlargement or tenderness.
STI screening. This involves obtaining a sample of discharge from your urethra. Your doctor may insert a narrow swab into the end of your penis to obtain the sample, which will be viewed under a microscope or cultured to check for gonorrhea and chlamydia.
Urinalysis. A sample of your urine, collected either at home first thing in the morning or at your doctor's office, is analyzed in a lab for abnormalities in appearance, concentration or content.
Ultrasound imaging. This test, which uses high-frequency sound waves to create precise images of structures inside your body, may be used to rule out twisting of the spermatic cord (testicular torsion). Ultrasound with color Doppler can determine if the blood flow to your testicle is reduced or increased, which helps confirm the diagnosis of orchitis.
Nuclear scan of the testicles. Also used to rule out testicular torsion, this test involves injecting tiny amounts of radioactive material into your bloodstream. Special cameras can then detect areas in your testicles that receive less blood flow, indicating torsion, or more blood flow, confirming the diagnosis of orchitis.

How is orchitis treated?

Treatments may include:
- Antibiotics -- if the infection is caused by bacteria (in the case of gonorrhea or chlamydia, sexual partners must also be treated)
- Anti-inflammatory medications
- Pain medications
- Bed rest with the scrotum elevated and ice packs applied to the area



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