Infections of the genital apparatus: orchitis

By Cristiano Antonino On Jun 6, 2023

Among infections of the genital apparatus, orchitis is one of the most common. This pathology affects a large number of men and can cause a lot of discomfort and pain

Those who most frequently suffer from this disease are children: 80% of patients are younger than 10 years old.

However, this infection can also affect adolescents: about 33% of cases that do not affect children, occur in adolescence and the developmental age.

Adults can also be at risk of developing orchitis as youngsters

Orchitis is often linked to other concomitant diseases in the subject: about 25% of men with mumps also have this inflammation, and 60% of those who contract this infection consequently develop atrophy of at least one testicle.

The only way to be certain of having contracted this disease is to have a specialist examination, which is also essential in order to understand exactly which treatments to undergo and which medications to take.

Here is more information on this disease, such as symptoms, causes, complications and remedies.

What is orchitis

Orchitis is an inflammation that affects one or both testicles and is often related to a more complex disease: mumps.

The main cause of this disease is therefore viral.

Mumps is a disease, caused by a specific virus of the Paramyxovirus family, that has enlarged parotid glands as symptoms and can complicate into orchitis.

Usually orchitis can be associated with inflammation of the epididymis.

The name orchitis is derived from orcheis, meaning testicle, and the ending -itis, which instead takes on the meaning of inflammatory process.

When the inflammatory pathology also affects the epididymis, it can be called orchi-epididymitis.

This pathology can lead to a great deal of discomfort and complications in the male genital apparatus, which is why early diagnosis and the prescription of appropriate therapies to reduce the inflammation is essential.

Symptoms of orchitis

Symptoms of orchitis can be diverse and can occur suddenly, within days of infection.

These symptoms can vary in intensity, depending on the stage of inflammation and other factors such as the patient’s age and lifestyle.

In addition, the typical symptoms of this disease can also occur in only one testicle.

Among the most common symptoms of orchitis are:

a strong pain in the groin, particularly in the testicle area;
one or both testicles may present swelling and redness;
the penis may emit secretions and blood may be present in the semen;
fever and nausea are very common symptoms in patients with orchitis;
swelling of the scrotum, prostate and lymph nodes in the groin;
pain during ejaculation;
headache;
muscle pain.

Often in younger patients and men suffering from mumps, the first symptom is swollen salivary glands.

After the appearance of this symptom, 4 to 7 days later, it is possible for others to appear.

The most common in this case are nausea, fever and muscle pain.

Causes

The causes of orchitis are diverse.

This inflammation can be bacterial, viral, parasitic, mycobacterial, prostatectomy or traumatic.

The causes of orchitis therefore depend on its origin:

In the case of bacterial orchitis, the inflammation is usually related to the presence of epididymitis. This word is used to define the inflammation of a precise area of the male genital apparatus, a canal that acts as a link between the ductus deferens and the testis. This disease is usually caused by an infection of the bladder and urethra that spreads to this connecting canal called the epididymis. In addition, this infection can also be sexually transmitted. Bacterial orchitis in fact mainly affects men in a sexually active age group, i.e. from 19 years to 35/40 years.
Viral orchitis is often related to the presence of mumps. In this case, the inflammation is a complication of the disease better known as ‘mumps’. This acute infectious disease presents as an initial symptom swelling of the salivary glands and after a few days the typical symptoms of orchitis.

Risk factors and complications

There are several risk factors that can lead to complications of orchitis and an increased likelihood of its occurrence.

In particular, there are factors that can lead to contracting viral orchitis.

These include:

The age of over 45 years;
lack of vaccination for mumps;
surgery of the urinary or genital tract;
congenital malformations of the urinary tract.

Improper sexual behaviour is another risk factor that can lead to an increased risk of contracting orchitis.

Sexual intercourse with different partners and lack of protection are certainly two of the biggest risk factors.

Using condoms can help defend against this and other sexually transmitted diseases.

Most patients who suffer from orchitis manage to cure this disease without long-term complications.

Despite this, however, it is possible that there are several complications, including infertility.

Other complications are abscesses or blisters in the scrotum, testicular stenosis, chronic inflammation of the epididymis and death of testicular tissue.

Diagnosis of orchitis

Early diagnosis is essential in order to avoid complications and to identify the causes of this inflammation at an early stage.

With an immediate diagnosis, it is possible to start specific treatments that can solve the problem.

Certain tests and examinations are necessary to diagnose orchitis:

In order to detect the inflammation, it is first necessary to perform a careful clinical-anamnestic examination, during which it is possible to check for increased size of the inguinal lymph nodes and a possible enlargement of the testicles, which is typical of this pathology;
It is then necessary to perform an ultrasound examination with which it is possible to see if there is an alteration of the blood flow. Furthermore, thanks to this ultrasound test, a possible torsion of the testicle can be detected. Through these two tests, the health status of different areas of the testicle, which are usually affected by this type of inflammation, is checked.

The doctor may then request further tests, such as a blood culture or urethral swab.

These two tests are useful to check for the presence of any sexually transmitted diseases.

Prevention

The possibility of prevention for this disease depends on the cause.

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If it depends on congenital disorders, prevention is possible by intervening to resolve them.

Proper intimate hygiene contributes to the prevention of orchitis.

With a few responsible attitudes, viral orchitis can also be prevented.

This type of inflammation is sexually transmissible and is particularly prevalent in men between the ages of 19 and 40.

Among these responsible prevention behaviours are

getting the mumps vaccine whenever possible to prevent the disease known as ‘mumps’. Moreover, this vaccine is very useful because it also protects against diseases such as measles and rubella. This vaccine is usually given to children at two different times: at the 13th month and at the 5th/6th year. Today, this vaccine is mandatory, but can be requested by adults who were not vaccinated in childhood. In this case, the time between doses may be as little as four weeks.
Avoid having numerous sexual partners, which increases the likelihood of coming into contact with an infected patient.
Always use appropriate protection during sexual intercourse, in particular use a condom with every intercourse to avoid not only this but also other sexually transmitted diseases.

Therapies for orchitis

Once the diagnosis has been made by a specialised physician, similar therapies for orchitis are usually prescribed.

Depending on the severity of the inflammation, alternative therapies and second-line drugs may then be added.

Treatment for orchitis involves the administration of antibiotics and cortisone. Azithromycin, ciprofloxacin and ceftriaxone are usually prescribed.

When taking these drugs, it is essential to inform your doctor of any ongoing treatment in order to avoid allergic reactions or side effects.

In the case of viral orchitis, painkillers are often recommended.

If the symptoms of orchitis include severe swelling, redness and pain, it may be advisable to apply ice to the scrotum.

In this case, however, there should be no direct contact between skin and ice, because this area of the body is particularly sensitive and direct application could cause frostbite burns.

Finally, surgery may be necessary in cases where pus is present in the scrotal sac.

For faster resolution of the problem, it is advisable to lie supine in bed or hold the scrotum in a raised position.

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