Testicular inflammation: Causes, Symptoms, Diagnosis, And Prevention

 Testicular infections mainly affect boys before puberty and adult men.

Orchitis is inflammation of the testicles. It also often occurs as a side effect of another condition, such as epididymitis. The most common triggers are mumps viruses.

The main symptom of testicular inflammation is painful testicle swelling, and fever often occurs. If an acute inflammation of the testicles is treated with anti-inflammatory drugs, among other things, it heals within a few weeks, depending on the cause. In severe cases, damage to the testicular tissue can lead to sterility (infertility).

Vaccination against mumps and the use of condoms during sexual intercourse offers preventive protection.

Frequency of testicular inflammation

The disease rarely occurs in infancy. Boys before puberty and adult men are mainly affected. 20 to 30% of all mumps cases occurring after puberty are associated with testicular inflammation as an accompanying complication.

 

Causes of testicular inflammation

1. Sex hormones and sperm are produced in the testicles of men. The walnut-sized glands in the scrotum are connected to the inside of the body via blood vessels, lymphatics, the urinary tract, and the vas deferens.

 

2. If viruses or bacteria penetrate the testicular tissue, inflammation can occur. It is most commonly caused by germs that reach the testicles via the bloodstream (e.g., mumps). Other viral diseases that precede testicular inflammation include influenza, chickenpox, mononucleosis, and HIV.

3. More rarely, the disease occurs as a result of inflammation of the epididymis, prostate, seminal vesicles, or urinary tract (see Urinary Tract Infection).

4. The bacteria reach the testicles via the urethra or have spread to the testicles in the case of a bacterially inflamed epididymis. This occurs mainly in sexually active men, the spectrum of pathogens is similar to that of the urinary tract infection.

 

5. Testicular inflammation can also (rarely) occur with various general bacterial diseases such as typhus, tuberculosis, syphilis, and gonorrhea.

 

6. Via the bloodstream, streptococci can lead to inflammation of the testicles, for example in the case of scarlet fever, pneumococcal, or salmonella.

 

7. Violent injuries can also cause orchitis.

 

Symptoms of testicular inflammation

The most common symptom of testicular inflammation is painful testicular swelling. Redness, tenderness. At the beginning of the insidious disease, usually, only one testicle is affected, in 10 to 30% the disease runs on both sides, but with a time lag. Depending on the disease trigger, different additional symptoms can occur:

 

1. High fever, chills, tiredness

2. Burning pain when urinating,

3. Urge to urinate, groin and lower abdominal pain

4. Blood in the urine and ejaculate

5. Nausea, headache

6. Vomit

Because an acute inflammation of the testicles is usually an accompanying disease, these symptoms only become noticeable a few days after the start of the primary infection, eg in the case of mumps 4 to 7 days after the inflammation of the parotid glands (parotitis).

If the disease persists for a long time, the testicular tissue can be damaged. In addition to the direct damage caused by the germs, this can lead to the regression of the testicles in severe cases, and to infertility if it occurs on both sides.

 

Diagnosis of testicular inflammation

In addition to a thorough physical examination, the urologist can make the diagnosis using

 

A. Ultrasonic: Color Doppler ultrasound to rule out testicular torsion (= twisted testicles)

B.A urine culture and blood analysis and possibly with the help

C.An ELISA mumps antibody determination to back up. In addition, it should be clarified whether the drainage of urine in the bladder and urinary tract works smoothly. Therapy can only be started when it has been established beyond a doubt that it is a viral or bacterial testicular inflammation.

Therapy for testicular inflammation

1. The therapy depends on the triggering cause. There is currently no standard therapy for testicular inflammation caused by the mumps virus. Strict bed rest, cooling, and elevation of the testicles should be taken as general measures. A jockstrap (a holding device for the scrotum) is helpful.

2. Pain medication is also used. In addition, anti-inflammatory drugs can bring relief. If the inflammation of the testicles occurs as part of a mumps infection after puberty, there are recommendations to treat with alpha interferon. Mumps hyperimmune globulin and cortisone are rarely used.

 

3. A bacterial infection is treated with antibiotics after a urine culture has been taken.

 

4. Acute testicular inflammation heals within a few weeks, depending on the cause. However, they can also become chronic or occur repeatedly. If so, confusion can emerge. For example, a shrinking of the testicular tissue (atrophy) and accumulations of pus in the tissue (abscesses).

 

5. An operation may be necessary if the testicular swelling is very pronounced or purulent abscesses form in the testicular tissue. The procedure is performed under general anesthesia, regional anesthesia (anesthesia of a larger body area), or local anesthesia.

 

What else can the person concerned do against testicular inflammation?

With the help of mumps vaccination, men are protected against the most common pathogen. The use of condoms for frequently changing sexual partners is also very important as a precautionary measure. Regular prostate screening for the early detection of bladder emptying disorders is recommended for men over the age of 45.