Is Orchitis A Serious Condition & Can It Be Reversed?

Orchitis is an inflammatory disease in which the testes and their membranes are involved in the pathological process. The disease can affect men of all ages, but most often children suffer from it. One of the common causes is mumps – an acute infectious disease of the parotid glands. It is in 70% of cases that it leads to inflammation of the testicles. Men who have had orchitis in childhood often become infertile.(1)

Is Orchitis A Serious Condition?

The consequences of orchitis are quite serious. The possibility of the inflammatory cycle is its ability to penetrate the adjacent tissues. With the untimely treatment of orchitis, you may experience:

  • Testicular tissue necrosis (cell death);
  • Complete removal of the testicle through surgery;
  • Infertility, which in the future will not be able to respond to treatment.

It is necessary to note that orchitis is handled effectively by antibiotics and appropriate treatment is required for every underlying cause. Therefore, do not hesitate to treat.(1)

Can Orchitis Be Reversed?

Management of orchitis is divided into conservative and surgical. The first is used in uncomplicated inflammatory processes and includes antibacterial, symptomatic and pathogenetic treatment. Antibacterial involves the appointment of antibiotics. Depending on the severity of the process, medications can be administered in the form of injections or tablets.

With severe intoxication, intravenous administration of a solution of glucose, sodium chloride, etc. is prescribed. They help to remove toxins and improve the general condition. Anti-inflammatory drugs are used as pathogenic treatment.

If not treated properly, the disease can recur and may also present as a chronic condition. Moreover, the infection causing the disease can recur as well, thus increasing the chance of orchitis to recur.(5)

Diagnosis Of Orchitis

Diagnosis of orchitis begins with an examination of the patient, which is often the main method since the symptoms are quite specific. The examination begins with the clinical analysis of blood and urine. 

An increased number of leukocytes is detected in the blood with a shift in the formula towards young cells and an increase in the erythrocyte sedimentation rate. These signs indicate the presence of an inflammatory process in the body.

White blood cells and a small number of red blood cells can be detected in the urine. When checking urine for sterility, microorganisms such as E. coli, staphylococci, streptococci, etc. are determined in it.

If there is a suspicion of an infection of the genitourinary system, a bacteriological examination of the smear from the urethra is necessary. With its help, mycoplasmal, gonococcal, ureo-plasmal infections, etc. are detected.

To determine abnormalities in spermatogenesis, a spermogram should be performed. This study will help identify abnormal sperm, motility, and vitality.

Causes Of Orchitis

In the development of the disease, the main role is played by infectious pathologies; most often the pathogen enters the testes from adjacent organs – the epididymis, rectum, and urethra. The most common causes are: 

  • Acute infectious diseases – pneumonia, typhoid, etc.
  • Brucellosis
  • Flu
  • Infectious mumps
  • Infectious processes in the urethra, prostate, bladder, rectum
  • Traumatic damage to the testicles; epididymitis – inflammation of the epididymis
  • Urogenital infections – mycoplasmosis

Often, inflammation from the appendages passes to the entire testicle and epididymal-orchitis develops. This is due to the proximity of the location of the organs.(2)

Risk Factors For Orchitis

  • Decreased immune defense of the body against a background of chronic diseases. 
  • The impact of low temperatures – long sitting on cold surfaces, general hypothermia. Maintaining irregular sex life. 
  • Violation of the outflow of urine with prostate adenoma, urolithiasis, etc.
  • The presence of chronic infections in the body. 
  • Inactivity, maintaining a sedentary lifestyle (at-risk – drivers, office workers).(3)

Symptoms Of Acute Orchitis

The inflammatory process in the testicles is acute or chronic, on which the signs of the disease depend. In acute orchitis in men, there is an increase in body temperature above +38 degrees.

The right and left testicles can be affected, or both at the same time. They increase in size, compact, become red. The skin of the scrotum is stretched and red. Patients are worried about severe pain in the testicles, it radiates (spreads) to the inguinal region, lower abdomen and sacrum. 

Unpleasant sensations intensify with movement and walking. Symptoms of intoxication appear in the form of weakness, malaise, headache. Chronic orchitis is much less common than acute, and is characterized by the following symptom complex:

  • Testicular pain – inconstant, moderate, worse after a long walk.
  • Body temperature rises to +38 degrees.
  • On palpation of the scrotum, the pain intensifies.
  • The testicular enlargement is moderate, the tension is weak.(4)

References:

  1. Pilatz A, Fijak M, Wagenlehner F, Schuppe H. Orchitis. Der Urologe. Ausg. A. 2019;58(6):697-710.
  2. Ip CCK, Tumali K, Hoh IM, Arunasalam A. Acute epididymo-orchitis from brucellosis melitensis in Australia. BMJ Case Reports CP. 2019;12(7):e230007.
  3. Ozcan H, Ceran C. Epididymo-orchitis caused by Behcet’s disease: An unusual cause of acute scrotum. Pediatric Urology Case Reports. 2019;6(3):51-55.
  4. Waisanen KM, Osumah T, Vaish SS. Testicular Metastasis From Prostatic Adenocarcinoma Presenting as Recurrent Epididymo-orchitis. Urology. 2017;108:e7-e9.
  5. Klebanov N, Raghavan A. Tuberculous orchitis following intravesical bacille calmette-guérin (BCG) therapy. Cureus. 2018;10(5).

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