Orchitis

Orchitis
Other names	Orchiditis
Pronunciation	/ˌɔːrˈkaɪtɪs/, /ˌɔːrkɪˈdaɪtɪs/
Specialty	Urology

Orchitis is inflammation of the testicles. It can also involve swelling, pains and frequent infection, particularly of the epididymis, as in epididymitis. The term is from the Ancient Greek ὄρχις meaning "testicle"; same root as orchid.

Signs and symptoms

Symptoms of orchitis are similar to those of testicular torsion. These can include:

• hematospermia (blood in the semen)
• hematuria (blood in the urine)
• severe pain
• visible swelling of a testicle or testicles and often the inguinal lymph nodes on the affected side.

Causes

Orchitis can be related to epididymitis infection that has spread to the testicles (then called "epididymo-orchitis"), sometimes caused by the sexually transmitted infections chlamydia and gonorrhea. It has also been reported in cases of males infected with brucellosis. Orchitis can also be seen during active mumps, particularly in adolescent boys.

Ischemic orchitis may result from damage to the blood vessels of the spermatic cord during inguinal herniorrhaphy, and may in the worst event lead to testicular atrophy.

Diagnosis

Doppler ultrasound of the scrotum, in the axial plane, showing orchitis (as part of epididymo-orchitis) as hypoechogenic and slightly heterogenic left testicular tissue (right in image), with an increased blood flow. There is also swelling of peritesticular tissue.

• Blood – ESR high
• Urine – Cultural & Sensitivity test
• Ultrasound scanning

Treatment

In most cases where orchitis is caused by epididymitis, treatment is an oral antibiotic such as cefalexin or ciprofloxacin until infection clears up. In both causes non-steroidal anti-inflammatory drugs such as naproxen or ibuprofen are recommended to relieve pain. Sometimes stronger pain medications in the opiate category are called for and are frequently prescribed by experienced emergency department physicians.

Other animals

Orchitis is not rare in bulls and rams. It has also been described in roosters.

Further reading

• Lefort C, Thoumas D, Badachi Y, et al. (July 2001). "Orchites ischémiques: À propos de 5 cas diagnostiqués en écho-Doppler couleur" [Ischemic orchiditis: review of 5 cases diagnosed by color Doppler ultrasonography]. Journal de Radiologie (in French). 82 (7): 839–42. PMID 11507447. INIST 1080037.
• Chung JJ, Kim MJ, Lee T, Yoo HS, Lee JT (September 1997). "Sonographic findings in tuberculous epididymitis and epididymo-orchitis". Journal of Clinical Ultrasound. 25 (7): 390–4. doi:10.1002/(SICI)1097-0096(199709)25:7<390::AID-JCU7>3.0.CO;2-5. PMID 9282805. S2CID 23653479.
• Fong Y, Wantz GE (May 1992). "Prevention of ischemic orchitis during inguinal hernioplasty". Surgery, Gynecology & Obstetrics. 174 (5): 399–402. PMID 1570618.
• Beard CM, Benson RC, Kelalis PP, Elveback LR, Kurland LT (January 1977). "The incidence and outcome of mumps orchitis in Rochester, Minnesota, 1935 to 1974". Mayo Clinic Proceedings. 52 (1): 3–7. PMID 609284.
• Bigazzi PE, Kosuda LL, Hsu KC, Andres GA (February 1976). "Immune complex orchitis in vasectomized rabbits". The Journal of Experimental Medicine. 143 (2): 382–404. doi:10.1084/jem.143.2.382. PMC 2190126. PMID 129498.
• Lynch VP, Eakins D, Morrison E (August 1968). "Granulomatous orchitis". British Journal of Urology. 40 (4): 451–8. doi:10.1111/j.1464-410X.1968.tb11832.x. PMID 5678169.
• Dreyfuss W (April 1954). "Acute granulomatous orchiditis". The Journal of Urology. 71 (4): 483–7. doi:10.1016/S0022-5347(17)67813-3. PMID 13152871.
• Lambert B (1951). "The frequency of mumps and of mumps orchitis and the consequences for sexuality and fertility". Acta Genetica et Statistica Medica. 2 (Suppl. 1): 1–166. PMID 15444009.
• Grünberg H (1926). "Three unusual cases of chronic orchitis clinically resembling tumors of the testis". Frankfurt Z Pathol. 33: 217–27.