Definition

Orchitis is pain and swelling in one or both testicles. It may also affect fertility.

Copyright © Nucleus Medical Media, Inc.

Causes

Orchitis is often caused by an infection from:

• Viruses, especially mumps
• Bacteria, such as those found in:
  • Epididymitis, which is usually caused by sexually transmitted infections (STIs)
  • Urinary tract infections
  • Tuberculosis
• Problems with the immune system, such as Henoch-Schonlein purpura
• An inflammatory reaction after a bacterial infection from another place in the body

In others, the cause is not known.

Risk Factors

Things that may raise the risk of this problem are:

• A history of:
  • Epididymitis
  • STIs
  • Rubella
  • Urinary tract infections
  • Genital surgery
• Never having the measles, mumps, rubella (MMR) vaccine
• Long-term urinary catheter use
• Structural defects

Behaviors that raise the risk of STIs also raise the risk of orchitis. These are:

• Having more than one sexual partner
• Sex without condoms
• Having sex with a person who has an STI

Symptoms

The main problem is pain and swelling of the testicles. Other problems may be:

• Groin pain
• A feeling of heaviness in the scrotum
• Blood in the urine or semen
• Pain during urination, ejaculation, or sex
• Lack of energy
• Fever
• Nausea and vomiting

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done. It will focus on the testicles. This may be enough to make the diagnosis.

These tests may be done to look for signs of infection:

• Blood tests
• Urine tests
• Testing any discharge from the urethra

Images of the testicles may be taken. This can be done with an ultrasound.

Treatment

Treatment depends on the cause. The goal is to ease pain and swelling. Medicines may be given, such as:

• Over the counter pain relievers
• Antibiotics to treat a bacterial infection

People who are not helped by medicine may need surgery. Choices are:

• Epididymectomy—removal of the epididymis (duct) of the affected testicle, while leaving the testicle in place
• Orchiectomy —removal of the affected testicle

Prevention

The risk of this problem may be lowered by:

• Getting the MMR vaccine
• Practicing safe sex