Orchitis is inflammation of the testicles that may occur in one or both testicles. It can cause pain and may affect fertility.
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Orchitis is often caused by an infection from:
- Viruses—The most common virus is mumps.
- Bacteria, such as those found in:
- Autoimmune diseases, such as Henoch-Schonlein purpura
- An inflammatory reaction following a bacterial infection somewhere else in the body
In some cases, the cause may be unknown.
Factors that may increase your chances of orchitis include:
- A history of epididymitis or other STIs
- History of rubella (German measles)
- Never having measles, mumps, rubella (MMR) vaccine
- Long-term urinary catheter use
- Structural defects
- History of recurrent urinary tract infections
- A history of genital surgery
- Receptive anal intercourse
Behaviors that increase the risk of STIs also increase the risk of orchitis. High-risk behaviors include:
- Multiple sexual partners
- Sex without condoms
- Partner with a current STI
Orchitis causes testicular pain with swelling. Other symptoms include:
- Feeling of heaviness in the scrotum
- Blood in the urine or semen
- Pain during urination, ejaculation, or sexual intercourse
- Generalized groin pain
Viruses and bacteria may also cause body-wide symptoms such as fatigue, fever, nausea, and headache.
You will be asked about your symptoms and medical history. A physical exam will be done. A diagnosis may be made based on an exam of the testicles, scrotum, and groin area.
Testing is done to confirm the cause and to rule out testicular emergencies, especially testicular torsion. Signs of infections and the exact virus or bacteria involved can be determined with:
- Blood tests
- Urine tests
- Swab from the urethra to look for causes of infection
An ultrasound may be done to check the testicles and nearby structures for damage.
Treatment depends on the cause of orchitis.
A viral infection will gradually pass on its own. Comfort measures, such as over-the-counter medications to reduce pain and fever, may be advised.
Antibiotics will be prescribed if a bacterial infection is present.
If other treatments do not work or there is risk of damage, surgery may be needed. The goal of surgery is to reduce pain and prevent further damage.
- Orchiectomy —Removal of the affected testicle.
- Epididymectomy—Removal of the epididymis of the affected testicle, while leaving the testicle in place.
To help reduce your chance of orchitis:
- Get vaccinated with the MMR vaccine.
- Practice safe sex, including wearing a latex condom to prevent STIs.
- Get prompt treatment for any infections.
Centers for Disease Control and Prevention
Urology Care Foundation
Canadian Urological Association
Public Health Agency of Canada
Acute epididymitis. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T114552/Acute-epididymitis. Updated October 6, 2017. Accessed March 16, 2018.
Epididymitis and orchitis. Urology Care Foundation website. Available at: http://www.urologyhealth.org/urologic-conditions/epididymitis-and-orchitis. Accessed March 16, 2018.
Orchitis. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/genitourinary-disorders/penile-and-scrotal-disorders/orchitis. Updated November 2017. Accessed March 16, 2018.
Trojian TH, Lishnak TS, et al. Epididymitis and orchitis: an overview. Am Fam Physician. 2009;79(7):583-587.
Last reviewed March 2018 by EBSCO Medical Review Board James P. Cornell, MD Last Last updated: 6/17/2016