Testicular inflammation, which has the medical name orchitis, is one of the particularly common male diseases. Characteristic of this clinical picture are severe pain and swelling in the affected testicle. Sometimes testicular inflammation can develop into a chronic disease.
What is testicular inflammation?
Testicular inflammation or orchitis is one of the classics among male diseases. It is an infectious disease that is usually caused by viruses. In rare cases, the disease is caused by a bacterial infection. Mostly adult men are affected by it. It rarely occurs before sexual maturity. Testicular inflammation is characterized by severe pain and swelling in the affected area and high fever. Occasionally, the disease also spreads to the epididymis, resulting in epididymitis. Treatment should be rapid and consistent so that the painful inflammation can subside without consequences. In particularly severe cases, testicular inflammation can cause damage to the testicular tissue, which can lead to infertility.
Causes
Testicular inflammation almost always develops from another infectious disease caused by viruses. It often occurs as a concomitant of mumps disease, although children usually do not suffer from it. However, other viral diseases can also be reasons for this male disease. These include glandular fever, herpes zoster, chickenpox and any infections caused by coxsackieviruses. In addition, bacteria can be the cause of testicular inflammation. It can therefore occur, for example, as a result of the sexually transmitted disease gonorrhea or tuberculosis of the urinary bladder or ureter. An already existing epididymitis can be transferred to the testicle and thus also trigger this painful inflammatory disease. In a few cases, the reason for testicular inflammation is an injury to the testicles caused by external force.
Symptoms, complaints and signs
Acute testicular inflammation is manifested by swollen and painful testicles. The skin in the area of the scrotum is reddened and strongly heated, and it also hurts when touched. This may be accompanied by a general feeling of illness. The inflammation is often associated with fever. Affected persons usually have problems with urination and urge to urinate more frequently. The pain may radiate to the groin or back. Symptoms are usually limited to one testicle. However, in 10 to 15 percent of cases, both testicles are affected by the inflammation. The first symptoms of orchitis usually appear a few days after the onset of the underlying disease. As the disease progresses, other symptoms may be added, depending on which organs are involved. Testicular inflammation often occurs together with epididymitis. The latter is also manifested by pain, urinary disorders and increasing discomfort. If the underlying disease is treated quickly, the testicular inflammation subsides after one to two weeks at the latest. In the absence of treatment, further symptoms may occur, such as spread of the inflammation to surrounding organs. The aforementioned complaints and signs therefore require early clarification by the family doctor or a urologist.
Diagnosis and course
Testicular inflammation is noticeable by severe pain in the affected testicle. It is also considerably swollen and reacts very sensitively to touch. With high fever, the body tries to fight against the inflammation. The symptoms of testicular inflammation usually subside significantly after a week. A diagnosis of testicular inflammation begins with a detailed examination of the symptoms by the physician. In this way, other diseases can be ruled out in advance. The doctor then carefully palpates the testicle for the symptoms of sensitivity to touch, swelling and redness. If the doctor concludes that testicular inflammation is likely, an examination of the urine is performed. This will rule out a urinary tract infection. A blood test reveals whether viruses or bacteria are the cause of the inflammation. Ultrasound examination provides a pictorial representation of testicular inflammation.
Complications
Testicular inflammation can cause several complications.Initially, there is a risk that the inflammatory processes will destroy the testicular tissue and reduce testicular function. In case of severe inflammation, such testicular atrophy may possibly lead to complete inability to conceive. More often, as a result of testicular inflammation, abscesses or pus accumulations develop in the testicular sheaths. Sometimes the inflammation then spreads to the epididymis and the testicular sheaths, causing further stress on the testicular tissue. As the inflammation progresses, the risk of blood poisoning also increases. In addition, the condition known as Fournier’s gangrene can occur, in which the tissue becomes inflamed and dies. A urinary tract infection can also occur and, if left untreated, lead to further discomfort and complications. Another possible complication is testicular torsion. As a result of the inflammation, the testicles become malpositioned and can no longer be supplied with blood. If left untreated, such a torsion leads to the death of the soft body within a few hours. Due to the severity of these complications, a physician should be consulted immediately if testicular inflammation is suspected. During treatment, the antibiotics and cortisone-containing preparations administered can sometimes cause side effects such as high blood pressure and itching.
When should you see a doctor?
Affected individuals who suffer from pain in the testicles that lasts for several days should see a doctor. If ejaculation does not bring a significant improvement in the sensations in the testicles, it is advisable to have the complaints clarified. A feeling of pressure or a pulling sensation are considered unusual and should be investigated. If the complaints increase in intensity over the next few days or if they spread further, a medical clarification of the indications is necessary. Often, a deterioration of health sets in within a short time. In the case of testicular inflammation, an increase in symptoms can be expected within a few hours or days. If there is fever, irritability, a feeling of illness or an internal sensation of warmth, a doctor is needed. If there is dizziness, swelling of the testicle or sexual dysfunction, it is advisable to see a doctor. Since persistent testicular inflammation threatens permanent disruption of sperm production as well as infertility, a visit to the doctor should be made in time at the first discomfort. Additionally, the pathogens are considered highly contagious, so prompt medical attention is necessary. A feeling of pressure or a perception of tightness in the testicle are considered unusual and should be clarified. If discomfort or perceptual disturbances occur during locomotion, a visit to the doctor is also recommended.
Treatment and therapy
After the doctor has diagnosed testicular inflammation, consistent and comprehensive treatment is given. This provides for strict bed rest and cooling compresses for the affected testicle to reduce swelling. Sometimes a jockstrap is also prescribed, which is a pouch-like support device used to immobilize and elevate the inflamed body part. Nonsteroidal anti-inflammatory drugs can relieve the pain and reduce the infection somewhat. Depending on the cause of the inflammation, the use of other medications may be advised. If the cause of the testicular inflammation is a bacterial infection, antibiotics must be taken accordingly. If it is a concomitant of a viral infection, these medications cannot be used. However, administration of preparations containing cortisone may help in decongesting the inflammatory focus. In exceptional cases, it is too late to treat the testicular inflammation with medication, so surgical intervention must be performed. The testicle is already so massively swollen and enlarged that serious damage to the tissue is likely. These can cause infertility in the later course. If this clinical picture is present in testicular inflammation, the doctor opens the connective tissue envelope with small incisions.
Outlook and prognosis
The entire healing process of inflammation in the testicles requires a lot of patience and perseverance. In some circumstances, the entire healing process may take 6 weeks. Even with optimal treatment, this said healing time is to be expected. As a rule, this clinical picture can be treated very well and effectively. Since it is a bacterial infection, an antibiotic is most suitable.If the affected person does not seek medical and drug treatment, then significant complications can occur. Under certain circumstances, the inflammation can spread throughout the entire body, resulting in the formation of pus. In this context, there is a risk of an abscess, which must be treated medically. Otherwise, there is a risk of blood poisoning, which in the worst case can lead to death. Normally, the outlook and prognosis for inflammation of the testicles looks positive and confident. Prompt and complete recovery is the rule. However, in some cases, complications may occur and medical attention should be sought. In order to positively influence the prospect and prognosis of a quick and uncomplicated recovery, medical and drug treatment should be resorted to in case of testicular inflammation.
Prevention
The preventive measures against testicular inflammation are limited. Because this male disease is usually a concomitant of another disease, efforts should be made to protect against the causative disease. This includes early vaccination against mumps and timely drug treatment of relevant viral diseases. Furthermore, to prevent testicular inflammation, a condom should not be dispensed with during sexual intercourse with changing partners.
Aftercare
Follow-up care for testicular inflammation consists of keeping the patient on bed rest until the local inflammation disappears and the temperature decreases. To minimize potential complications such as infertility or a chronic pain syndrome, prescribed tablet use is mandatory. Careful cooling of the testicles with cooling pads may somewhat alleviate the symptoms. In some cases, an ointment is applied to the testicle for the first few days and a scrotal bandage is applied to hold it in place. As a rule, follow-up care should be completed within a few weeks. If there is no improvement after this time, the attending physician must be contacted and a new diagnosis made. In particular, if swelling and tenderness persist for a long time, the possibility of tuberculosis, testicular cancer or other diseases must be considered. Affected persons whose inflammation was caused by the bacterium Neisseria gonorrhoeae must inform their sexual partners about the presence of the disease. If these partners also experience symptoms within 60 days of the affected person’s symptom detection, a medical examination with subsequent treatment is essential. Until the infection has been clarified and all sexual partners have been completely cured, they must abstain completely from sexual intercourse. In the course of a microbiological examination, the doctor can determine whether there is still an increased bacterial load or the healing is complete.
What you can do yourself
Testicular inflammation is a serious condition and should always prompt a doctor’s consultation. However, the patient himself also has a great influence on the course of the disease. However, if the patient’s general condition is poor, he should be hospitalized and treated with antibiotics or antivirals under constant medical supervision. In most cases, however, patients can remain at home. There they must then keep the testicles still and cool them by elevating them. For elevation, there is a special carrying bag called a suspensorium. With the help of this carrying bag, the swollen scrotum is relieved of its own weight. During the acute phase of the disease, the patient should also wear tight-fitting underpants. Pain relief can be achieved by cooling the swollen scrotum with cold water in the form of cooling compresses. A washcloth soaked in cold water could serve as a poultice. However, the water must not be too cold. Furthermore, the patient must regularly take the anti-inflammatory, analgesic and antibiotic medications prescribed by the doctor. Even if the treatment can thus be carried out by the patient largely on his own, constant medical supervision is necessary. For example, the urologist should check the progress of the testicular inflammation at regular intervals by means of palpation and ultrasound examinations in order to detect possible abscess formation in good time.
