Brief overview
- Symptoms: Relatively rapid onset of pain, redness and swelling of the testis, unilateral or bilateral, possibly fever.
- Treatment: Depending on the cause, symptomatic therapy in case of viral infections, painkillers, anti-inflammatory drugs, possibly cortisone, sometimes local anesthesia in the area of the spermatic cord, antibiotics in case of bacterial infections
- Course of disease and prognosis: Usually good, rarely complications such as abscess formation or consequences such as impaired fertility.
- Examination and diagnosis: Based on history, palpation, Prehn’s sign, if necessary detection of the triggering infection, ultrasound examination (sonography).
- Prevention: Protective vaccinations are available against some causes, such as certain viral infections (e.g. mumps).
What is testicular inflammation?
Testicular inflammation occurs mainly in boys after puberty and in men. It is less common in children. In most cases, orchitis can be treated successfully.
What are the symptoms of testicular inflammation?
Very often, mumps viruses are the causative agents of testicular inflammation. Patients then usually also have swelling of the parotid glands and pain in the face and neck area, especially when chewing.
Bacterial testicular inflammation is also accompanied by symptoms such as severe pain, redness and swelling. However, symptoms develop over the course of a few days rather than within hours. In bacterial inflammation, the epididymis is usually also affected.
What can you do yourself against testicular inflammation?
The treatment of testicular inflammation depends on whether bacteria or viruses are the triggers.
Treating viral testicular inflammation
In the case of a viral infection such as mumps orchitis, the therapy generally consists of alleviating the symptoms. This symptomatic therapy includes the following measures in particular:
- Bed rest
- Raising the testicles
- Analgesics against the pain
In adults with viral testicular inflammation, the doctor sometimes prescribes cortisone to reduce the inflammation in the testicular tissue.
Treat bacterial testicular inflammation
Regardless of the cause of testicular inflammation, in some cases the doctor injects a local anesthetic near the spermatic cord to relieve pain.
What are the causes of testicular inflammation?
Other viral infections are sometimes accompanied by testicular inflammation. These include infections with the varicella-zoster virus (causative agent of chickenpox and shingles), the Ebstein-Barr virus (causative agent of mononucleosis = Pfeiffersches glandular fever) or with Coxsackie viruses.
Sometimes patients first suffer from epididymitis (inflammation of the epididymis), for example due to ascending germs in a urinary tract infection. Subsequently, the pathogens spread from the epididymis to the testicles.
Testicular inflammation also sometimes occurs as a result of trauma (such as violence to the testicle).
Testicular inflammation: Duration and prognosis
Testicular inflammation is usually very painful and uncomfortable. However, it can generally be treated successfully.
After a viral testicular inflammation, sperm production is usually impaired for several months. In rarer cases, the testicular tissue is so damaged that permanently too few or too slow sperm are produced – in extreme cases, the patient remains infertile. This affects one to two percent of patients with mumps orchitis.
How can testicular inflammation be diagnosed?
From the description of the symptoms and the careful examination of the testicle, the doctor usually concludes very quickly that the testicle is inflamed. An important diagnostic clue is provided by the so-called Prehn’s sign: In the case of testicular inflammation, the pain often subsides when the testicle is lifted slightly.
Differentiation from testicular torsion
Both examinations (Prehn’s sign and Doppler sonography) are important to rule out testicular torsion (twisting of the testicle) as the cause of the pain. In this case, the testicle twists on the spermatic cord, which interrupts the blood supply (visible in Doppler sonography).
Laboratory tests
If mumps orchitis is suspected and no vaccination against mumps has taken place, a blood test helps to detect the disease. For this purpose, the blood is searched for specific antibodies against the mumps virus.
A urine test can detect any accompanying urinary tract infections.
How can testicular inflammation be prevented?
Prevention is not possible against every cause of testicular inflammation. However, vaccinations are available against some viral infections (such as mumps, chickenpox) that are associated with inflammation of the testicles.
The mumps vaccination is usually given together with the vaccination against measles and rubella in a joint vaccination (MMR vaccination), the vaccination against chickenpox (varicella-zoster virus) is given separately.
