Orchitis (ICD-10-GM N45.-: orchitis and epididymitis) is the inflammation of the testis (ancient Greek: ὄρχις orchis). Orchitis is often present in combination with epididymitis (inflammation of the epididymis) and is then called epididymoorchitis.
The following forms of orchitis (testicular inflammation) can be distinguished:
- Hematogenous-metastatic – occurring as a complication of infectious diseases such as mumps (mumps virus), rubella (rubella virus), varicella (chickenpox), tuberculosis (Mycobacterium tuberculosis), with mumps orchitis being the most common cause.
- Ascending (ascending infection) – Via the ductus deferens (vas deferens) ascending infection in pre-existing urethritis (urethritis) or prostatitis (prostatitis); common pathogens are E. coli, neisseria (gonorrhea, gonorrhea), Proteus, staphylococci, streptococci (= bacterial orchitis).
- Post-traumatic – occurring after injuries.
Note: Isolated orchitis occurs much less frequently than epididymitis (inflammation of the epididymis). In contrast, in the context of a bacterial epididymitis in up to 90% of cases, a concomitant orchitis occurs as a result of germ ascension (“ascending infection”).
Most cases of mumps orchitis occur before puberty. Approximately 30% of mumps sufferers develop orchitis beyond puberty. Usually, mumps orchitis occurs unilaterally (on one side), but the second testis may also be affected after a time lag.
The incidence (frequency of new cases) of acute isolated orchitis is not known. For acute epididymitis (AE; epididymitis), an incidence of 290 cases per 100,000 men per year is reported.
The incubation period (time from infection to onset of disease) for mumps orchitis is usually 14 to 25 days.
Course and prognosis: Orchitis begins with swelling of the testis (edema), followed by testicular pain (orchialgia). These can have a varying spectrum of intensity, i.e. they can range from unpleasant pulling to severe pain in the sense of acute scrotum (acute, painful swelling of the scrotum). This symptom can occur within a few hours. After one to two weeks, there is a spontaneous improvement in mumps orchitis. Therapeutic measures include bed rest, elevation and cooling of the testicle and, if necessary, the administration of an analgesic (painkiller) and, in the case of bacterial orchitis, a suitable antibiotic.
Consequence of orchitis may be sterility (infertility).
