Introduction
As testicle inflammation, or also orchitis, one calls the inflammation of the male gonads (gonads), which are arranged in pairs. An inflammation of the testicles is almost always accompanied by intense pain, because the testicles are supplied by a strong nerve plexus. This nerve plexus immediately transmits pain impulses to the body in case of swelling or heating. In this way, the body signals that something is wrong and that there is a risk of irreversible loss of function if treatment is not given.
Causes
The causes of testicular inflammation are usually an inflammation of surrounding structures, as inflammation of the testicles alone is relatively rare. In most cases it is the result of an epididymitis or a systemic infection. Infections leading to testicular inflammation can be caused by viruses and bacteria.
While bacteria usually enter the testes via the ascending urinary tract, viruses in this case tend to spread hematogenically – i.e. via the bloodstream. Typical viral pathogens that can cause testicular inflammation are the paramyxoviruses that occur in mumps disease. Mumps can therefore cause an inflammation of the testes (testicular mumps).
Therefore, a vaccination in the form of measles mumps rubella vaccination is an important preventive measure. In addition to paramyxoviruses, varicella can also cause testicular inflammation. Varicella is better known as the causative agent of chickenpox.
This is also a disease typical of childhood, which in itself is relatively uncomplicated. Other viruses that can be responsible for testicular inflammation are echoviruses and coxsackieviruses. While viral infections tend to be more typical in childhood, bacterial infections are more common in sexually active men.
Thus, frequent changes of sexual partners, or frequent sexual intercourse itself, increase the chance of getting infected with bacteria. Accordingly, the pathogen spectrum is similar to that of urinary tract infections: In addition to Neisseria (Neisseria gonorrhoeae), the pathogen causing gonorrhoeae, Chlamydia and E. coli bacteria also belong to the typical bacterial pathogen spectrum of a testicular inflammation. These pathogens are typical for urinary tract infections, but are not necessarily caused by a lack of hygiene, but rather by sexually active behavior.
However, this need not be the case, some other pathogens that cause testicular inflammation are relatively unspecific: Staphylococci and streptococci belong to the pathogen spectrum as well as pseudomonads and brucella. These are very widespread pathogens, which can also cause infections of the respiratory tract or the skin, for example. Almost always an inflammation of the testes occurs as a concomitant disease of an epididymitis, or an inflammation of the urinary tract.
Due to the anatomical proximity and the close connections among each other, infections quickly spread from one organ to the other. In the prostate, the two spermatic ducts lead to the urethra. These lead directly to the epididymis, and finally to the testicles.
Ascending urinary tract infections are therefore responsible for the majority of testicular inflammations. Mumps is a disease caused by the mumps virus and typically affects the salivary glands. As a complication of the infectious disease it can also lead to testicular inflammation.
In this case, the viruses are distributed from the salivary glands through the blood and are particularly likely to settle in the testicles. While children with a mumps infection are often spared this complication, orchitis after mumps infection affects up to 30% of all men with mumps after puberty. Men with mumps infection should therefore have a standard testicular examination.
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