Orchitis
Introduction
If you're an adult male, you may have heard that getting mumps may affect your fertility. The reason is viral orchitis, an inflammation of one or both testicles, most commonly associated with the virus that causes mumps. About one-third of males who contract mumps after puberty develop orchitis.
Fortunately, infertility as a result of mumps-related orchitis is rare. And in those countries where use of the mumps vaccine is widespread, such as in the United States, your risk of contracting mumps is small.
Other causes of orchitis usually are bacterial, including sexually transmitted diseases (STDs). The best way to prevent orchitis is to prevent mumps and to avoid behaviors that may result in STDs.
Signs and symptoms
The signs and symptoms of orchitis usually have an abrupt onset. They may include:
- Testicular swelling on one or both sides
- Pain ranging from mild to severe
- Tenderness in one or both testicles
- Nausea and vomiting
- Fever
- Discharge from penis
- Prostate enlargement and tenderness
Causes
A number of bacterial and viral organisms can lead to orchitis.
Bacterial orchitis
Most often, bacterial orchitis is the result of epididymitis, an inflammation of the coiled tube (epididymis) that connects the vas deferens and the testicle. The vas deferens carries sperm from your testicles. When inflammation in the epididymis spreads to the testicle, the resulting condition is known as epididymo-orchitis. Bacterial orchitis is rare without epididymitis.
Epididymitis usually is caused by an infection of the urethra or bladder that spreads to the epididymis. Often the cause of the infection is an STD, particularly gonorrhea or chlamydia. The highest incidence of sexually transmitted epididymo-orchitis occurs in men ages 19 to 35. Non-sexually transmitted forms of the infection may be related to anatomical abnormalities in the urinary tract or having had a catheter or medical instruments inserted into the penis.
Viral orchitis
Most cases of viral orchitis are the result of mumps. About one-third of males who contract the mumps after puberty develop orchitis during the course of the mumps, usually four to six days after onset. The mumps virus can spread from the salivary glands to other parts of the body, including the testicles.
Complications
Orchitis may cause the affected testicle to shrink (atrophy). It also can cause scrotal abscess, in which the infected tissue fills with pus, or lead to recurrent episodes of epididymitis. In rare cases, orchitis can impair fertility; however, if orchitis affects only one testicle, sterility is rare.
Treatment
Treatment depends on the cause of orchitis.
Treating viral orchitis
Treatment for viral orchitis, the type associated with mumps, is aimed at relieving symptoms. Your doctor may prescribe pain medication, nonsteroidal anti-inflammatory drugs, such as ibuprofen (Motrin, Advil, others) or naproxen (Aleve, Anaprox, others) and recommend bed rest, elevating your scrotum and applying cold packs.
In addition to measures to relieve discomfort, bacterial orchitis and epididymo-orchitis require antibiotic treatment. If the cause of the infection is an STD, your sexual partner also may need treatment.
Treating bacterial orchitis
Antibiotic drugs most commonly used to treat bacterial orchitis include ceftriaxone (Ceftin), ciprofloxacin (Cipro), doxycycline (Vibramycin, Doryx), azithromycin (Zithromax), and trimethoprim and sulfamethoxazole combined (Bactrim, Septra). Make sure your doctor is aware of any other medications you're taking or any allergies you have. This information, as well as whether your infection is sexually transmitted and what type of STD you have, will help your doctor select the best treatment.
Be sure to take the entire course of antibiotics recommended by your doctor. Even if your symptoms clear up sooner, complete the course to ensure that the infection has been eradicated.
Prevention
Getting immunized against mumps is your best protection against viral, mumps-related orchitis. Having sex with just one partner and using a condom helps protect against STDs.
Informations obtained from National Institute of Health.