What is Orchitis

Orchitis is inflammation of a testicle. Testicles are the male organs that produce sperm. The testicles are held in a fleshy sac (scrotum) located behind the penis. Orchitis usually affects only one testicle, but it can affect both.

Orchitis is caused by infection. Many kinds of bacteria and viruses can cause this infection. The condition can develop suddenly.

What are the causes?

This condition may be caused by:

• Infection from viruses or bacteria.
• Other organisms, such as fungi or parasites (rare). This is common in men who have a weak body defense system (immune system), such as men with HIV.

Bacteria

• Bacterial orchitis often occurs along with an infection of the tube that collects and stores sperm (epididymis).
• In men who are not sexually active, this infection usually starts as a urinary tract infection and spreads to the testicle.
• In sexually active men, sexually transmitted infections (STIs) are the most common cause of bacterial orchitis. These can include:
  • Gonorrhea.
  • Chlamydia.

Viruses

• Mumps is the most common cause of viral orchitis, though mumps is now rare in many areas because of vaccination.
• Other viruses that can cause orchitis include:
  • The chickenpox virus (varicella-zoster virus).
  • The virus that causes mononucleosis (Epstein–Barr virus).

What increases the risk?

The following factors may make you more likely to develop this condition:

• For viral orchitis:
  • Not having been vaccinated against mumps.
• For bacterial orchitis:
  • Having had frequent urinary tract infections.
  • Engaging in high-risk sexual behaviors, such as having multiple sexual partners or having sex without using a condom.
  • Having a sexual partner with an STI.
  • Having had urinary tract surgery.
  • Using a tube that is passed through the penis to drain urine (Foley catheter).
  • Having an enlarged prostate gland.

What are the signs or symptoms?

The most common symptoms of orchitis are swelling and pain in the scrotum. Other signs and symptoms may include:

• Feeling generally sick (malaise).
• Fever and chills.
• Painful urination.
• Painful ejaculation.
• Headache.
• Fatigue.
• Nausea.
• Blood or discharge from the penis.
• Swollen lymph nodes in the groin area (inguinal nodes).

How is this diagnosed?

This condition may be diagnosed based on:

• Your symptoms. Your health care provider may suspect orchitis if you have a painful, swollen testicle along with other signs and symptoms of the condition.
• A physical exam.

You may also have other tests, including:

• A blood test to check for signs of infection.
• A urine test to check for a urinary tract infection or STI.
• Using a swab to collect a fluid sample from the tip of the penis to test for STIs.
• Taking an image of the testicle using sound waves and a computer (testicular ultrasound).

How is this treated?

Treatment for this condition depends on the cause.

For bacterial orchitis, your health care provider may prescribe antibiotic medicines. Bacterial infections usually clear up within a few days.

For both viral infections and bacterial infections, you may be treated with:

• Rest.
• Anti-inflammatory medicines.
• Pain medicines.
• Raising (elevating) the scrotum with a towel or pillow underneath and applying ice.

Follow these instructions at home:

• Rest as directed by your health care provider.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.
• Do not have sex until your health care provider says it is okay to do so.
• Elevate your scrotum and apply ice as directed:
  • Put ice in a plastic bag.
  • Place a small towel or pillow between your legs.
  • Rest your scrotum on the pillow or towel.
  • Place another towel between your skin and the plastic bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have a fever.
• Pain and swelling have not gotten better after 3 days.

Get help right away if:

• Your pain is getting worse.
• The swelling in your testicle gets worse.

Summary

• Orchitis is inflammation of a testicle. It is caused by an infection from bacteria or a virus.
• The most common symptoms of orchitis are swelling and pain in the scrotum.
• Treatment for this condition depends on the cause. It may include medicines to fight the infection, reduce inflammation, and relieve the pain.
• Follow your health care provider’s instructions about resting, icing, not having sex, and taking medicines.