Symptoms of testicular orchitis

Inflammation of the genitourinary system in men can occur in both acute and chronic forms. Symptoms of testicular orchitis depend on the causes of the disease and the presence of concomitant pathologies. There are a number of common signs that allow one to suspect the disease:

• Swelling and pain in the scrotum.
• Swollen tissue in the groin area.
• Deterioration of general well-being.
• Feverish condition.
• Presence of blood in the seminal fluid.
• Pain in the scrotum, increasing during defecation or urination.
• Discomfort during ejaculation.

The appearance of the above symptoms is a reason for immediate medical attention. The sooner orchitis is diagnosed, the higher the chances of avoiding its complications.

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Temperature with orchitis

An increase in the general body temperature in diseases of the male genitourinary organs indicates pathological processes in the body. In orchitis, a local increase in the temperature of the testicles is observed in combination with reddening of the skin of the scrotum. These symptoms develop due to the expansion of small vessels, excessive blood flow to the affected organs and the accumulation of biologically active substances.

Temperature is a protective reaction of the body and from the first days of the disease rises to subfebrile values. On the 4-5th day it can rise to 40 °C and more. The painful condition is accompanied by symptoms of general intoxication: increased weakness, chills, deterioration of general health, headaches. If the pathology is complicated by purulent processes, this can lead to testicular atrophy.

Left-sided orchitis

Most often, orchitis is unilateral, affecting the left or right testicle. Left-sided inflammation can be a complication of previous infectious diseases, injuries, allergic reactions, and a number of other factors.

After an infection, the body produces antibodies that are sensitive to pathogenic microorganisms, i.e. sensitization occurs. Because of this, the immune system begins to attack the testicular tissue. The disease proceeds with the following symptom complex:

• Increase in general and local body temperature.
• Sharp pain in the groin, perineum and lower back.
• Swelling of the testicle.
• Hyperemia of the scrotum.

In addition to the above symptoms, left-sided orchitis may be accompanied by dyspeptic disorders and severe headaches.

Treatment depends on the factors that triggered the inflammation. Most often, patients are prescribed a course of antibiotics, painkillers, moderate physical activity and wearing special tight underwear. Without timely medical care, there is a risk of complications: inflammation of the epididymis, atrophy of the sex glands, irreversible infertility.

Orchitis on the right

Inflammatory lesions of the right testicle can occur in both acute and chronic forms. Most often, orchitis on the right is a complication of an infectious disease - mumps. The painful condition is manifested by the following symptoms:

• Severe pain in the testicle area, radiating to the groin, leg and lower back.
• The discomfort increases during movement.
• Enlarged scrotum.
• Hyperemia of the scrotum.
• Local inflammation and elevated temperature.
• Chills and fever.

If the above symptoms are left to take their course, this will lead to the disease becoming chronic.

Treatment depends on the severity of the disease. As a rule, patients are prescribed antibacterial and symptomatic therapy. After the inflammation has been relieved, thermal physiotherapy procedures are prescribed for the scrotum area. If the disease becomes chronic or is complicated by an abscess, then surgical intervention may be required to drain the organ.

Bilateral orchitis

According to medical statistics, the development of bilateral inflammation of the testicle is much less common than unilateral lesions. The main causes of orchitis include:

• Trauma and mechanical impact.
• Inflammatory processes in the body.
• Infectious diseases.
• Hypothermia.
• Stagnant processes.

The main feature of this form of the disease is that it has a high risk of developing infertility. The inability to conceive is associated with the growth of connective tissue in the appendages of the testicles and the narrowing of their lumen, which makes it impossible for sperm to pass through.

Bilateral inflammation requires careful diagnostics with mandatory differentiation from similar pathologies. Treatment consists of a course of antibiotics, vitamin therapy, immunostimulants and physiotherapy. A favorable prognosis depends on timely diagnostics and correctly prescribed treatment.

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Acute orchitis

As a rule, the acute form of damage to the male genitourinary organs develops secondarily. The infection penetrates the testicular tissue hematogenously, that is, with the blood flow. This type of orchitis often acts as a complication of epidemic parotitis, brucellosis, pneumonia, rheumatism, scarlet fever and a number of other diseases.

Infection is also possible by contact, when the infection passes to the testicle from its appendage. In this case, orchiepididymitis is diagnosed. Pathogenic microorganisms can penetrate the testicle tissue through the vas deferens from the prostate gland, seminal vesicles or the posterior urethra. If the disease is caused by trauma, this indicates a circulatory disorder in the organ area.

Symptoms of acute inflammation:

• Body temperature 38-39 °C.
• Intense pain in the testicle area, radiating to the groin, back and lower abdomen.
• The skin of the scrotum is edematous and hyperemic.
• General weakness.
• Headaches and dizziness.
• Nausea.
• Feverish condition.

The appearance of painful sensations is associated with the stretching of the protein membrane of the organ, which contains many nerve endings. Without treatment, the above symptoms subside in 10-14 days. But there are high risks of the disease becoming chronic and developing infertility.

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Chronic orchitis

If left untreated, acute orchitis becomes chronic, which can be primary or secondary. Primary orchitis is caused by infectious diseases of the body or injuries, while secondary orchitis is a complication of acute orchitis.

Signs of chronic inflammation:

• The pain in the testicle is of an intermittent, aching nature, but intensifies after prolonged walking and physical exertion.
• The testicle is enlarged and compacted.
• Subfebrile body temperature.
• Violation of the secretory function of the testicle.

In chronic lesions, testicular tissues become denser, which leads to organ atrophy. Against this background, fibrosis and complete disappearance of the parenchyma develop. If the pathology is bilateral, then the disruption of spermatogenesis leads to irreversible infertility.

Diagnosis is not difficult. The doctor collects anamnesis, conducts visual examination and palpation of the organ. When palpating, isolated enlargement of the testicle and its soreness are determined. The disease is differentiated from tumor lesions and tuberculosis.

Treatment consists of a course of antibacterial drugs, painkillers and physiotherapy. If conservative methods are not effective or fistulas have formed against the background of orchitis, then hemicastration is indicated.

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Types of Orchitis

Inflammation of the testicle is the body's response to the action of pathogenic microorganisms and foreign agents. Traumatization, that is, damage to the tissues of the scrotum, also very often leads to the development of an inflammatory reaction.

The types of inflammation and the nature of the pathological process depend on the general condition of the body. Today, the following types of orchitis are distinguished:

• Serous – develops as a result of mechanical or chemical impact, trauma, frostbite.
• Fibrous – occurs in the presence of exudate, which is formed due to an acute inflammatory reaction and contains a large amount of fibrinogen. Leads to the replacement of the testicular parenchyma with fibrous tissue, which entails a number of other diseases and complications.
• Purulent - the inflammatory exudate contains a large number of neutrophils, which, when broken down, form purulent bodies. Pus is a cloudy, thick, yellow-green liquid. Purulent orchitis very often ends in an abscess.
• Catarrhal - inflammation occurs with severe swelling of damaged tissues and the release of a large amount of exudate. Without timely treatment, it takes a purulent form.
• Mixed – is a complex of all types of inflammatory reactions. Painful symptoms correspond to several pathological processes at the same time. This type can develop against the background of infection, allergic reactions, trauma.

In addition to the above classification, the disease is divided depending on the localization of the lesion: left-sided, right-sided or bilateral orchitis. Also, inflammation can occur in acute, subacute or chronic form.

Purulent orchitis

Infectious and inflammatory lesion of the testicle with an acute course, pronounced clinical symptoms and abscess formation is purulent orchitis. The disease develops due to infection of tissues with pathogenic microorganisms.

Main types of infection:

1. Specific – pathogenic microorganisms (chlamydia, mycoplasma, trichomonas, etc.) affect only the genitourinary system. Inflammation develops when bacteria spread from the external genitalia or the mucous membrane of the urethra.
2. Non-specific – not associated with the structures of the urogenital tract, develops in other organs and systems. Purulent processes can be provoked by streptococci, proteus, staphylococci, E. coli or the mumps virus.

Very often purulent orchitis is complicated by an abscess and causes the following symptoms:

• The scrotum is enlarged.
• Local swelling and hyperemia.
• An increase in temperature to febrile values of 39-40 °C.
• Intense painful sensations.
• Symptoms of general intoxication.
• Dysfunction of the affected organ.

In an abscess, the inflammation focus is limited by a capsule that contains purulent exudate and is located in the tissues of the scrotum or testicle. If the abscess breaks through, purulent-bloody discharge with an unpleasant putrid odor comes out.

Treatment of purulent orchitis is aimed at eliminating the cause of the disease. Antibiotics (penicillins, cephalosporins, tetracyclines, macrolides) are used to combat pathogens. If necessary, antiviral and immunomodulatory drugs are used.

Particular attention is paid to symptomatic therapy. The patient is prescribed painkillers and antipyretics. To reduce the inflammatory reaction, compresses with a warm antiseptic solution and treatment of the testicles with ointments are indicated. An operation is performed to treat an abscess. The doctor opens and drains the purulent focus. In particularly severe cases, hemicastration is indicated, that is, removal of the affected organ.

Viral orchitis

The main cause of the development of the viral form of testicular inflammation is the mumps virus. Medical statistics indicate that in adult patients, in 27% of cases, mumps is complicated by acute orchitis and in 20% of cases leads to male infertility. In adults, bilateral lesions are more common, while in children, unilateral lesions are more common.

The main gateway for infection is the mucous membrane of the upper respiratory tract. The virus penetrates the salivary glands and is carried throughout the body by the hematogenous route. Pathogenic microorganisms find favorable conditions for their reproduction in glandular organs, which include the testicles.

Symptoms of viral orchitis usually develop on the 5th-7th day from the onset of the viral disease and are manifested by the following signs:

• Feverish condition with elevated body temperature up to 39-40 °C.
• Sharp pain in the scrotum area, radiating to the lower back, groin, and lower abdomen.
• The testicle is enlarged and hyperemic.
• Headaches, nausea.
• General intoxication of the body.
• Painful sensations during urination.

Laboratory and instrumental methods are used to diagnose viral lesions. The tests determine the type of pathogen and effective antibacterial drugs. Ultrasound diagnostics reveals damage to all structures of the genitourinary system that may be involved in the pathological process.

Treatment is conservative in most cases. Patients are prescribed a course of antibacterial therapy, painkillers and anti-inflammatory drugs. In case of acute painful sensations, a novocaine blockade of the spermatic cord is possible. If the pathological process is complicated by a purulent infection and the development of an abscess, then surgical intervention is performed to drain the purulent formation.