Orchitis

Orchitis is inflammation of one or both testicles, which may be acute or chronic, and is mainly caused by viral (particularly mumps) or bacterial diseases. Common bacterial causes are sexually transmitted bacteria (e.g., Neisseria gonorrhoea and Chlamydia trachomatis) and urinary infections. The common presentation is with an acute onset of testicular pain, oedema, redness, a heavy or aching scrotum, fever and occasionally blood in the semen or painful urination. Systemic symptoms such as malaise and nausea may be present. Diagnosis is clinical, with scrotal ultrasound to exclude torsion, urinalysis, STI testing, and targeted cultures/PCR as indicated.

Bacterial orchitis is treated with appropriate antibiotics (including treatment of the sexual partner if it is sexually transmitted), scrotal support, rest, analgesics, and cold packs. Viral orchitis is treated with NSAIDs, scrotal elevation, and hydration. Complications include abscess formation, chronic pain, testicular shrinkage and, if both testes are involved or therapy is delayed, infertility in some cases. Preventive methods include mumps immunisation, healthy sexual behaviour, prompt treatment of urinary or sexually transmitted diseases, and early medical attention for scrotal pain.