human health

Orchitis: symptoms and therapies

Definition

The inflammatory process on the testicle, the orchitis precisely, can occur suddenly, with acute and stabbing pain, or it can arise gradually. In the introductory article, the orchitis has been described in a general way, examining the triggering causes, the risk factors and the classification. In this brief disquisition, the topic will be expanded and studied through the analysis of typical symptoms of orchitis: in conclusion, possible viable therapies and hopes for recovery will be reported.

We have seen that the disease may have an acute or chronic course; based on this, it is clear that the symptoms differ according to the type of orchitis.

Symptoms typical of orchids

To learn more: Symptoms of orchitis

When the symptoms of orchitis occur suddenly, acute testicular inflammation is likely to be in progress: in similar situations, the patient generally complains of pain, swelling of the testicle (or both), tension or discomfort in the area included between the thigh and the abdomen, blood in the sperm and urine, and urethral secretions, sometimes visible after the glans have been squeezed.

The affected subject also shows a slight alteration of the basal temperature (low-grade fever) which, often, degenerates into a true fever, among other things almost never above 38 ° C.

Among the characteristic symptoms of chronic orchitis, we note: chills, stranguria (particularly slow and painful urine emission), constant feeling of nausea, testicular pain of mild or severe intensity, abdominal tension, swollen lymph nodes and conspicuous redness scrotal. The symptoms of orchitis can also affect the sexual act, causing a typical painful ejaculation.

It is important to remember that a patient suffering from orchitis does not generally have all the symptoms listed above: in fact, the disorders can be more or less serious depending on the subject and, again, the symptoms can arise at different times of the illness.

Complications

Like all genital diseases, the orchitis must not be underestimated because, when neglected or untreated, it could become worse and cause irreversible damage. In particular, when testicular pain is perceived as excruciating and unbearable, the opinion of the doctor is absolutely necessary.

Orchitis can be directly or indirectly related to testicular torsion, so it would be unwise not to seek medical attention. In such situations, the disease could in fact develop in a negative sense causing irreversible lesions of the testicle, such as to make surgical removal of the diseased testicle unavoidable.

It has been shown that chronic orchitis, and all phlogosis in the chronic course of the testicle, compromise spermatogenesis, generating alterations in the quantity, quality and morphology of the spermatozoa; again, chronic forms - especially those resulting from mumps - can cause testicular atrophy and inhibit sperm production. It is good to remember that testicular atrophy is often the cause of sterility, unfortunately, irreversible.

Another complication of the orchitis is the formation of an abscess of the scrotum, which is filled with pus.

Hypotheses have been formulated, among other things not yet proved, concerning the relationship between orchitis and alteration of seminal parameters: in affected patients, the production of antibodies against the spermatozoa themselves is hypothesized, instigated by damage at the level of haemato-epidermal barriers and blood testicular. This correlation seems even more credible when, in conjunction with the orchitis, the patient is also affected by epididymitis [taken from clinical Andrology, by Wolf-Bernhard Schill, Frank H. Comhaire, Timothy B. Hargreave]

Diagnosis

The diagnosis of orchitis is a fundamental step, useful for identifying the problem and above all the cause that generated it. In this way, it is possible to opt for the most suitable therapy, according to the patient's symptoms. First, a careful clinical-anamnestic examination is useful, useful for identifying possible inguinal lymph nodes and the abnormal enlargement of one or both testicles. The ultrasound study is also very important for diagnostic purposes: in fact, the genital ultrasound allows us to identify a hypothetical blood flow at the testicular level and to diagnose a possible testicular torsion.

These assessment exams allow to highlight both possible structural lesions of the didymus, and potential or hypothesized accumulations of transparent transudate around the testicle (hydrocele). In some cases of suspected orchitis, the doctor may require more detailed clinical tests, such as blood culture.

Among the various diagnostic options, the doctor can recommend a urethral swab, in order to exclude or ascertain possible venereal diseases. In some subjects particularly problematic from the diagnostic point of view, a testicular nuclear magnetic resonance is recommended.

The orchite should not be confused with the epididymitis: in this regard, the differential diagnosis is required. Testicular torsion outlines the most relevant differential diagnosis of the acute form of orchitis, while chronic forms generally cause relatively milder disorders.

therapies

To learn more: Useful drugs in the care of Orchite

In general, the patient is given antibiotics and corticosteroids. Specifically, antibiotics such as ciprofloxacin, azithromycin and ceftriaxone are particularly indicated against bacterial orchids. When the orchitis is caused by venereal diseases, the partner should also undergo antibiotic medical treatment.

As for the viral orchitis, painkillers and anti-inflammatories (eg naproxen) are recommended. Furthermore, the patient must rest, preferably staying in bed; topical application of ice at scrotal level is useful for lightening pain and reducing swelling.

When the patient is also diagnosed with an accumulation of pus (piocele) or purulent fluid in the scrotal sac, it is almost always necessary to have surgery.

Prognosis

The prognosis is variable: it depends, in fact, on the severity of the disorder and on the way in which the patient responds to therapies. In some cases, the orchitis may present itself in such a severe form that it generates irreversible sterility, while in other cases sterility could only be a temporary phenomenon. Usually, the mumps orchitis is the most dangerous form in terms of sterility: in fact, the hopes of regaining fertility again are not very high, especially when the start of therapy is postponed beyond due.

Prevention

If mumps represents a serious risk factor for orchitis, it is clear that the first preventive practice is the mumps vaccine. Another fundamental prophylactic measure consists in avoiding unprotected sexual relations, potentially dangerous for the transmission of venereal diseases.