Inflammation of the egg in men. Orchitis, what is it? Symptoms and treatment at home

Orchitis- a disease of the male genitourinary organs, in which inflammation of the testicles occurs. In most cases, orchitis develops against the background of another infectious disease (mumps, influenza, typhoid, paratyphoid, pneumonia, etc.). Often, bilateral testicular damage causes irreversible infertility.

Testicular anatomy

The testicles are located in the scrotum and are covered with seven membranes. The testicle has the shape of an oval, flattened laterally. The length of a testicle in an adult is 4-5 cm, width 2-3 cm, and thickness reaches up to 3.5 cm. The weight of one testicle is about 20-30 grams. The left and right testicles are separated from each other by a septum, with the left testicle being lower than the right one. The posterosuperior edge of the testicle is suspended from the lower end of the spermatic cord. The epididymis (epididymis) is closely adjacent to the posterior edge of the testicle. The testicle, together with the tail of the epididymis, is fixed to the scrotum using the lower part using the scrotal ligament.

The septa extending like rays from the tunica albuginea divide it into 250-300 lobules. Moreover, each such lobule contains from 2, 3 or more convoluted seminiferous tubules. The length of the straightened convoluted tubules reaches up to 30-45 cm. Here, in the convoluted seminiferous tubules, sperm formation occurs. They are formed in special cells lining the walls of the tubules (Sertoli cells). Between the tubules there is another type of unique cells that produce sex hormones (Leydig cells).

Features of blood supply to the testicle

Blood supply to the testicle:

• Testicular artery (a. testicularis);
• Artery of the vas deferens (a. ductus deferentis);
• Artery of the levator testis muscle (a. cremasterica);
• All of the above arteries intertwine with each other, providing good blood supply to the testicle.

• Right testicle: venous blood collects in the pampiniform plexus, then through the testicular vein the blood enters inferior vena cava.

• Left testicle: venous blood through the pampiniform plexus, then through the testicular vein enters left renal vein. This anatomical feature explains why the left testicle is subject to more frequent infectious and inflammatory processes than the left one. The thing is that the outflow into the left renal vein is a little difficult, since the pressure in the renal vein is 2 times higher than in the inferior vena cava. This increased resistance to blood outflow often creates congestion in the testicle, which is favorable conditions for the development of an infectious-inflammatory process.

• Branches of the genitofemoral nerve (n. genitofemoralis)
• Branches of the pudendal nerve (n. pudendus)
• These nerves at the level of the spermatic artery form a plexus (plexus testicularis) from which branches go to the testicle and appendages.
• In addition, branches from the renal and solar plexuses are suitable for the plexus.

Functions of the testicle

• Sperm formation (spermatogenesis)

• An important component of male sperm are special substances (prostaglandins), which are also synthesized in the testicle. Prostaglandins such as E2, E2-alpha are found in large quantities in the ejaculate. They are able to relax and contract the smooth muscles of the female genital tract, thereby increasing the speed of passage of the egg through the fallopian tubes towards the sperm.
• Maximum production of male sex hormones by the testicles is observed at 25-30 years of age. The body of a man (25-35 years old) produces from 4 to 7 mg of testosterone per day.

Main effects of testosterone:

• Promotes the appearance of secondary sexual characteristics of a man (male hair growth, deep voice, distribution of fatty tissue, etc.).
• Forms libido
• Promotes sperm maturation
• Increases protein synthesis and increases muscle growth (anabolic effect)
• Stimulates the formation of red blood cells (erythrocytes)
• Under the influence of testosterone, produced in the womb by the fetal testicles, the formation of external and internal male genital organs occurs.
• In addition, testosterone stimulates the formation of fructose in the seminal vesicles, which is an energy source for sperm activity. The amount of fructose in semen can be used to judge the level of testosterone in the body.

• 80% of female sex hormones (estrogens) in men are produced in the testicles, and only 20% in the adrenal glands.

• They have a stimulating effect on the cells of the gonads (Leydig cells)
• Stimulates smooth muscles
• Promotes the formation of connective tissue
• Actively influence the growth of specific epithelium

Causes of orchitis

• More often, the cause of testicular inflammation is an infectious factor. Moreover, the infection can penetrate the testicle both from nearby organs (urethra, prostate, bladder, rectum) and from distant foci with sore throat, sinusitis, bronchitis, pneumonia, etc.
• Often transmission of infection occurs through sexual contact, and in this case the causative agents of the disease can be urogenital infections (mycoplasma, chlamydia) or a specific infection such as gonorrhea, syphilis.
• In some cases, orchitis develops after viral diseases such as influenza, parainfluenza, herpes, measles, and especially often orchitis becomes a dangerous complication of mumps. With mumps, orchitis can develop either on the third or tenth day of the disease. In most cases, both testicles are affected, and therefore the risk of irreversible male infertility increases. However, even with bilateral testicular damage, the percentage of infertility development is low.
• In addition to infections, orchitis can be caused by injury or congestion in the pelvic and genital areas. This may be as a result of circulatory problems or impaired outflow of seminal fluid.
• Often, the development of orchitis is caused by several factors, for example, stagnation is often combined with the addition of pathogenic microflora.

Predisposing factors

• Irregular sex life, sexual excesses, sexual abstinence
• Sedentary lifestyle, sitting for long periods of time
• A decrease in the overall resistance of the body, as a result of serious illnesses (chronic hepatitis, diabetes mellitus, AIDS) or overwork (mental or physical).
• Hypothermia or overheating can significantly reduce the body's protective functions
• Obstructed outflow of urine, more often in older people suffering from prostate adenoma, narrowing of the urethra. Stagnant phenomena are excellent conditions for the development of pathogenic flora.
• Concomitant diseases of the genitourinary system (prostatitis, pyelonephritis, etc.)
• Chronic foci of infection (tonsillitis, sinusitis, bronchitis, etc.)

Symptoms of orchitis

Symptoms of general intoxication often occur: weakness, headache, nausea, dizziness, chills.

Without treatment, the symptoms of acute orchitis subside by the end of the 2nd week. However, without treatment, the risk of developing irreversible infertility increases. In addition, acute orchitis often becomes chronic.

Symptoms of chronic orchitis
Chronic orchitis is much less common than acute orchitis and more often occurs as a consequence of improperly treated acute orchitis.

Pain in the testicle is intermittent and aching in nature, intensifying after long walking, physical exertion, and hypothermia. In this case, the testicle is somewhat compacted and enlarged. The testicle is slightly painful when touched. Symptoms of general intoxication are not pronounced, the temperature rarely rises to 38 C.

Although the manifestations of the disease are not so pronounced and in most cases patients do not even seek medical help. In chronic orchitis, the secretory function of the testicle is significantly impaired, which often becomes the cause of male infertility.

Diagnosis of orchitis

Study title	Purpose of the study	Results for the disease (orchitis)
Laboratory research
General blood analysis Treatment of orchitis is carried out according to the main stages of the development of the disease, namely: Eliminating the cause of the disease– more often orchitis is caused by infectious agents (staphylococcus, E.coli, etc.) in this case it is prescribed antimicrobial therapy. In most cases, broad-spectrum antimicrobials (macrolides and fluoroquinolones) become the drugs of choice. But the most effective treatment is realized if, on the basis of microbiological studies, the causative agent of the disease is isolated and a drug is selected that is most active against this particular microorganism. Drugs used: Macrolides (erythromycin, macropen, sumamed) Fluoroquinolones (ciprofloxacin, levofloxacin, ofloxacin, norfloxacin, etc.) Tetracyclines (methacycline, doxycycline) Trimethoprim with sulfonamides (biseptol, sulfatone) Nitrofurans (furagin, nitrofurantoin, etc.) Cephalosporins (cefuroxime, cefepime, etc.) Effect on the mechanisms of disease development– with orchitis, inflammatory processes occur in the testicular tissue, which, growing more and more, damage the structure of the organ. To stop this destructive mechanism, anti-inflammatory drugs(indomethacin, ibuprofen, diclofenac, etc.). Elimination of unpleasant symptoms of the disease– in most cases, orchitis is accompanied by severe pain; for this, various analgesic drugs are used (ketoprofen, ketorolac, analgin, etc.), and sometimes novocaine blockade is used. Creating favorable conditions for treatment- bed rest in the first days of acute orchitis, minimal movement in the scrotum area. Using a special support bandage to improve blood circulation (suspensor). For the same purposes and to reduce congestion in the pelvic and genital areas, angioprotectors are used (Agopurin, Dartilin, aescusan, venoruton, etc.). Supportive treatments: Physiotherapy (UHF, etc.) helps reduce the inflammatory process, limit the spread of infection, activate local protective mechanisms and speed up recovery processes. Also in the treatment of orchitis, especially the chronic form, methods such as reflexology, electrotherapy, physical therapy, mud and mineral baths can be used. ! In case of a sharp deterioration in the general condition (temperature above 39 °C, weakness, chills, dizziness), as well as a significant increase in the testicle in the scrotum, urgent hospitalization measures should be taken. Surgical treatment of orchitis Indications for surgical intervention: Acute orchitis developing after injury Suppuration of testicular tissue (abscess, testicular microabscesses) Ineffective treatment of acute orchitis after 3 days from admission to the hospital Severe acute orchitis, accompanied by a noticeable disturbance in the general condition The presence of painful, dense formations in the testicle that do not dissolve for a long time Chronic orchitis with frequent exacerbations Orchitis of tuberculous nature Type of operation Advantages Flaws Methodology Forecast Removal of part of the testicle(resection) - Allows you to maintain the functional ability of the organ - repeated cases of the disease are possible, high probability of complications It is performed under local anesthesia. Selective wedge removal of the damaged area of ​​the testicle Favorable Orchiectomy(removal of the testicle along with the epididymis) A vital operation in cases of severe purulent lesions. Total elimination of the source of infection, preventing the spread of infection to other organs and tissues. Bilateral removal deprives a man of the ability to reproduce, and also significantly reduces the level of male sex hormones Local anesthesia (infiltrative and conduction anesthesia). The anterior surface of the scrotum is cut (8-10 cm) without opening the inguinal canal. The testicle is removed along with its epididymis. Favorable for life With bilateral testicular removal – infertility + lack of sex hormones Notch method Makes it possible to promptly detect small foci of suppuration and decompress the organ (reduce tension) Effectiveness is more diagnostic than therapeutic Many incisions are applied to the surface of the testicle, 5 mm deep. Favorable Scrotal puncture Reduces the number of unnecessary surgical interventions Quickly and effectively reduces pressure in the scrotum, reducing the intensity of pain Not effective in case of extensive infectious process. After local anesthesia, a puncture is made with a puncture needle. Favorable Traditional methods of treating orchitis Treatment of orchitis is not an easy task and therefore only treatment with folk remedies is not always effective. The best option is when traditional medicine complements modern medicines. In addition, do not forget that medicinal plants are the same medications and you need to be very careful with their dosage and duration of treatment. Form Compound Cooking method Mode of application Effect Infusion Wintergreen, sweet clover (2 parts); Knotweed, birch leaves, lingonberries (3 parts); Chamomile flowers (4 parts); rosehip (10 parts); cudweed (5 parts); Carefully crushed herbs (2 tablespoons), pour 500 ml of boiling water. Leave for 6-8 hours. Strain, 1/3 cup, take 5 times a day Relieves inflammation Has an antimicrobial effect Accelerates tissue repair processes Strengthens local and general immune mechanisms Infusion Elderberry flowers, black poplar buds, chamomile flowers, lingonberry leaves, St. John's wort Take the ingredients in equal proportions, chop, mix, pour 2 tablespoons into 500 ml of boiling water, leave for 5-8 hours. 5 times a day, 2 tablespoons Relieves swelling, pain, inflammation Acts against many pathogenic microorganisms Accelerates healing and recovery processes Increases general and local resistance of the body Infusion Common hop flowers 100 grams of flowers, pour 500 ml of boiling water Leave for 30 minutes, strain 2 times a day 1/2 cup Reduces excessive sexual arousal during treatment of orchitis Gadgets: 1) Propolis, milk, cocoa butter 2) Crushed and ground flax seeds 3) Cabbage leaves soaked in vinegar 4) Honey, chopped coriander, dried vine Possible consequences of orchitis Untreated or poorly treated acute orchitis becomes chronic. Reactive hydrocele is an accumulation of fluid between the membranes of the testicle. This process usually resolves after the underlying disease is eliminated. Suppuration of testicular tissue. It is possible to develop one purulent localized focus (testicular abscess) or many small purulent foci (microabscesses) in the testicular tissue. As the process progresses, complete diffuse suppuration of the testicle is possible. Inflammation of the appendages (epididymitis). In most cases, the inflammatory process also extends to the epididymis. Spread of the inflammatory process to the other testicle. Reduction in size, drying of the testicle (testicular atrophy), a frequent complication of acute orchitis. Development of infertility. About 50% of cases of acute bilateral orchitis can lead to the development of male infertility. Possible mechanisms for the development of infertility: Direct damaging effects of infectious factors Secretion disorder Damage to the paths along which sperm pass, various structures, proliferation of non-viable tissue. Development of autoimmune processes. A situation in which the body begins to produce protective cells (antibodies) against its own structures, including sperm. Rarely: Decreased hormone production capacity Decreased libido Changes in the quality of orgasm, erectile dysfunction Prevention of orchitis Prevention of orchitis Should be avoided: Worth doing: Hypothermia, overheating, overwork (physical and mental), since such conditions can sharply reduce both local and general functions of the body’s defenses. Promiscuous and unprotected sexual intercourse Sexual excesses, masturbation, interrupted sexual intercourse, sexual overexertion A sedentary lifestyle, alcohol, smoking and other bad habits. Injuries in the scrotum area Poor nutrition Timely and correct treatment of all acute infectious and inflammatory processes of the genitourinary system Eliminate all chronic foci of infection: tonsillitis, sinusitis, bronchitis, prostatitis, proctitis, urethritis, pyelonephritis, etc. Regular sex life Protected sex During sexual abstinence, use exercises to relieve congestion in the pelvic and genital areas (yoga, Chinese gymnastics, etc.). Active lifestyle, sports (swimming, running, physical education, etc.) Use special protective equipment when practicing active sports such as martial arts, hockey, football, etc. Proper nutrition (sufficient amounts of proteins, vitamins, microelements) What is epididymitis orchioepididymitis? How is it different from orchitis? Epididymitis- inflammation of the epididymis, an organ that is a duct in which sperm accumulate and mature. Orchiepididymitis– inflammation of the testicle and its epididymis. These two conditions are often combined due to the close anatomical and functional connection between the testicle and the epididymis. Is it possible to have sex with orchitis? Is there a chance of transmitting the infection to my partner? During treatment of the disease, sexual abstinence is necessary. Sometimes sexual intercourse can be painful. If orchitis is caused by a sexually transmitted infection (this most often occurs in sexually active men under the age of 40), then the pathogen can be transmitted during sexual contact. The partner must also undergo examination and treatment. Sometimes it is not the man who is initially “to blame”: orchitis can be the result of an infection received from a partner. With orchitis caused by other causes, a man is not contagious. How is orchitis coded in the ICD? To designate different forms of orchitis, several codes are used in the International Classification of Diseases, 10th revision: N45– orchitis and epididymitis; N45.9– orchitis, epididymitis and orchiepididymitis without suppuration; N45.0– orchitis, epididymitis and orchiepididymitis with suppuration; N51.1– damage to the testicle and its appendages in diseases related to other headings; B26.0– orchitis with mumps (mumps); N49– inflammatory diseases of the male genital organs, not included in other sections; A54.2– orchitis due to gonococcal infection (gonorrhea); A56.1– orchitis due to chlamydial infection (chlamydia). Firstly, you must strictly adhere to all the doctor’s recommendations. In addition, the following measures will help alleviate the condition: keep bed rest if prescribed by a doctor, get plenty of rest, avoid physical activity; lie so that the scrotum is in an elevated position, this will help reduce swelling; use a cold compress on the scrotum; try not to lift heavy objects. What is specific orchitis? Orchitis, like any infectious-inflammatory process, comes in two varieties: Non-specific. Caused by common pyogenic microorganisms, such as streptococci, cavities with pus. With purulent orchitis, body temperature rises, fever, and malaise occur. Surgical opening of the abscess and removal of pus is necessary. What questions might the doctor ask during the appointment? During the appointment, the urologist may ask the man the following questions:: What symptoms bother you?? Tell your doctor about all the symptoms you have, even if you think they are not related to orchitis. When did the symptoms start?? What preceded their appearance? What illnesses did you suffer as a child? Have you ever had a sexually transmitted infection (STI)? Which? Are you currently taking any medications, vitamins, or dietary supplements? Provide the doctor with the most complete and detailed information - this will help to prescribe the necessary tests and studies, establish the correct diagnosis as quickly and accurately as possible and prescribe the correct treatment. In turn, you can ask the doctor the following questions: What is most likely causing my symptoms? Are there other possible reasons? What studies are needed to clarify the diagnosis? How and when will they be held? How should I prepare? What treatment will you prescribe for me? Approximately how long will it last? Will the disease affect my erection and ability to have children? What recommendations will I need to follow during treatment? Will it be necessary to limit sexual activity? What diseases may resemble the symptoms of acute orchitis? Disease Description Epididymitis Inflammation of the epididymis. Orchitis can be combined with epididymitis - this condition is called orchiepididymitis. The doctor makes a final diagnosis after examination and ultrasound examination of the scrotum. Strangulated inguinoscrotal hernia With an inguinoscrotal hernia, a communication is formed between the abdominal cavity and the scrotum. Intestinal loops and part of the omentum may extend into the hernial sac. When an inguinal-scrotal hernia is strangulated, pain occurs and a pear-shaped swelling occurs that rises upward from the scrotum. As a rule, the man or boy had already been previously diagnosed with an inguinoscrotal hernia. Testicular torsion An emergency condition in which compression of the nerves and vessels of the testicle occurs. Emergency medical attention is required, otherwise it may occur necrosis testicles. With torsion, pain suddenly occurs in the testicle, scrotum, and groin - symptoms develop faster than with orchitis. Testicular torsion is corrected surgically. Torsion of Morgagni's hydatid Hydatida Morgagni- a rudiment, a small formation on the testicle that has a stalk. Symptoms of hydatid torsion resemble torsion of the testicle itself. This condition also requires emergency assistance. Hydrocele of the testicle Hydrocele of the testicle can also occur as a result of inflammation. In this case, an elastic formation can be felt in the corresponding half of the scrotum.

How to treat orchitis

Orchitis symptoms and treatment with folk remedies

● Orchitis is a disease characterized by inflammation of the testicle, which occurs in men of any age, but young men and boys are more often affected.

As you know, the testicles are a paired glandular organ of the male reproductive system that performs two main functions: it produces sex hormones (both androgens and estrogens) and forms sperm (male reproductive cells).

I welcome all readers and guests to the “” blog page.

● If the inflammatory process in the testicles is not treated in a timely manner, it can lead to persistent male infertility. Quite often, orchitis is complicated by inflammation of the epididymis; in medicine, this complication is called epididymitis, which further increases the possibility of infertility.

Symptoms of the disease

● Clinical observations have established that orchitis is a complication of some other diseases, after an injury to the scrotum and hypothermia of the body.

However, the share of hypothermia and injury is only 5-7% of the causes of testicular inflammation; other cases are due to the inflammatory process of the genitourinary system (,) and as a result of acute infectious diseases - pneumonia (), brucellosis, typhoid or typhus,.

● Orchitis can be transmitted sexually when a partner suffers from any urogenital infection (chlamydia, mycoplasmosis, etc.) or a sexually transmitted disease (syphilis, gonorrhea, trichomoniasis).

Newborn boys can develop orchitis due to the penetration of pathogens into the testicle through infected umbilical vessels.

● At the age of five to ten years, boys can get inflammation of the testicles due to complications when the pathogen enters the testicular tissue through the bloodstream.

What is mumps? This is a disease that affects almost all children who have ever attended kindergarten. It is popularly called the earworm or mumps.

Orchitis in children appears simultaneously with mumps, although it can occur after the onset of mumps in 6-10 days.

● Like most other infectious diseases, orchitis occurs in an acute form or can become chronic. With an acute onset, the patient complains of severe pain in the scrotum area, which radiates to the sacrum, lower back, perineum and groin.

In parallel with the pain, typical symptoms of the inflammatory process begin - high body temperature (38-39⁰C), general weakness, nausea, headache, loss of appetite.

● In the area of ​​the inflamed testicle, the scrotum enlarges, hyperemia (redness) of the skin is noted, it becomes tense and hot to the touch, and due to swelling it loses its usual folding.

A few days after the development of orchitis, if complex treatment is not started, the manifestations of the disease subside and can lead to malnutrition of the testicle and its reduction in size.

● With orchitis, a secretory form of infertility may occur due to complications such as the development of a testicular abscess, its suppuration, and necrosis of the reproductive organ.

As noted above, if the disease is treated incorrectly or insufficiently, a chronic form of orchitis can develop, in which the intensity of the pain decreases and it is aching in nature.

● In many patients in this form, the only manifestation may be pain when touching the testicle, pain in the scrotum when walking, aggravated by physical activity or hypothermia.

Upon examination, the testicle is slightly compacted, increased in volume and painful when squeezed.

Why do inflammatory processes occur in the testicle?

● Sexual abstinence, its excess or irregular sex life.

● Prolonged sitting, sedentary lifestyle.

● Decreased immunity, the body’s overall resistance to infections due to serious illnesses (chronic hepatitis) or physical and mental fatigue.

● Prolonged exposure to high or low temperatures.

● Pathological disturbance of the outflow of urine in elderly people with a history of narrowing of the urethra or prostate adenoma.

● The patient has concomitant diseases of the genitourinary organs, such as pyelonephritis, prostatitis, urethritis, etc.

● Concomitant foci of chronic infection - sinusitis, tracheitis, etc.

Traditional medicine recipes

● Mix two tablespoons each, lingonberry leaves, flowers, black poplar buds, flowers; we will insist for 5-8 hours two tbsp. tablespoons of the mixture in half a liter of boiling water, then take two tbsp. spoons five times a day.

● First chop, then mix two parts of wintergreen herb and; three parts each of knotweed grass, leaves and lingonberries; four parts of chamomile flowers, five parts of marshweed herb and ten parts of dry. Pour 500 ml boiling water 2 tbsp. spoons of the collection, wrap the container, leaving it in a dark place for 6-8 hours; After filtering, take a warm infusion of 50 ml five times a day.

● Grind 100 grams of flaxseed, place the powder in a gauze bag, which is immersed in hot water for ten minutes; after cooling, apply to the sore spot for 15-20 minutes; Repeat the procedure until pain and swelling disappear.

● The medicinal mixture consists of black poplar buds, chamomile inflorescences, black elderberry flowers, St. John's wort herb and lingonberry leaves taken in equal parts; we will insist all night 2 tbsp. spoons of the mixture in half a liter of boiling water. We filter the infusion and drink half a glass five times a day for fourteen days.

● Fill a liter of water with five tablespoons of dry crushed rose hips, put it on the stove and cook for ten minutes, leave for 10 hours. Take a whole glass 4-5 times a day.

● 3 tbsp. Infuse tablespoons of dried and crushed chamomile flowers in one liter of boiling water for two hours. Filter through cheesecloth and add 80 g.

We take the drug in three to four doses per day. We continue treatment for 1-1.5 months. After a seven-day break, we can repeat the treatment.

● Tincture: infuse 50 g of alder cones in half a liter of high-quality vodka for three weeks, shaking the contents periodically. Strain and take 30 drops of tincture before meals two to three times a day.

● Mix the crushed roots of Potentilla erecta (kalgan) and leaves into powder in equal parts; Take half a teaspoon of this mixture two or three times a day with a small amount of water.

● Grind and mix 20 g of licorice root, 10 g of galangal root, 20 g of chamomile flowers, 30 g of gray alder cones; we will insist 40 minutes 1 tbsp. a spoonful of the mixture in a glass of boiling water; Should be taken warm with honey after a meal.

● Mix an equal amount of herb and St. John's wort, take a teaspoon of the mixture and leave it in a glass of boiling water for half an hour. Take half a glass twice a day.

● Mix by first chopping 1 tbsp. a spoonful of stone fruit berries and 4 tbsp. spoons of rose hips; pour the mixture with half a liter of boiling water and cook over low heat for half an hour.

A minute before removing from heat, add two tbsp. spoons of rosehip flowers and let it boil a little. Remove from heat and filter the infusion, which we will take cold twice a day, one whole glass.

That's all. Be healthy and God bless you!

Orchitis is a pathological condition characterized by inflammation of the testicle. This reproductive organ has a complex structure and is responsible for the balance of male hormones and the production of seminal fluid. The disease is quite common in urological practice, since the range of predisposing factors is wide. Orchitis in men requires timely contact with a urologist: detailed diagnosis and drug treatment are required. If you do not start eliminating testicular inflammation on time or interrupt the therapeutic course, the risk of secondary infertility increases.

Causes of orchitis in men

Orchitis occurs both independently and secondary - against the background of other diseases and conditions. The following factors predispose to the development of inflammation inside the testicle:

1. Inflammatory processes that have passed from nearby organs or anatomical structures (especially if the disease is long-standing, indolent, or of microbial origin).

2. Infection of bacterial, fungal or viral origin. The source of pathology can even be distant, such as pneumonia, otitis media, sinusitis. Mumps orchitis often occurs - inflammation of the testicle against the background of a viral pathology - mumps.

The pathological process affects the organ from the third to the tenth day of the disease and is classified into unilateral and bilateral inflammation. In the case when the process affects both testicles, there is a high probability of infertility in a man.

3. Congestion inside the pelvic cavity (a common cause of this is irregular sex life, a sedentary, sedentary lifestyle).

4. Previous injuries to the perineum, pelvis, and groin area.

5. The presence of concomitant diseases affecting the organs of the genitourinary system (pyelonephritis, prostatitis).

6. Too active sex life.

7. If a man is exposed to overheating or hypothermia - both general and local.

8. Problems with the outflow of urine, which often accompanies elderly and elderly patients due to the presence of prostate adenoma.

9. The presence of urogenital infections - chlamydia, syphilis, gonorrhea.

10. Poor resistance of the body, which may be due to the presence of chronic foci of infection or serious diseases - AIDS, systemic lupus erythematosus, tuberculosis.

11. Chronic fatigue.

Orchitis also occurs as a result of surgery on the reproductive organs: for example, after surgical treatment of varicocele. Also, inflammation of the testicle develops as a complication of standard urological manipulations of a therapeutic or diagnostic plan - cystoscopy, catheter installation, bougienage.

Orchitis in children occurs against the background of respiratory diseases and is complicated by mumps and influenza. Also, the cause of testicular inflammation in boys is the increased physical activity inherent in children. As in the case of the disease in adult patients, at this age there is a high probability of infertility and atrophy of the affected testicle.

Symptoms of orchitis in men

The way the disease progresses does not go unnoticed by the patient himself - all the signs of the pathology are quite pronounced and cause a lot of physical inconvenience for the man.

There are two forms of orchitis, the manifestations of inflammation differ slightly depending on this criterion.

Acute orchitis

The disease occurs spontaneously, unexpectedly for the patient. The first symptom that attracts attention is hyperthermia. Body temperature rises to 39-40 degrees. The second, no less painful symptom is pain. An unpleasant sensation spreads to the lower abdomen, sacrum, lumbar region, and groin. A characteristic difference between pain during orchitis is that it intensifies when the patient tries to change body position. This sensation is caused by excessive stretching of the tunica albuginea (one of seven available), which is enriched with a large number of nerve fibers.

An enlarged inflamed testicle is visualized without the need for additional measures. To the touch, the affected organ is tense and has a glossy appearance. Skin tension is caused by excessive effusion of pathological fluid. Also, inflammation of the organ causes redness and a local increase in body temperature.

The general condition of the patient also changes, which is explained by the general intoxication of his body. Characteristic signs of this phenomenon are nausea, lack of appetite, weakness, body aches, the desire and need to take a horizontal position, and limit physical activity. If the condition is not treated at this stage, there is a high probability of becoming chronic or developing infertility.

Chronic orchitis

This type of inflammation occurs much less frequently in urological practice. It often acts as a negative consequence of improperly treated acute orchitis. The pain syndrome is somewhat different: the unpleasant sensation is not paroxysmal in nature, intensifies only after prolonged physical activity, and does not occur at rest. The testicle is compacted, which can be easily determined by touch. Manifestations of intoxication are practically not expressed: dyspeptic disorders occur rarely, appetite remains unchanged, the level of general body temperature only periodically exceeds 38 degrees. Attempts to conduct a palpation examination (to palpate the inflamed area) cause additional pain.

In the chronic course of the disease, the ability of the testicle to produce testosterone and ejaculate is impaired.

The severity of the pathology in one form or another may vary from patient to patient. The man’s individual sensitivity to pain, the presence of concomitant diseases, age, stability of sexual life and other criteria are of decisive importance.

The disease has a code according to ICD 10:

1. N45.9 – Orchitis without mention of abscess.
2. A54.2 – Orchitis due to gonococcal infection.
3. A56.1 – Orchitis due to chlamydial infection.
4. N45.0 – Orchitis complicated by an abscess.

The first clinical case is more common in urological practice, since only a small number of patients ignore such intense signs and bring orchitis to a severe stage.

Diagnosis of orchitis in men

In order to plan therapeutic tactics and know which treatment for orchitis is most effective in a particular clinical case, you will need a thorough diagnosis of the patient’s condition. The following activities are carried out:

General blood analysis. An increase in the concentration of leukocytes and ESR is detected in the material sample, which indicates a progressive inflammatory process.
General urine analysis. If leukocytes are detected (especially in high concentrations), pyuria should be suspected, which indicates the presence of an inflammatory process within the genitourinary tract.
Bacteriological examination of a urine sample. Urine culture is an informative analysis, but it will take at least 1 week to complete, due to the nuances of the procedure. The analysis will determine which pathogenic microorganism caused the disease, and which pharmacological group of antibiotics will help eliminate the infection.
Urethral smear for bacteriological examination. The results of this analysis help to understand the degree of the inflammatory process, identify and specify the pathogen.

Ultrasound of the testicle. Informative, accurate and fast way of research. Helps identify the spectrum of inflammatory lesions, localization of the lesion, and the presence of pathological fluid.
Testicular MRI. It is used less frequently than ultrasound, but is an even more accurate type of diagnosis. Allows you to determine the stage of the inflammatory process and understand the preliminary prognosis for the disease.

The doctor prescribes other types of diagnostics at his own discretion - based on assumptions regarding the presence of concomitant diseases in the patient or the development of complications of orchitis.

Treatment

In no case should orchitis be ignored - regardless of the age of the patient!

First of all, you need to go to the hospital and explain to the doctor what caused the inflammation, what events preceded its appearance - casual sex, playing football, long-term problems with the kidneys or prostate.

Treatment depends on the stage at which the pathology is at the time the man goes to the doctor. The urologist will prescribe bed rest, abstinence from intimate life until recovery occurs, and will recommend limiting the mobility of the inflamed area (he will advise you to wear tight-fitting, but not overly tight, underwear).

If the inflammation is at the initial stage, the urologist will prescribe conservative therapy. Antibiotics are actively and successfully used for orchitis. This is explained by the need and importance of quickly stopping the inflammatory process that can affect the epididymis. Then the condition will take on a complicated form and will be defined as orchiepididymitis. Preferred antimicrobial options include:

1. Fluoroquinolones (Ofloxacin, Levofloxacin).
2. Macrolides (Erythromycin).
3. Drugs of the nitrofuran series (Furazolidone, Furagin).
4. Cephalosporins (Cefepime, Ceftazidime).

To fix the affected area, the specialist prescribes the use of a suspensor - a special supporting bandage, thanks to which the testicle will be secured and will be able to remain in one position all the time, which will reduce pain for the patient. To relieve discomfort, the urologist will prescribe intramuscular injections of ketonal or ketorol, since tablet analgesics in this case will not provide the expected effect.

For additional impact on the inflammatory process, non-steroidal anti-inflammatory drugs are prescribed - Ibuprofen, Diclofenac, Voltaren. To reduce body temperature, the patient is prescribed injections of analgin with diphenhydramine, since standard Paracetamol will not bring benefit in this case. If a child has orchitis and you need to quickly reduce the fever, it is permissible to give the child Panadol before the doctor arrives.

Surgery is the preferred treatment option for orchitis if there are the following indications:

1. Inflammation of the testicle occurred after suffering damage to the scrotum and groin.
2. The testicular membranes are subject to a purulent process with abundant formation of corresponding masses (phlegmon, abscess).
3. Lack of therapeutic effect after 3-day treatment of orchitis in the acute stage.
4. If the course of inflammation in the acute phase of its development has led to significant disturbances in the general condition of the patient.
5. If areas of tissue compaction have formed inside the testicular membranes, which are painful when you try to palpate them, and treatment does not bring a positive result.
6. Inflammation of the testicle is of tuberculous origin.
7. The disease has become chronic and is accompanied by frequent exacerbations.

The decision to treat orchitis surgically is made by the surgeon; if we are talking about inflammation in a child, then together with his parents.

There are these types of operations for orchitis:

1. Testicular resection. Only part of the inflamed area is removed if it is subjected to severe suppuration. The advantage of the operation is the ability to preserve the functional activity of the organ. But there is a high risk of re-inflammation, which can also be accompanied by abundant accumulation of purulent masses. In general, the prognosis is favorable.

2. Orchiectomy. The intervention involves complete excision of the testicle along with the epididymis. The decision on this approach is made by the doctor when it comes to saving the patient’s life, the risk of mortality of which is explained by abundant suppuration of the soft tissue of the testicle. More often when orchitis is detected in an advanced stage. The negative side of the intervention is subsequent male failure due to the inability to reproduce. Secondary hormonal imbalance also develops, since the testicles, which synthesize testosterone, are eliminated.

3. Surgical intervention involving incisions. The advantage of the technique is the ability to promptly eliminate the identified purulent focus. Elimination of this is possible provided the spectrum is small, which will relieve tension inside the inflamed organ.

4. Puncture of scrotal tissue. It is necessary to quickly relieve tension inside the inflamed testicle, which will reduce the severity of the pain syndrome (but does not stop the inflammatory process itself). The intervention will not have the desired effect if the purulent focus is quite extensive, and the patient has not been in the first week.

Each type of surgical intervention is carried out only after a thorough diagnosis and clarification of whether the appendage or other anatomical structures are involved in the pathological process.

Treatment at home is impossible if the patient has not been examined by a urologist. Only in a small percentage of cases is it permissible to carry out therapeutic measures outside the hospital, but they must be prescribed by a specialist.

Prevention of orchitis in men

To prevent the development of an inflammatory process inside the testicle, a man needs to adhere to a number of recommendations.

Avoid:

Damage to the scrotum, perineum;
hypothermia or overheating of the body;
wearing tight underwear;
mental or physical fatigue;
casual sexual contact, which entails infection with dangerous diseases;
unhealthy diet, bad habits;
interrupted sexual intercourse.

At the same time, it is important to adhere to the following rules:

1. Timely eliminate all foci of inflammation - both nearby and related to the urological system (prostatitis, pyelonephritis), and located remotely from it (tonsillitis, otitis).
2. Prevent any acute disease from becoming chronic.
3. Organize your sex life and make it stable.
4. Avoid masturbation.
5. Be attentive to your health during the postoperative recovery period.
6. Normalize nutrition (regime and quality).
7. Use special protective equipment when playing sports.
8. Make your lifestyle active, avoiding physical inactivity.

Following these tips will help prevent the development of testicular orchitis. Since inflammation is fraught with infertility and multiple complications for the body, it makes sense to consult a doctor as soon as possible, without delaying until the only possible treatment option is complete excision of the inflamed organ.

(from the Greek orchis - testicle), inflammation of the testicle in humans. It most often occurs as a complication of an infectious disease: mumps, influenza, gonorrhea, typhoid, etc. (the so-called hematogenous route of infection) or due to testicular trauma. It begins acutely - the testicle quickly increases in size, becomes tense and painful, its surface is smooth due to effusion in the membranes. Body temperature rises. With hematogenous infection, the epididymis and vas deferens remain unchanged. Usually after 2-3 weeks the phenomena subside, although in some cases suppuration and even necrosis of the testicle are possible. Chronic orchitis occurs slowly, with scant symptoms.

Treatment: rest, wearing a jock strap, painkillers, antibiotics. When suppuration occurs, the abscess is opened. In case of long-term, recurrent course, removal of the affected testicle. Orchitis can develop after mumps (mumps), influenza, scarlet fever, chicken pox, pneumonia, brucellosis, and typhoid fever.

But more often it develops with inflammatory diseases of the genitourinary system - urethritis, prostatitis, vesiculitis, epididymitis. Orchitis can also appear after injury. According to its course, it can be acute and chronic. Acute orchitis is usually caused by an acute inflammatory disease, while chronic orchitis is caused by a chronic one.

Classification of orchitis

Depending on which testicle is affected, there is right-sided and left-sided orchitis in men. In 15% of cases in men, bilateral inflammation of the testicles occurs in men. Orchitis is classified according to the following criteria:

Type of pathogen

• specific (trichomoniasis, gonorrhea, tuberculosis);
• nonspecific (bacterial and viral);

Cause

• necrotic (as a result of incomplete torsion of the testicle or hydatid);
• granulomatous;
• congestive (arising due to proctitis, hemorrhoids, varicose veins, dysrhythmia of sexual life, etc.);
• traumatic;

Course of orchitis

• acute orchitis (purulent or serous);
• chronic orchitis (usually occurs after insufficient treatment of the acute form);
• ischemic orchitis;
• recurrent orchitis.

Acute orchitis

Orchitis begins with the appearance of pain in the testicle. The pain can radiate to the groin, perineum, lower back, sacrum. The scrotum on the side of the disease enlarges 2 times or more, its skin becomes smooth, a few days after the onset of the disease, the skin of the scrotum sharply turns red, becomes hot, and may acquire a glossy tint.

The inflamed testicle is enlarged and sharply painful when touched. Simultaneously with pain in the scrotum, general symptoms of inflammation appear - weakness, fever 38-39 ° C, chills, headache, nausea. Usually, even without treatment, the disease goes away on its own within 2-4 weeks. But in some cases, the inflammatory process leads to its suppuration and the development of a testicular abscess. The skin of the scrotum becomes bright red, smooth, and sharply painful when touched. The main complication of acute orchitis is possible suppuration of the testicle and the subsequent development of a secretory form of infertility.

If suppuration is possible, the patient is hospitalized. Therapeutic measures are fundamentally the same as for acute epididymitis: treatment of the underlying disease that led to orchitis, fixed elevated position of the scrotum, local application of cold, antibacterial therapy, and when acute inflammation subsides - physiotherapy, thermal procedures. When a testicular abscess develops, it is opened and drained. In severe cases, when the testicular tissue has completely melted with pus, an orchiectomy is performed - unilateral removal of the testicle.

Chronic orchitis

Chronic orchitis develops with improper or insufficient treatment of acute orchitis or as a complication of chronic inflammatory diseases of the genitourinary system - chronic prostatitis, urethritis, vesiculitis. In a chronic case, often the only manifestation of the disease is some pain in the testicle when touched.

During an exacerbation of the disease, pain appears in the testicle when walking. More often than acute, it leads to a decrease in secretory function and can cause infertility. Treatment of chronic orchitis is long and labor-intensive. Treatment of the underlying disease is mandatory. A course of taking antibacterial drugs is also carried out, and local thermal and physiotherapeutic procedures are actively used. In severe cases with prolonged absence of effect from conservative therapy, unilateral orchiectomy is performed.

Causes of orchitis

Causes of acute orchitis

• testicular injuries
• long-term catheter use
• complications of infectious diseases
• complications of urethritis, prostatitis, epididymitis and vesiculitis

Orchitis in newborns is explained by infection from the umbilical vessels into the testicle.

Causes of chronic orchitis

• ineffective treatment of acute orchitis
• complications of chronic inflammation such as vesiculitis, urethritis, prostatitis and epididymitis.

Symptoms of orchitis

Symptoms of acute orchitis in some cases appear gradually, but sometimes patients may experience sharp pain radiating to the groin, perineum, sacrum or lower back, as well as swelling of the scrotum, which doubles in size. Due to swelling, the skin of the scrotum becomes smooth, all folds are smoothed out. A few days after the onset of the inflammatory process, it turns red (sometimes acquiring a glossy tint) and becomes hot. The main symptoms of acute orchitis include:

• Swelling and enlargement of one or both testicles;
• Redness of one or both testicles;
• Pain of varying severity;
• Discomfort when sitting;
• Discharge from the penis;
• Sharp pain in the testicle when touched;
• Swelling and increased temperature of the scrotum;
• Pain along the spermatic cord.

Pain in the scrotum and swelling are also accompanied by general symptoms, including:

• Fever and chills at a temperature of 38-40°C;
• Weakness;
• Headache;
• Nausea;
• Loss of appetite;
• Signs of inflammation of the salivary glands.

Chronic orchitis is rarely accompanied by pronounced symptoms. Most often, the only sign of the inflammatory process is some pain when touching the testicle. Moreover, during periods of exacerbation, pain may intensify when walking. Chronic orchitis, much more often than the acute form of the disease, leads to the development of secretory infertility in men.

Treatment of orchitis

Uncomplicated acute orchitis is treated on an outpatient basis. The patient should be placed on bed rest and spicy foods should be excluded from the diet. The affected organ requires rest and an elevated position. Treatment is being carried out for the underlying disease, the complication of which is acute orchitis. The patient is prescribed antibiotics, vitamins, absorbable drugs, and enzymes. If there is a threat of suppuration, hospitalization is necessary. After eliminating acute inflammatory phenomena, the patient with acute orchitis is prescribed physiotherapeutic procedures.

In acute orchitis complicated by a testicular abscess, the purulent focus is opened and drained. Complete purulent melting of the testicle is an indication for orchiectomy (removal of the affected testicle).

Treatment of chronic orchitis presents significant difficulties due to the persistent course of the disease. In addition, due to the scanty symptoms, patients are often unaware of chronic orchitis and begin to receive treatment when there are already pronounced changes in the testicle. Patients with chronic orchitis are prescribed antibacterial therapy, physiotherapeutic and thermal procedures. If the course is unfavorable and conservative therapy is ineffective, a unilateral orchiectomy is performed.

Treatment of orchitis with folk remedies

A decoction made from flax roots

One tablespoon of carefully crushed raw materials should be poured with 250 milliliters of boiling water, and then kept on low heat for twenty minutes. Next, remove the broth from the heat, and then leave for at least half an hour and strain. Take fifty milliliters before meals three or four times a day.

Rue grass

Freshly harvested, carefully crushed rue herb should be mixed with bay leaf crushed to a powder. Prepare medicinal dressings; to do this, spread the mixture on a cotton cloth in an even layer and apply it like a compress to the scrotum.

Bean flour dough

Mix bean flour thoroughly with vinegar until it forms a dough. Prepare medicinal dressings; to do this, spread the mixture on a cotton cloth in an even layer and apply it like a compress to the scrotum.

Larkspur

Larkspur seeds effectively resolve testicular tumors. You need to take three seeds at least three times a day.

Horsetail

Freshly harvested horsetail grass needs to be crushed, medicinal dressings must be prepared, for this, the mixture should be spread on a cotton cloth in an even layer, and applied as a compress to the scrotum.

Honey compresses

You will need to mix honey, wine, and aloe pulp in fairly equal proportions. Again, make a medicinal bandage on the scrotum.

Herbal collection

Prepare a collection consisting of the following plants: St. John's wort, lingonberry leaves, chamomile inflorescences, black elderberry flowers, black poplar buds. During an exacerbation of the disease, you need five tablespoons of the crushed (can be in a coffee grinder) mixture, pour into a thermos and pour half a liter of boiling water, leave overnight. Next, strain.

During an exacerbation, take one glass at least five times a day for two or three weeks. Next, until complete healing, prepare an infusion of 2 tablespoons, just as described above, and also take it five times a day. At the same time, it is recommended to make compresses from flax seeds. The entire course of treatment should be three months. Then there is a break for two weeks. Then you can continue to be treated in some other way. In order to be able to increase the healing effect, as well as improve the taste, it is better to add honey to the prepared infusion.

Compresses from wiki

Fresh vetch grass should be thoroughly crushed using a meat grinder, medicinal dressings should be prepared, for this, the mixture should be placed on a cotton cloth in an even layer, and applied as a compress to the scrotum.

Folk recipe for making special propolis candles

You should take 2 or 3 grams of royal jelly, five grams of crushed propolis. Melt cocoa butter or internal rendered fat (lamb) in an enamel bowl. When the butter or fat is completely melted, you should add already prepared royal jelly and crushed propolis to it. Then mix the mixture thoroughly until it thickens to the consistency of dough.

Next, take half or a full teaspoon of this mixture, roll it into tubes and form candles, one end of which is slightly rounded, pack these candles in a special film and store them in the refrigerator. Every day before going to bed, you will need to insert this suppository into the anus, first dipping it a little in rosehip oil or olive oil.

Prevention of orchitis

Prevention comes down to the treatment of chronic inflammatory diseases of the genitourinary organs, careful monitoring of one’s condition during common infectious diseases (mumps, influenza, scarlet fever, pneumonia and others), with trauma to the scrotum, perineum and pelvic area.

Questions and answers on the topic "Orchitis"

Question:A month ago I had orchitis, which seemed to have cured. Everything was normal on the ultrasound. The pain stopped. But two days ago, after physical exercise, veins appeared on the left side of the scrotum and pain (tugging) on ​​both sides + radiated to the groin. The doctor said it was a varicocele. I did an ultrasound, they didn’t reveal a varicocele, but only a predisposition on the left side. After that, he said that it was untreated orchitis and prescribed the antibiotic “Suprax” + Traxevasin (as last time). Does this mean that my orchitis has become chronic? Is this treatment adequate? Aching pain in the groin and lower abdomen begins with long or fast walking

Answer: You do not have epididymitis orchioepididymitis.

Question:Hello. 3 months ago I discovered that I have orchitis. I went to the urologist, they prescribed me a bunch of antibiotics, I had the injection within 2.5 weeks (as the doctor told me). Today I discovered that the testicle had enlarged and there was a slight pain in the groin area and, most importantly, a discharge appeared. I read a lot about orchitis but didn't find anything about discharge. What could this mean?

Answer: Hello! I think you are going through an inflammatory process. Perhaps the antibiotic you injected did not have an effect on the infection, but only “muffled” it. Do a test for sexually transmitted infections (you need to exclude chlamydia in particular), using PCR, ultrasound of the scrotum and prostate gland. Sowing the secretions onto the flora.

Orchitis is one of those diseases for which a man may be embarrassed and even ashamed to consult a specialist. This pathology is characterized by inflammatory damage to the paired gonads (or one testicle). It leads to enormous discomfort and severe pain and often interferes with leading a normal lifestyle.

It should be noted that it is precisely because of shame in front of a medical worker that the disease is very often allowed to take its course. Which entails an inevitable deterioration in the patient’s condition. In the end, the man will have to decide to go to the doctor. Because the pain will become unbearable, the inflammation will be impossible to ignore. But by this time the disease may be very advanced. So the problematic part of the body will have to be amputated in order to prevent the infection from spreading further.

Self-medication or treatment “grandmother’s way” is a bad idea. The result of which, with a good outcome, will be the same as from no treatment. In other cases, this can lead to many complications, the treatment of which will require a lot of effort, time and money. Don't play with your health! This can lead to harmful consequences that cannot always be corrected, even if the diagnosis is made in a timely manner.

Orchitis: symptoms

So, we figured out that it is urgent to visit the appropriate specialist (urologist or andrologist). Now you need to learn how to identify such a disease, that is, find out the symptoms of orchitis.

There is some difference in the manifestations of acute, subacute or chronic variants of the inflammatory process in the testicles.

It should be noted that most often only one of the two glands is affected, although bilateral disease also occurs.

• The first sign of the disease discussed in this article is a sharp increase in body temperature (up to approximately 38-39 degrees), which is accompanied by severe dull, pressing or bursting pain in the scrotum area. Characterized by heaviness in the testicles. There is a reflection of pain in the groin, lower abdomen, and sacral region. Increased pain is provoked by touching and walking, which will significantly complicate the performance of various everyday household activities. Nerve endings are responsible for the pain, irritated by stretching of the white membrane of the testicle by edema.

• The affected paired sex gland increases in size, the scrotum, stretching, begins to resemble gloss and turns red.
• Further, most often the patient experiences symptoms characteristic of general intoxication: headaches, dizziness, weakness, chills and nausea. Urinary disorders, bloody semen, and other rarer manifestations may occur.

In the absence of adequate medical care, orchitis enters the subacute stage and the symptoms begin to subside. But this does not mean at all that the disease goes away.

Very often, without treatment, it goes from acute to chronic. Also, the lack of medical intervention creates a risk of infertility, which, alas, cannot be cured.

Chronic orchitis, as mentioned above, occurs with poor quality or lack of treatment. In this form of the disease in question, pain in the groin area and the affected organ ceases to cause discomfort. They become aching and unstable, but can get worse with long walking. Touching the affected area also brings pain, but less than in the acute version.

Body temperature can occasionally rise to 38 degrees. Due to the fact that the signs of chronic orchitis are not as pronounced as acute ones.

Males are usually in no hurry to go to specialized clinics. Which leads to slow progression of the disease and various complications.

Causes

Now let’s talk about why this unpleasant life-spoiling pathology can arise:

• In approximately five percent of cases, the appearance of the disease discussed in this article is due to mechanical trauma to the testicle.
• An infectious disease can cause orchitis. In this case, the disease can be either sexually transmitted (for example, syphilis, gonorrhea, trichomoniasis, etc.) or non-venereal (for example, tuberculosis or influenza).
• The most common infectious cause of the development of pathology is viral parotitis. With mumps (mumps), along with the testicles, the salivary glands (primarily the parotid) are affected and the pancreas may suffer (acute viral pancreatitis).
• Quite often, the disease can begin with epididymitis, which was not treated on time, was treated poorly, or was not treated at all.
• Various inflammatory diseases of the genitourinary area, for example, urethritis (inflammation of the urethra) or prostatitis (inflammatory disease of the prostate gland).
• Catheterization of the bladder for a long time, which led to infection.

In addition to the reasons, you can also list a list of predisposing factors to the appearance of orchitis:

• Lack of regular sex life.
• A sedentary lifestyle, which may be related to the profession (for example, this problem is observed among programmers and truck drivers).

• Decreased immunity as a result of vitamin deficiencies, overwork, stress, the presence of severe chronic diseases (for example, HIV, diabetes or hepatitis), overheating (in baths, saunas) or, conversely, hypothermia.

• Obstructed outflow of urine (for example, with an adenoma - a benign tumor in the prostate gland or narrowing of the urinary canal).

Testicular orchitis in men

Often, when faced with infertility at a young or mature age, a man does not even remember that in childhood he suffered from orchitis due to the banal mumps. In this case, the doctor has to be especially attentive to collecting an anamnesis of his patient’s life. It is ideal when medical documentation is preserved. However, quite often, children’s outpatient records are submitted to the archives of the children’s clinic at their place of residence. And much information about their childhood is irretrievably lost.

For a boy infected with the mumps virus in childhood, a mild disease such as mumps can be complicated by pancreatitis and orchitis. At the same time, the clinical picture of acute inflammation is no different from that of an adult. This is swelling, enlargement of the affected organ, redness of the scrotum, pain in the testicles, perineum, reflected in the groin, lower back. An increase in temperature is also typical.

The second wave of fever, if inflammation of the testicles is added to the pre-existing lesion of the parotid gland. Symptoms of intoxication occur (headaches, muscle pain, fatigue, weakness, lethargy). Specific therapy for viral (mumps) testicular disease has not been developed.

It is possible to protect a child or adult from such a disease only through timely vaccination, that is, primary prevention of pathology. Mumps vaccination is included in the national vaccination schedule and is free for children. Children should receive their first vaccination at one year of age and be revaccinated again at six years of age.

For those who are weakened or have had medical withdrawal by 12 months, vaccinations can be carried out according to an individual calendar at 18 months and a year after that. If these conditions are met, a fairly decent artificial immunity to the virus is formed. This helps protect the boy from secondary inflammation and testicular atrophy of a viral nature. An emergency vaccination option is also possible in cases where patients with mumps appear in the child’s environment.

Acute orchitis

This variant of pathological changes in the organ has a sudden onset.

Although it may not begin in isolation, it complicates other urological pathologies. For example, urethritis, prostatitis, combined with epididymitis. This pathology can appear even in newborns and children in the first year of life. Accounts for almost 30% of all acute pathologies of the scrotal organs, including surgical diseases. The prerequisites for this are the anatomical features of male infants: a clear separation of the testicular membranes. Non-fusion of the processus vaginalis in some boys, as well as increased tone of the levator testis muscle. This determines its greater mobility.

The disease often begins subacutely in this form, but with clear manifestations.

There is an undoubted dependence on urinary tract infection. The failure of the immune response determines the severe course and destruction of organ tissue. This requires surgical treatment and often leads to testicular loss.

Traumatic damage to the scrotum in children with breech presentation also plays a role.

• The second peak of childhood morbidity occurs in the prepubertal and pubertal periods (mumps, post-traumatic).
• In adults, in addition to the considered cases associated with sexually transmitted infections (purulent bacterial), orchitis can be associated with other specific pathogens. For example, Mycobacterium tuberculosis. Up to 80% of the tuberculous process of the urogenital tract is represented by lesions of the scrotal organs. The testicles suffer in this case a little less often than their appendages. The result of inflammation is obstructive infertility. Involvement of the testicle means that the tuberculosis infection is very aggressive and generalized in the body. In this case, the matter almost always ends with surgical amputation of the gonads and appendages. Granulomatous orchitis is diagnosed pathomorphologically on a remote organ. Ultrasound reveals areas of compaction and purulent melting of the gland.

A urologist will be involved in the management of a patient with orchitis.

Treatment should always be preceded by diagnostics, including ultrasound diagnostics with Dopplerography of its vessels. Tests will also include laboratory blood tests. Those. clinical, biochemistry, immunology, polymerase chain reactions.

Sperm analyzes (assessment of the biochemistry of the secretion and morphology of sperm).

• In order to decide on the tactics and the question of how to cure the disease as efficiently as possible and, if possible, preserve the integrity of the testicle and its function, the doctor will have to not only establish a diagnosis of orchitis, but also try to understand its origin. The choice of a conservative or surgical approach to the pathology will depend on this.
• The doctor should also tell you how to treat the disease at home, whether it can be done. Of course, it is not advisable to admit a patient to the inpatient stage in the case of viral or specific chronic orchitis without tissue destruction.
• The standard of treatment determines not only drug therapy, but also the creation of a protective regime (semi-bed), an elevated position for the suffering area and sexual rest. It is also advisable to follow a dairy-vegetable diet with limited salts, marinades, smoked foods and spices. It is advisable not to wear tight synthetic underwear and to cool the affected area or prevent it from overheating.
• Newborns and children under one year of age are treated mainly in surgical hospitals with the involvement of operating urologists. Mumps processes require the participation of a pediatrician and an infectious disease specialist.
• In adults, in cases of a specific venereological history, a venereologist is involved. For the tuberculosis variant - a phthisiatrician.
• Folk remedies do not cure the disease. In addition to transferring the acute version of the disease to subacute or chronic, similar tactics can achieve purulent melting of glandular tissue and organ loss or sepsis. Infectious-toxic shock and death. Infertility in this case can be considered the mildest type of loss. Which a careless lover of traditional medicine will have to come to terms with.
• Surgical treatment may be required to drain purulent foci: opening the testicular membranes, dissecting the testicle.
• Surgical removal is an extreme scenario when preservation of the organ is impossible and even dangerous from the point of view of infectious, septic or thrombotic complications.

Treatment with antibiotics

Antibiotic therapy is advisable in cases where the causative agent of inflammation is bacterial or mixed microflora.

Escherichia coli, staphylococcus, various bacterial pathogens of sexually transmitted infections (gonococcus, chlamydia, mycoplasma, ureaplasma, treponema pallidum) and tuberculosis require mono- or combined treatment with antibacterial drugs. Also, the surgical stage of treatment forces the urologist to prescribe antibiotics to prevent microbial complications.

Semi-synthetic penicillins, betalactams (amoxiclav) - options for use in children and treatment of syphilis and gonorrhea.

Surgical support is provided with cephalosporins. Sexual infections require fluoroquinolones, josamycin, tetracyclines (urea and mycoplasma). In pediatric practice, fluoroquinlones are not used as reserve antibiotics. If Mycobacterium tuberculosis is detected, treatment is carried out using rifampicin, isoniazid, and less often fluoroquinlones.

Prescribing antibacterial drugs for viral infection, mumps orchitis, is inappropriate.

Orchitis: medications

In addition to antibiotics, to manage the patient, the doctor may need drugs that alleviate the manifestations of the disease.

• Non-steroidal anti-inflammatory drugs (ketorol, meloxicam, ibuprofen, paracetamol) are required to reduce pain, reduce swelling and suppress inflammation. Most of them, according to the standard, should be used in conjunction with proton pump blockers (omeprazoles, esomeprazoles) to avoid gastropathy. Both tablets and injections, suppositories are possible when caring for a patient in a hospital or at home.

• Alpha blockers (tamsulosin, alfuosin).
• an autoimmune process and a number of orchitis in children may require glucocorticosteroids to suppress inflammation.
• In a hospital setting, it is possible to use novocaine blockades to relieve pain.

Sex with orchitis

When treating acute or subacute orchitis, sexual rest should be observed. In order to prevent an increase in swelling of the affected area against the background of venous stagnation. In chronic orchitis, inflammation is prolonged over time and does not cause acute pain or significant swelling.

It is recommended to practice protected sex and not neglect treatment of the underlying disease. Whether it is possible to have sex with a partner or masturbate in your particular case, you should check with your doctor.

Consequences

With timely, high-quality treatment from a specialist, men can avoid complications of the pathology. Reproductive functions will then be preserved. Advanced variants, as well as purulent-necrotic changes in the organ, can result in amputation of one or both testicles.

Prevention consists of:

• competent obstetric care for male fetuses in breech presentation.
• timely vaccination of boys against mumps.
• practice of protected sex
• avoiding trauma to the scrotal organs for men.
• timely screening for tuberculosis and sexually transmitted infections with adequate treatment if infections are detected.

If you suspect damage or disease to the scrotal organs, you should immediately seek medical help.