Orchitis is an inflammation of one or both of the testicles. It is most often caused by the mumps * , a viral disease.
Orchitis is swelling and inflammation of one or both testicles. Orchitis is usually an acute problem that comes on suddenly.
Approximately 20 to 25 percent of males who have mumps develop orchitis. Most cases of mumps-related orchitis occur in boys younger than 10 years old. Most cases of orchitis caused by bacterial infections occur in males who are sexually active and in older men with enlarged prostate * glands.
Orchitis may be caused by a bacterial or viral infection. Mumps, a viral disease, is the most common cause of orchitis. Orchitis may also occur if a person has an infection of the prostate or epididymis * , called epididymitis. Other causes of orchitis include sexually transmitted infections (STIs) such as gonorrhea * or chlamydia * . A swollen testicle that is associated with little to no pain may also be a sign of testicular cancer, or cancer of the testicle.
Orchitis is a disease of males. Men who are at increased risk for orchitis include those who are age 45 and older, have had repeated urinary tract infections * , have had surgery on the genitourinary tract, and have used a Foley catheter (a tube for draining urine from the bladder) long term. Men who have not received childhood immunizations * for mumps are at increased risk for orchitis associated with mumps. Boys who were born with a congenital (present at birth) problem of the urinary tract are also at increased risk for developing orchitis.
Risk factors for orchitis related to an STI include those who participate in high-risk sexual behaviors, have multiple sexual partners, have a history of gonorrhea or other STIs, or have a sexual partner who has been diagnosed with an STI.
Signs of orchitis are related to infection. These include fever as well as swelling of the scrotum, testicle, and groin area. There may also be pain or tenderness in the testicle and/or groin. The affected testicle may also feel hardened to the touch and the skin around the scrotum may be reddened. Other signs specific to orchitis include pain in the affected testicle(s), pain during sexual intercourse, pain with urination, and pain in the groin area. There may be a discharge from the penis and blood in the semen * . The signs of mumps-related orchitis usually occur approximately three to seven days following the mumps infection. The person may also have nausea, headache, and muscle aches.
The healthcare provider obtains a complete health history. This includes asking questions about the person's childhood immunizations, sexual history, and history of urinary tract infections or STIs.
A physical examination is done to determine specific signs of orchitis, such as swelling of the testicle, groin, and/or scrotum * . Laboratory tests of the blood and urine are done to determine specific indicators of infection. A blood test may be done to determine the presence of the mumps virus. A urine culture * test may be ordered to determine if a bacterial infection is present. A culture of the urethra will be done to determine the presence of gonorrhea or chlamydia. If an infection is present, the specific organism will be identified to determine the best antibiotic medication to treat it. An ultrasound * examination of the testicle may also be done to examine blood flow to the testicles.
The primary treatment for orchitis is antibiotic medication specific to the bacterial organism identified. The doctor may prescribe anti-inflammatory medication to reduce swelling and combat inflammation, as well as over-the-counter or prescription medications to treat pain. Bed rest with the scrotum elevated and ice packs applied to the groin area may also relieve pain and promote healing.
Orchitis can be prevented by insuring that all children are vaccinated against mumps. It can also be prevented by practicing safe sex behaviors to decrease the risk of acquiring an STI.
See also Bacterical Infections • Chlamydial Infections • Epididymitis • Gonorrhea • Infection • Mumps • Scrotal Swelling • Sexually Transmitted Infections (STIs): Overview • Urinary Tract Infections • Viral Infections
Parsons, John Kellogg, John B. Eifler, and Misop Han. (eds.). Handbook of Urology. Hoboken, NJ: Wiley-Blackwell, 2013.
MedlinePlus. “Orchitis.” U.S. National Library of Medicine, National Institutes of Health. https://www.nlm.nih.gov/medlineplus/ency/article/001280.htm (accessed March 30, 2016).
Merck Manual: Consumer Version. “Orchitis.” http://www.merckmanuals.com/home/men-s-health-issues/penile-and-testicular-disorders/orchitis (accessed March 30, 2016).
Urology Care Foundation. “What Are Epididymitis and Orchitis?” http://www.urologyhealth.org/urologic-conditions/epididymitis-andorchitis (accessed August 1, 2016).
Urology Care Foundation. 1000 Corporate Blvd., Linthicum, MD 21090. Toll-free: 800-828-7866. www.urologyhealth.org (accessed March 30, 2016).
* mumps is a contagious viral infection that causes inflammation and swelling in the glands of the mouth that produce saliva.
* prostate (PRAH-state) is a male reproductive gland located near where the bladder joins the urethra. The prostate produces the fluid part of semen.
* epididymis (eh-pih-DIH-i-mis) is a long coiled tube that stores sperm and transports it from the testes.
* gonorrhea (gah-nuh-REE-uh) is a sexually transmitted disease (STD) spread through all forms of sexual intercourse. The bacteria can also be passed from an infected mother to her baby during childbirth. Gonorrhea can affect the genitals, urethra, rectum, eyes, throat, joints, and other tissues of the body.
* chlamydia (kla-MIH-dee-uh) are microorganisms that can infect the urinary tract, genitals, eye, and respiratory tract, including the lungs.
* urinary tract infections (YOORih-nair-e), or UTIs, are infections that occur in any part of the urinary tract.
* immunization (ih-MYOON-ih-zashun), also called vaccination, is giving, usually by an injection, a preparation of killed or weakened germs, or a part of a germ or product it produces, to prevent or lessen the severity of the disease caused by that germ. It is usually given by an injection.
* semen (SEE-men) is the spermcontaining whitish fluid produced by the male reproductive system.
* scrotum (SKRO-tum) is the pouch on a male body that contains the testicles.
* culture (KUL-chur) is a test in which a sample of fluid or tissue from the body is placed in a dish containing material that supports the growth of certain organisms. Typically, within days the organisms will grow and can be identified.
* ultrasound, also called a sonogram, is a diagnostic test in which sound waves passing through the body create images on a computer screen.