Orchitis

What are the risk factors for orchitis?

The risk factors include:

• A history of epididymitis.

• Unprotected sex.

• Multiple sex partners.

• Long-term use of a Foley catheter.

• Bladder outlet obstruction.

• A structural abnormality.

• Surgery of the urinary tract (genitourinary surgery).

• Not having the MMR vaccine (it reduces the risk of developing orchitis after mumps).

What are the symptoms of orchitis?

The possible symptoms include:

• Pain and tenderness in the testicle.

• Fever.

• Pain with urination.

• Pain with intercourse or ejaculation.

• Groin pain.

• Scrotal swelling.

• The skin of the scrotum may become red or purplish.

• Blood in the semen.

• Swollen lymph nodes in the groin.

How is orchitis diagnosed?

Your health care provider will do a physical exam. This is to check for enlarged or tender testicles, prostate gland, or lymph nodes on the affected side. To check the prostate, the provider will do a rectal exam. This is done by inserting a gloved finger into the rectum.

You will also have an ultrasound. This is to rule out a condition called testicular torsion. It has symptoms that are similar to orchitis. It occurs when the spermatic cord gets twisted. The spermatic cord is a network of nerves and blood vessels that runs into each testicle. This condition can affect your fertility if it cuts off blood flow to your testicles. So it needs to be treated right away.

A urethral swab and urine sample may be taken to check for a urinary tract infection and for STIs.

How is it treated?

To treat bacterial orchitis, you will be prescribed antibiotics for 10 to 14 days. Treatment for viral (mumps) orchitis is aimed at symptom relief only. This is because antibiotics don't work for viruses. It often takes 1 to 3 weeks for mumps orchitis to go away.

Home care

These guidelines will help you care for yourself at home:

• If you were given antibiotics, take them all as prescribed. It's important to finish them, even if you're feeling better.

• You may use over-the-counter medicines to control pain, unless you were given another medicine. If you have chronic liver or kidney disease or have ever had a stomach ulcer or digestive tract bleeding, talk with your health care provider before using these medicines. Also talk with your provider if you take other medicines.

• Elevate your scrotum. Use snug-fitting briefs or an athletic supporter.

• To help with pain and swelling, place an ice pack over the scrotum. Do this for no more than 20 minutes every 3 to 6 hours during the first 24 to 48 hours. Then keep using ice packs as needed for pain and swelling. To make an ice pack, put ice cubes in a plastic bag that seals at the top. Wrap the bag in a thin towel. Don't put ice or an ice pack directly on the skin.

• Tell your partner if you have a STI. If you have an STI, your partner will need treatment too.

Follow-up care

Follow up with your health care provider after you finish all of your antibiotics, or as advised. If a swab or urine sample was taken, call as directed for the results. Use condoms or don't have sex until you get the results. If you have an STI, continue this protection until both you and your sexual partner finish treatment.

What are the complications?

Other complications of orchitis are rare but can include:

• Infertility.

• Epididymitis.

• Testicular atrophy (shrinkage of testis).

• Testicular abscess.

Call 911

Call 911 if you have:

• Weakness, dizziness, or fainting.

When to get medical advice

Contact your health care provider right away if you have:

• Continued nausea or vomiting.

• Trouble passing urine.

• A fever of 100.4ºF (38ºC) or higher, or as advised by your provider.

• Increasing pain and swelling in one or both testicles.