Symptoms and signs of orchitis in men, main treatments

The diagnosis of male infertility is sometimes caused by orchitis. It seems, well, the testicle turned red, well, it hurts when walking, nothing serious. However, if you "start" the process, it will go into a chronic phase and two testicles will be involved. And soon a man may become completely sterile.

Description of the disease

Orchitis is an inflammatory reaction of testicular tissue, their edema. In medicine, the Latin name is sometimes used - testitis. The disorder is often observed in children 10-15 years old, as a complication of inflammation of the parotid salivary glands (mumps). And in elderly men it can be a consequence of stagnation of blood in the pelvic organs or volvulus of the vascular cord.

According to the international classification of diseases of the tenth revision (ICD 10), several pathology codes are distinguished:

N45.0. Orchitis, epididymitis and epididymo-orchitis with a purulent process, which is complicated by an abscess of the testicle or its epididymis.

N45.9. Testicular orchitis in men, epididymitis and epididymo-orchitis without purulent inflammation.

If the doctor has a need to clarify the causative agent that led to the disease, he uses the auxiliary code (B95-B98).

Orchitis symptoms

Pathology is characterized by all the main local signs of inflammation:

• redness of the groin;
• testicular swelling;
• pain;
• the lesion is hot to the touch;
• and the most formidable is erectile dysfunction.

Orchitis symptoms are often characterized by a general intoxication syndrome with systemic fever, the temperature in the armpit can reach 39C, chills, goose bumps, nausea, dizziness are also observed.

However, the main symptom due to which patients quickly turn to the doctor is acute bursting pain arising from damage to the tunica albuginea, which is densely innervated by pain receptors.

If orchitis is a consequence of mumps, it occurs at the end of the first week of the disease or at the beginning of the child's recovery (and the symptoms of the disease are being layered). A distinctive feature is the presence of involvement in the pathological process of two testicles at once in a third of men.

Diagnostics - which doctor should I contact?

If you find the above symptoms in yourself, you should immediately contact your local therapist, who will refer you to a urologist at a polyclinic. Uncomplicated orchitis can be treated at home with bed rest and other doctor's recommendations, with hospital visits on designated days to monitor the situation.

An experienced specialist can make a diagnosis based only on the medical history and examination. However, to confirm the diagnosis and prevent complications, it is necessary to pass a number of laboratory tests so that the treatment is as effective as possible.

A general blood test will help clarify the nature of the pathogen: with a bacterial, the total number of leukocytes will be increased, mainly due to a group of neutrophils. Whereas with viral etiology, an increase in the number of lymphocytes is observed.

A general urinalysis will reveal whether orchitis is primary or secondary, that is, perhaps the disease has arisen as a result of some kind of damage to the urinary and genital tract. Bacteriological examination of urine will clarify which specific microorganism caused the disorders.

It is imperative to conduct an analysis to determine the level of testosterone in the blood and spermogram to clarify the degree of damage to spermatids. Since the infection of the testicle disrupts its functions: the synthesis of the male hormone and the maturation of sperm.

In difficult cases, instrumental studies are carried out to accurately determine the diagnosis and identify complications: ultrasound diagnostics and biopsy.

Reasons

Testicular orchitis often occurs precisely as a consequence of other infections: brucellosis, pneumonia, flu, tuberculosis. The main bacterial pathogens are staphylococci and streptococci, which are carried by blood from the main focus.

In newborns, microorganisms penetrate from the umbilical vessels infected during birth. And in school-age children, orchitis most often occurs as a complication of mumps (popularly called "mumps").

In adults, orchitis can be aseptic, that is, inflammation without the participation of microbes, for example, after a traumatic injury to the testicle. Also, the causes can be systemic diseases, such as rheumatic arthritis, systemic vasculitis, sarcoidosis and standard causative agents of infections of the genitourinary system (gonorrhea, chlamydia, Escherichia coli).

In addition to the hematogenous route of penetration, some doctors also isolate a contact path, from one infected testicular tissue to another, that is, orchitis can overlap with an existing prostatitis or epididymitis.

Views

Orchitis, like any other inflammatory disease, is classified according to the duration of its course into two main types.

Acute orchitis

The duration of the acute process does not exceed a month from the onset of the disease. A sudden onset means a sharp rise in body temperature to 38-39C, general symptoms: weakness, increased fatigue, vomiting, chills; as well as painful sensations of varying intensity in the groin, which usually intensify during physical exertion.

The prognosis for the acute variant is predominantly positive, however, with a relapse of the disease, epididymitis and obstruction of the vas deferens may develop.

Chronic orchitis

Chronic inflammation is characterized by a long course, more than a month from the manifestation of the first signs. This is usually a consequence of poorly treated acute orchitis or sluggish chronic infections of the genitourinary system.

It is not characterized by a pronounced intoxication syndrome, it can manifest itself only by tension and redness of the testicle skin.

However, in rare cases, it can be nonspecific granulomatous orchitis, which is difficult to distinguish from a tumor without a biopsy. It is often asymptomatic, characterized by mild pain that may worsen during intercourse, and an enlarged testicle.

The causes of this type of disease have not yet been precisely determined. Some researchers suggest an autoimmune nature (for some unknown reason, its own immune system begins to attack its own cells).

Treatment options

The treatment tactics are determined by the attending physician. With uncomplicated acute orchitis, conservative therapy is always resorted to at home, but with outpatient supervision. It includes three main approaches.

First, the impact on the cause. For infections of the urinary and genital tract, antibiotics are prescribed. Such as macrolides (Erythromycin, Clarithromycin), beta-lactam (Ampicillin, Augmentin) and cephalosporins (Ceftriaxone, Ceperone). And with viruses: Tamiflu, Remantadin.

Secondly, if systemic bacterial diseases are simultaneously recorded, interruption of the mechanism of action of active bacteria is required. This happens through the use of glucocorticosteroids (Dexamethasone, Prednisolone); anti-inflammatory drugs (Ibuprofen, Paracetamol).

Third, relief of symptoms: pain relievers (Nimesulide, Diclofenac); antiemetics (metoclopramide).

You should also create favorable conditions for a speedy recovery: bed rest, wearing a suspensor (bandages for the scrotum), adherence to a diet. If, despite the ongoing treatment of orchitis, the patient's condition remains unchanged for two days, the treatment regimen is changed.

Chronic orchitis is treated surgically, as in the case of bilateral lesions, it threatens with complete infertility

In case of an acute one, which developed as a result of a blow, it is necessary to carry out a puncture in order to pump out caked blood from the hematoma. If it is complicated by microabscesses, it is necessary to open the suppurating cavity, which is performed by surgeons (exclusively in a hospital).

In case of severe purulent damage to the organ and the formation of an abscess, orchiectomy is performed, that is, the complete removal of the testicle with the epididymis. The operation is performed to prevent infection of other tissues and the development of sepsis. It is carried out with the consent of the patient, in especially difficult situations it is a necessary measure.

Orchitis: complications and consequences for men

In most cases, with nonspecific orchitis, the prognosis is favorable, however, quite a frequent consequence is the transition of inflammation to the epididymis and the formation of epididymitis, which in turn can spread the process further, leading to the involvement of the membranes of the spermatic cord.

Quite often, an untreated acute orchitis can fester, and micro-abscesses begin to appear, which can subsequently unite and lead to pyocele (dropsy of the testicle together with purulent fusion of its membranes).

The danger of mumps in boys is that it leads to testicular atrophy in 20% of cases. Very rarely, purulent inflammation can lead to blood vessel thrombosis and heart attack or gangrene. But the most formidable complication of orchitis is the defeat of the second egg and the development of secretory infertility.

Prevention

The main preventive measure is, of course, timely diagnosis and treatment of chronic infections and other diseases leading to orchitis.

It is recommended to undergo preventive examinations by a urologist annually, to avoid hypothermia and promiscuous sexual intercourse. You need to monitor your health and maintain immunity at the proper level. Proper nutrition and sufficient physical activity will help with this.

It is also worthwhile to warn the genitals against traumatic injury. To do this, it is recommended to use special protective equipment while practicing active sports: hockey, baseball, football, etc.

Older men should lead an active lifestyle (fitness, swimming) to prevent congestion in the pelvic organs and possible testicular vein thrombosis.