Chronic orchitis symptoms. Symptoms and treatment of orchitis (testicular inflammation) in men

Men are a strong and beautiful part of humanity. But they are also susceptible to disease. For the most part, men are not inclined, very interested in monitoring their health, and do not pay attention to the manifestation of any initial symptoms of the disease, and therefore the doctor's diagnosis becomes an unexpected bolt from the blue for them. But in many cases this could have been avoided.

Pay attention to your body in time - a chance to stay healthy

A little about what this disease is

Orchitis is a disease that in most cases arises as a result of complications that have arisen after suffering infectious viral diseases.

Also, the causes may be inflammation of the organs of the genitourinary system. A small number of cases of the disease occur due to prolonged catheterization or trauma to the testicle, and as an extremely rare case, orchitis can occur on its own. The disease occurs in acute and chronic forms.

Acute orchitis and its symptoms

In the acute form, orchitis is characterized by the appearance of severe dull pain in one of the testicles, especially when you want to touch it or when moving. Sometimes symptoms can occur in both testicles at the same time. The testicle begins to grow and hurt even more. This is caused by stretching of its protein membrane, on which a considerable number of nerve endings are concentrated, which leads to an increase in pain. Then there is an almost twofold increase in the scrotum, on the side where the disease manifested itself. Her skin becomes tight, hot, smooth. Pain in the testicle gives the groin, sacrum and perineum to the lower back. The patient's condition is deteriorating. This is manifested in an increase in temperature to 39˚ C, nausea, chills, headache, fever, and general weakness appear.

If treatment measures are taken in time, all these symptoms will disappear in a week. However, if the disease is not treated, the consequences can be different. First: the body itself will gradually cope with the disease. This will take several weeks. Secondly, and this happens quite often, the disease will become chronic. Thirdly, purulent inflammation of the testicle may develop. In this case, the pain will increase, the general condition will worsen, the temperature will remain high, and the scrotum will acquire a glossy, red tint. Due to the development of a purulent process in the testicular tissue, a minimum amount of sperm is formed, which can subsequently serve as a factor in the occurrence of secretory infertility. Sometimes the course of such an inflammatory process in the testicle can lead to purulent fusion of all its tissues or, in the worst case, to necrosis.

The danger of orchitis on the background of mumps occurring in a patient is that the result of such a disease can be testicular atrophy. Orchitis can develop as early as the third day of the course of the disease with mumps or a week after the cure for this disease. At the same time, both testicles hurt in a large number of patients.

Chronic orchitis and its symptoms

In the chronic form, orchitis can develop when the treatment of its acute form was carried out poorly or incorrectly. Also, the cause of chronic orchitis can be a complication after previously transferred urological diseases with a chronic course. The disease in this form passes rather slowly, asymptomatically.

There is only some hardness and soreness of the testicle when touched. In rare cases, the temperature rises to 38˚ C. In cases of exacerbation of the chronic course of the disease, there are pains in the testicle during movement. The presence of chronic orchitis in a patient significantly affects the decrease in the secretory function of the testicles. As a result, it contributes to the development of male infertility. This, not very pronounced, course of the disease quite often leads to the fact that patients do not seek medical help in time.

Causes of the disease

Let us consider in more detail the causes of orchitis. They may be different.

In infancy, orchitis occurs most often due to infection in the umbilical vessels, which have become inflamed, into the testicle itself. Also, one of the reasons is the manifestation of the disease against the background of the already existing epidemic parotitis in the patient (it is also called mumps). One of the causes of this disease may be the occurrence of complications after an operation performed on the external genital organs of men. A fairly common cause of this disease is also the penetration of a sexually transmitted infection from the organs of the genitourinary system into the testicle, and caused by chlamydia, ureaplasma, Trichomonas, gonococci, mycoplasmas, etc.

Orchitis can occur as a complication of other infectious diseases such as pneumonia, brucellosis, typhoid, chicken pox, scarlet fever and others. With this development of events, the infection enters the testicle with the bloodstream. Sometimes orchitis is the result of an autoimmune process in the body, such as rheumatic arthritis. Orchitis can also be the result of complications of such diseases of the genitourinary system as vesiculitis, urethritis, epididymitis. Also, orchitis can occur if there are violations of the outflow of seminal fluid and blood circulation, which occur due to existing congestion in the genital area, small pelvis, or testicular injury.

Diagnostics

To establish the diagnosis, the doctor conducts an initial examination of the patient. Then a survey is made about the presence of complaints, chronic diseases, infectious diseases predisposing to the development of orchitis, injuries, and more. The necessary laboratory and instrumental studies are assigned. After that, the cause of the disease is established and the necessary treatment tactics are selected.

• Laboratory studies include: analysis of seminal fluid, which includes a spermogram and microbiological examination, general urinalysis, examination of a smear from the urethra, complete blood count, bacteriological examination of urine.
• Instrumental studies include: ultrasound - diagnostics and, if necessary, magnetic resonance imaging.

Treatment (Video: treatment of prostatitis with folk methods)

As for the treatment of orchitis, it depends on the form of the disease. But both in the case of an acute and in the case of a chronic disease, the first and main action is to direct all available possibilities to cure the disease that led to the onset of orchitis. Consider the treatment of each form of orchitis.

Acute orchitis. Initially, a complex of antibiotics is prescribed, which have a wide spectrum of action,. To relieve pain, relieve fever and inflammation, painkillers and anti-inflammatory drugs are also prescribed along with them. If the pain is very strong, then a blockade is made by injecting anesthetics into the area of ​​the spermatic cord. The patient goes to bed. In order for the testicle to be at rest, its scrotum is fixed with a rolled towel. The patient is laid so that the testicle is elevated.

It is forbidden to eat at this time: alcohol, fried, spicy and fatty foods. Shows the consumption of large amounts of liquid. If the patient has a threat of suppuration, he must be admitted to a hospital. When acute orchitis is accompanied by the development of testicular abscess, the abscess is opened and drained. If a fistula is formed, it is excised and sutured. In the case of complete purulent fusion of the testicle, it is necessary to perform an orchiectomy.

After all the main foci of the disease are removed, and the inflammation begins to subside, physiotherapy is carried out. It includes warming compresses, UHF therapy, laser therapy, magnetotherapy.

Chronic orchitis. The treatment of this form of orchitis is a rather lengthy process and requires considerable patience and a desire to be cured. The most unpleasant thing about this form of the disease is that the patient may not even be aware of it for a long time, since the symptoms accompanying it are very mild. When he goes to the doctor, the changes in the testicle can be quite strong. Chronic orchitis is difficult to treat, and its main threat is that it often becomes a possible cause of infertility in men.

For treatment, hormonal anti-inflammatory drugs are also used. Together with them, physiotherapeutic procedures are carried out using magnetic therapy, UHF therapy, warm sitting mineral and mud baths, electrotherapy, reflexology and others. If in this case the treatment did not bring results and the patient's condition worsened, the removal of the testicle can be performed. This result is more common in older men.

Possible consequences of orchitis

Poorly or insufficiently treated acute orchitis can eventually turn into its chronic form, which requires long-term treatment. An unpleasant complication can be an abscess of the testicle, with insufficient treatment, which can lead to its complete suppuration.

Very often, the inflammation that occurs in the testicle is transferred to the epididymis, which causes their inflammation - epididymitis. During inflammation of one testicle, inflammation can occur in the other testicle. One of the complications of orchitis can be a decrease in the testicle until it completely dries out, the so-called testicular atrophy. During the disease, the formation of purulent inflammation is possible, which may result in the formation of a fistula or melting of the testicle. The disease can be complicated by the accumulation of fluid between the testicular membranes.

Prevention of orchitis

What should a man do to avoid this disease if possible? So, you need to follow certain rules, which are as follows:

• it is necessary to lead an active, vigorous and healthy lifestyle, engage in various sports: running, gymnastics, swimming and others;
• avoid smoking, drinking alcohol and other bad habits;
• in the event of any acute infectious diseases of the genitourinary organs, urgently and until complete recovery, carry out the necessary treatment;
• have sex regularly;
• consult a doctor and treat existing chronic inflammations of the respiratory and genitourinary systems that can cause orchitis;
• provide a balanced amount of trace elements, vitamins and carbohydrates in your diet;
• be sure to include exercises in your complex that help relieve congestion in the genital area and small pelvis;
• when playing football, hockey and other sports, be sure to use the necessary protective equipment.

As we can see, orchitis often causes irreversible infertility. In order to feel like a real man for a long time, to be able to see your continuation in children and hear their sonorous voices in the house, be attentive to your health.

Treatment of orchitis involves the use of antibacterial, anti-inflammatory and analgesic drugs. But since there are a lot of causes for this disease, the doctor first conducts a thorough diagnosis to establish the etiology of orchitis.

What it is?

Orchitis is an inflammatory testicular disease that occurs against the background of a viral or bacterial infection and often leads to infertility.

The testicles or testicles are the male reproductive organ that synthesizes sex hormones and produces spermatozoa, which ensure procreation. The testicles are located in the scrotum, have an ovoid firmness and are laterally flattened.

Causes

The causes of testicular inflammation are infections. Depending on the pathogen that caused, orchitis can be specific (caused by pathogens of tuberculosis, syphilis), or non-specific (caused by any other infection).

The most common triggering factor for orchitis (about a third of all cases), doctors call mumps (mumps). Typhus, influenza, gonorrhea can also cause this disease. Sometimes orchitis develops after trauma. Separately, granulomatous orchitis is isolated, the causes of which have not yet been reliably established.

Among the factors predisposing to the development of orchitis, there are:

• sedentary work or a sedentary lifestyle;
• regular physical or severe mental overwork;
• overheating or hypothermia, which reduce the protective functions of the body and contribute to the development of the disease;
• sexual abstinence or excesses, as well as the irregularity of sexual activity;
• chronic foci of infections - bronchitis, sinusitis, etc.;
• severe diseases (AIDS, diabetes mellitus, hepatitis), which reduce the overall resistance of the body;
• obstructed outflow of urine, prostatitis, pyelonephritis and other problems of the genitourinary system.

In the case of acute or chronic urethritis and prostatitis, the infection enters the testicle by descending hematogenous and lymphogenous routes, developing inflammation. With parotitis, the mechanism of the disease is somewhat different, associated with the formation of specific antibodies, which, in turn, having an affinity for testicular tissue, are deposited on them, and cause damage to testicular tissues.

In any case, orchitis never develops in isolation, there is always some kind of inflammatory focus in other organs or body systems.

Symptoms of acute orchitis

The disease in men begins suddenly with an increase in body temperature, different in intensity and duration of pain in the testicle. The pain may radiate to the groin, perineum, to the lumbar region. The testicle on the side of the lesion sharply increases in size, a few days after the onset of the disease, the skin of the scrotum becomes smooth, may be hyperemic.

The pain can be aggravated by walking (going down stairs), physical activity, changing the position of the body. In addition, in the clinic of acute orchitis, general symptoms of inflammation can sometimes be present: dyspeptic disorders, chills, headache.

Symptoms of chronic orchitis

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

Pain in the testicles are intermittent aching in nature, aggravated after a long walk, physical exertion, hypothermia. At the same time, the testicle is somewhat, compacted and enlarged. When touched, the testicle is slightly painful. Symptoms of general intoxication are not expressed, 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 testis is largely impaired, which often causes male infertility.

Complications

The consequences of this disease are quite serious. The danger of the inflammatory process lies in the fact that it can penetrate into neighboring organs, propagating the infection. With untimely treatment of orchitis, there may be:

1. Necrosis of testicular tissue (cell death);
2. Complete removal of the testicle through surgery;
3. Infertility, which in the future will not be able to respond to treatment.

It is important to understand that orchitis is successfully treated with antibiotics and there is an adaptive drug for each pathogenic agent. Therefore, do not hesitate to treat.

Diagnosis of orchitis

The diagnosis of orchitis is established by the doctor on the basis of the examination and the presence of an infectious disease or injury in the patient. On examination, the urologist can observe an increase in the scrotum; on palpation, the skin of the scrotum is hot, swollen, the testicle is greatly enlarged, edematous and sharply painful.

Of the laboratory diagnostic methods, the most conclusive confirmation of the disease of orchitis is the isolation of the mumps virus from the patient's blood, swabs from the pharynx, cerebrospinal fluid, salivary gland secretion and, of course, urine. Laboratory methods make it possible to detect viruses at the cellular level in a patient already 2 days after the first symptoms. So, to diagnose orchitis disease, you need:

• microscopic examination of a smear from the urethra;
• general urine analysis;
• antibiotic susceptibility testing, urine culture;
• sowing ejaculate;
• general blood analysis;
• Ultrasound of the scrotum.

The main method of differential diagnosis of a disease such as orchitis is ultrasound analysis, it is used if the diagnosis of orchitis is difficult due to dropsy of the testicle, scrotum or periorchitis. A testicular biopsy may also be done.

How to treat ortych in men?

Treatment of orchitis consists in prescribing drugs that are aimed at eliminating the focus of inflammation. First of all, antibiotics are recommended. Paracetamol is most often prescribed to lower the temperature. To eliminate pain and improve the outflow of sperm, antispasmodics are prescribed.

Orchitis treatment regimen:

1. Pathogenetic treatment - the use of anti-inflammatory drugs "Indomethacin", "Ibuprofen", painkillers "Baralgin", "Ketorol", angioprotectors "Venorus", "Detralex", vitamin complexes.
2. Etiotropic treatment is aimed at eliminating the cause of the disease. Antibiotic therapy is carried out: patients are prescribed drugs from the group of fluoroquinolones - Ciprofloxacin, Ofloxacin, cephalosporins - Cefotaxime, Cefazolin or macrolides - Azithromycin, Clarithromycin.
3. Physiotherapeutic procedures have anti-inflammatory, local immunostimulating and regenerating effects. Patients with chronic orchitis are prescribed UHF therapy, magnetotherapy, laser therapy, acupuncture, electrotherapy, exercise therapy, mud and mineral baths.
4. Patients with an acute form of the disease are shown bed rest, a minimum of movements, rest and an elevated position of the scrotum, the use of a supporting bandage that improves blood circulation in the inflamed organ and eliminates congestion in the pelvic organs.

At home, cold compresses are used as a pain reliever. Every 4 hours the compress is applied to the scrotum for 10 minutes. Treatment for orchitis includes dieting and giving up bad habits. Spicy, sour and salty foods should be excluded from the diet.

Surgical intervention

If conservative treatment of orchitis does not bring the desired results, then the question of surgical intervention is raised.

Indications for its implementation are:

• tuberculosis nature of the disease;
• frequent exacerbations in the chronic form of orchitis;
• suppuration of tissues;
• acute form, developed as a result of an injury;
• severe course of the disease, etc.

Depending on the complexity of the case, surgical intervention can be performed by several methods. With the least consequences for functioning, resection takes place - removal of the inflamed part of the testicle. With insufficient thoroughness of the operation and in the case of a number of other factors, complications and relapses are possible.

In severe purulent lesions - orchiectomy - removal of the testicle with the appendage. If the operation affects both organs, then this leads to a significant decrease in the level of male sex hormones and infertility. Also, the attending physician may suggest other methods of surgical intervention.

Prevention

It is impossible to completely prevent the development of orchitis, although each person has the opportunity to protect himself from infection as much as possible: to lead a healthy lifestyle, not to have intimate relationships with unknown people without a condom, not to overheat or overcool the body, including the scrotum area.

Orchitis is one of those diseases with which a man can be embarrassed and even ashamed to contact a specialist. This pathology is characterized by an inflammatory lesion of the paired gonads (or one testicle). It leads to great discomfort and severe pain and often interferes with the conduct of a normal lifestyle.

It should be noted that it is precisely because of shame in front of a medical worker that the disease very often takes its own 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 can be severely neglected. So the problematic part of the body will have to be amputated in order to prevent the infection from spreading further.

Self-medication or "grandma's way" treatment 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 detrimental 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 necessary to urgently visit the appropriate specialist (urologist or andrologist). Now you need to learn how to identify such a disease, that is, to know 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 more often only one of the two glands is affected, although bilateral disease also occurs.

• The first sign of the disease considered in this article is a sharp increase in body temperature (up to approximately 38-39 degrees), which accompanies severe dull, pressing or bursting pain in the scrotum. Characterized by heaviness in the testicles. There is a reflection of pain in the groin, lower abdomen, sacral region. Increased pain is provoked by touching and walking, which will significantly complicate the performance of various daily household activities. Nerve endings are responsible for the pain, irritated by the stretching of the albuginea 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 has symptoms characteristic of general intoxication: headaches, dizziness, weakness, chills and nausea. There may be urination disorders, semen with blood, and other rarer manifestations.

In the absence of adequate medical care, orchitis passes into 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 the risk of infertility, which, alas, cannot be cured.

Chronic orchitis, as mentioned above, occurs with poor-quality or absent treatment. In this form of the disease under consideration, pain in the inguinal zone and the affected organ ceases to cause discomfort. They become aching and unstable, but may be aggravated by 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.

Male representatives are usually in no hurry to contact specialized clinics. Which leads to a slow progression of the disease and various complications.

The reasons

Now let's talk about what can cause this unpleasant life-spoiling pathology:

• Approximately in five percent of cases, the appearance of the disease considered in this article is due to mechanical trauma to the testicle.
• An infectious disease can cause orchitis. At the same time, the disease can be either sexually transmitted (for example, syphilis, gonorrhea, trichomoniasis, and so on) 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 (acute viral pancreatitis) may suffer.
• Quite often, the disease can begin with epididymitis, which was not cured on time, treated poorly or not dealt with at all.
• Various inflammatory diseases of the urogenital area, such as urethritis (inflammation of the urethra) or prostatitis (inflammatory disease of the prostate gland).
• Bladder catheterization for a long time, which led to the appearance of an infection.

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

• Lack of regular sex life.
• A sedentary lifestyle that may be associated with a profession (for example, such a problem is observed among programmers and truckers).

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

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

testicular orchitis in men

Often, at a young or mature age, faced with infertility, a man does not even remember that in childhood he had orchitis against the background of a banal mumps. In this case, the doctor has to be especially attentive to the collection of an anamnesis of his patient's life. Ideally, when medical records are preserved. However, quite often outpatient cards of children are handed over to the archive of the children's polyclinic at the place of residence. And much information about their childhood is irretrievably lost.

For a boy infected with the mumps virus in childhood, such a mild illness as mumps can be complicated by pancreatitis and orchitis. At the same time, the clinic of acute inflammation is no different from that in an adult. This is swelling, an increase in 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 joins the pre-existing lesion of the parotid gland. There are symptoms of intoxication (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 an 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 and be revaccinated at six years of age.

For those who are weakened or who had a medical exemption by 12 months, it is possible to vaccinate according to an individual calendar at 18 months and a year after that. Under these conditions, a fairly decent artificial immunity is formed to the virus. That allows you to save the boy from secondary inflammation and atrophy of the testicles of a viral nature. A variant of emergency vaccination is also possible in cases when patients with epidparotitis 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 of the first year of life. It accounts for almost 30% of all acute pathologies of the scrotum, including surgical diseases. The prerequisites for this are the anatomical features of male infants: a clear division of the testicular membranes. Non-fusion of the vaginal process in some boys, as well as increased tone of the levator testicular muscle. This results in its greater mobility.

The disease begins in a similar variant, often subacutely, 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 the tissues of the organ. This requires surgical treatment and often leads to the loss of the testicle.

Plays a role and traumatic injury in childbirth of the scrotum in children with breech presentation.

• The second peak of childhood morbidity falls on the prepubertal and pubertal period (mumps, post-traumatic).
• In adults, in addition to the considered cases associated with sexual infections (purulent bacterial), orchitis may be associated with other specific pathogens. For example, Mycobacterium tuberculosis. Tuberculous process of the urogenital tract up to 80% is represented by lesions of the scrotum. The testicles suffer in this case a little less often than their appendages. The result of inflammation of which becomes an obstructive variant of infertility. Involvement of the testis means that the TB infection is very aggressive and has a generalized effect on the body. In this case, the case almost always ends with a surgical amputation of the gonads with appendages. Granulomatous orchitis is diagnosed at the same time pathomorphologically on a remote organ. Ultrasound reveals areas of seals and purulent fusion of the gland.

A urologist will manage the patient with orchitis.

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

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

• To determine 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 not only have to establish the diagnosis of orchitis, but also try to understand its origin. The choice of a conservative or operative approach to pathology will depend on this.
• How to treat the disease at home, is it possible to do this, the doctor should also say. Of course, it is not advisable to put a patient on a stationary 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 regimen (half-bed), an elevated position for the suffering area and sexual rest. It is also desirable to follow a dairy-vegetarian diet with a restriction of salts, marinades, smoked meats 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 mainly managed by surgical hospitals with the involvement of operating urologists. Parotitis processes require the participation of a pediatrician and an infectious disease specialist.
• In adults, in cases of a specific venereal anamnesis, a venereologist is involved. With a tuberculosis variant - a phthisiatrician.
• Folk remedies do not cure the disease. In addition to translating the acute variant of the course of the disease into subacute or chronic, such tactics can achieve purulent fusion of glandular tissue and loss of an organ or sepsis. Infectious-toxic shock and death. Infertility in this case can be considered the mildest option for loss. With which a careless lover of traditional medicine will have to put up with.
• Surgical treatment may be required for drainage of purulent foci: opening the membranes of the testicle, dissection of the testicle.
• Surgical removal is an extreme scenario when the preservation of the organ is impossible and even dangerous from the point of view of infectious-septic or thrombotic complications.

Antibiotic treatment

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

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

Semi-synthetic penicillins, beta-lactams (amoxiclav) - use cases for children and therapy for syphilis and gonorrhea.

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

The appointment of antibacterial drugs for viral lesions of mumps orchitis is impractical.

Orchitis: drugs

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) in order to avoid gastropathy. Both tablets and injections, suppositories are possible when managing a patient in a hospital or at home.

• Alpha-blockers (tamsulosin, alfuosin).
• the 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

In the treatment of 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 stasis. In chronic orchitis, inflammation is extended over time, does not give acute pain and significant swelling.

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

Effects

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

Prevention is:

• competent obstetric care for male fetuses in breech presentation.
• timely vaccination of boys against mumps.
• practicing safe sex
• avoidance of trauma to the scrotum for men.
• timely screening for tuberculosis and sexually transmitted infections with adequate treatment if infections are detected.

In case of suspicion of damage or disease of the scrotum, you should immediately seek medical help.

Orchitis is one of the most common complications after infectious diseases of various origins. With it, a man develops inflammation of the vessels of the testicle. The disease can occur in acute and chronic forms. As an independent disease, it practically does not occur, in most cases it occurs against the background of infectious inflammation or specific injuries of the testicles.

The main function of the testicles in the body is the production of the male hormone testosterone. They contribute to the growth and development of male genital organs, are responsible for the production of spermatozoa, stimulate the growth of muscle mass and the formation of male muscles.

What can cause orchitis?

The main reason is a viral or bacterial infection that enters the organ from the urethra, prostate or bladder. Sometimes it can occur in newborn boys as a result of a pathogenic infection from an unhealed umbilical wound.

In older children, inflammation may occur as a complication of mumps. In this case, there is a risk of further infertility.

In adults, the main causes of inflammation are:

• viral diseases - influenza, herpes;
• venereal diseases - , ;
• stagnation in the genitals, arising from violations of the outflow of seminal fluid;
• testicular injury;
• bacterial and fungal infections - candidiasis, staphylococcus aureus;
• some chronic diseases - prostatitis, pyelonephritis;
• frequent hypothermia of the lower body, a decrease in the level of immunity.

In some cases, inflammation of the testicle occurs as a negative consequence after surgery on the genital organs or as a result of prolonged use of catheterization.

There are frequent cases of pathogenic infection not only from nearby organs, but also from distant foci. So orchitis can become a complication after tonsillitis, bronchitis, pneumonia.

The pathological condition can be triggered by insufficient physical activity, difficulty urinating, sexual excesses, or, conversely, prolonged abstinence from intimacy. Reduced body resistance as a result of chronic overwork or the presence of serious illnesses (AIDS, diabetes, tuberculosis) can also be provoking factors in the development of the disease.

Clinical picture

Depending on the duration and nature of the course of the disease, its acute and chronic forms are distinguished. Acute orchitis is a complication that occurs against the background of another infectious disease. Duration of inflammation - from 2 weeks to 1 month.

Chronic orchitis develops as a result of improper or insufficient treatment of the acute form or with complications of other diseases of the urogenital area (cystitis, prostatitis).

The first symptom of an acute form is pain in the testicle. The pain radiates to the sacrum, lower back and groin. A few days later, developing subacute orchitis causes an increase in the scrotum, smoothing of its skin folds, redness, and fever.

One of the most characteristic symptoms is a change in the surface of the organ, it becomes as if varnished and glossy. The testicle increases significantly in size, upon examination, its severe pain is noted. Men experience pain during intercourse, a feeling of heaviness in the scrotum. In severe cases of the disease, the patient experiences muscle pain, dizziness, nausea.

Symptoms of acute orchitis often go away even if left untreated. However, in these cases, there is often a further aggravation of the inflammatory process, which can lead to testicular abscess. Under the influence of a purulent process, the tissue reduces the production of sperm, which leads to the development of infertility.

Signs of pathology in its chronic form are blurred. Patients experience mild aching pain in the testicle area. Pain is aggravated by sports, physical activity, severe hypothermia. The testicle is slightly compacted and enlarged, it is painful when pressed. The general condition of the patient is satisfactory, the body temperature does not rise. This condition is sluggish and can last up to six months.

Minor pain rarely causes patients to seek medical help in time. Lack of treatment disrupts the normal functioning of the organ and leads to loss or a significant decrease in fertility.

There are two types of inflammation:

1. Nonspecific orchitis - its cause is the ingestion of pathogenic streptococci, Escherichia coli.
2. Specific - occurs when the body is damaged by diseases such as mumps, brucellosis, malaria, syphilis, tuberculosis,.

If inflammation in other diseases is purulent, this is a predisposing factor to the development of purulent orchitis.

The most common mumps orchitis. It occurs as a complication of epidemic (infectious) mumps. The testicles are affected about a week after the onset of the disease.

5-7 days after the penetration of the infection, the testicle increases to the size of a goose egg, the patient develops a fever, severe pain in the scrotum. In 10-17% of parotitis, bilateral orchitis occurs, which increases the risk of development.

Diagnosis of the disease

Making the correct diagnosis is easy. For an experienced doctor, an external examination of the patient and a survey about complaints are sufficient. But in order to prescribe the most effective treatment and identify the causative agent of the infection, laboratory data are needed.

Diagnosis of testicular inflammation includes:

• a blood test to identify the nature of inflammation, the level of leukocytes, lymphocytes and eosinophils;
• urine analysis in order to establish the presence of possible inflammation in neighboring organs of the genitourinary system;
• urine test for bacteria - is carried out to determine the microbes that caused the disease and determine their sensitivity to the action of antibiotics;
• analysis of a smear from the urethra for the presence of chlamydia, staphylococci or gonococci;
• a study to determine the activity of spermatozoa and their ability to fertilize.

Additional diagnostic methods are also used, such as ultrasound and MRI. They allow you to determine the degree of damage, the prevalence of the inflammatory process.

Which doctor treats orchitis?

When the first signs of the inflammatory process appear, you need to seek medical help from a urologist.

If the disease has taken a chronic form and is complicated by infertility, a man needs to consult an andrologist. If the inflammatory process has arisen as a complication after mumps, additional treatment by an infectious disease specialist is necessary.

When diagnosing a disease, it is necessary to differentiate it from other pathologies that have similar symptoms:

• inflammation of the epididymis;
• inguinal hernia;
• hydrocele.

Treatment

To eliminate pain and inflammation, to prevent the development of complications, drug therapy is indicated. The long course of the disease with frequent relapses requires surgical intervention. At the initial stage of the inflammatory process, it is possible to use physiotherapeutic methods and traditional medicine.

Conservative methods involve treatment with antibiotics, anti-inflammatory drugs, painkillers. An important condition for successful recovery is the creation of favorable conditions for treatment.

In the acute course of the disease, bed rest, minimal physical activity, and the use of a special bandage on the inguinal region are recommended to normalize blood circulation. Drug therapy is prescribed to eliminate congestion in the genital area.

In the course of treatment, the following drugs are used:

• Prednisolone - used mainly to treat mumps orchitis in children;
• Azithromycin - effectively treats infections of the genitourinary system;
• Doxycycline - an antibiotic for relieving pain, inflammation, swelling and swelling;
• Ciprofloxacin is a broad-spectrum antimicrobial drug that destroys both active microorganisms and those that are at rest.

It is strictly forbidden to prescribe antibiotics on your own, without consulting your doctor. Uncontrolled intake of drugs can complicate the course of the disease, since the choice of antibiotics should be aimed at destroying the pathogen. If the cause of orchitis is a sexually transmitted disease, both partners should be treated.

Complex treatment of the disease is shown. Auxiliary methods are used for it: physiotherapy, mud and mineral baths, electrotherapy, physiotherapy exercises. Children must undergo mandatory vaccination against mumps.

At high temperature, dizziness, chills, urgent hospitalization is carried out. For moderate symptoms, a combination of outpatient therapy and home treatment is possible.

The prognosis of acute orchitis is more favorable than its chronic form. With timely treatment, the symptoms disappear within 5-7 days. Treatment of the chronic form of orchitis is a more complex process due to frequent complications. The most dangerous for health are bilateral inflammations suffered in childhood and adolescence.

During an exacerbation, fatty, spicy and fried foods, as well as any alcoholic beverages, are excluded from the patient's diet.

Surgical intervention

In some cases, complex therapy may not be effective enough. The operation is assigned with the following indicators:

• orchitis arose as a result of a severe injury;
• a purulent inflammatory process occurs in the body;
• seals appeared that were not amenable to conservative treatment;
• the disease takes a chronic form with frequent relapses;
• orchitis arose as a complication of tuberculosis.

With surgical intervention, partial removal of the ovary is possible, when the functionality of the organ is preserved, but further relapses of the disease are possible. With a purulent lesion, the testicle is completely removed. Such an operation allows you to completely eliminate infectious foci, but its consequences are negative for health. In a man, the level of production of sex hormones decreases and the ability to reproduce offspring is lost.

More sparing methods of surgical treatment include the method of notches and puncture of the scrotum. In the first method, small incisions up to 5 mm in size are applied to the organ. This allows you to eliminate infectious lesions of small sizes.

The scrotum is punctured with a special needle. The procedure helps to relieve pain, feeling of heaviness and swelling. However, it is ineffective for the treatment of severe inflammatory processes in the body.

How to treat testicular inflammation with alternative folk methods?

Doctors advise using traditional medicine only as an adjuvant therapy that complements the prescribed drug treatment. It is unrealistic to completely remove inflammation, eliminate severe soreness and swelling with the help of exclusively folk remedies.

Treatment of orchitis at home involves the use of various infusions, ointments, compresses and lotions prepared on the basis of medicinal herbs.

Among the most effective means used:

1. Tinctures from crushed leaves of birch, sweet clover, pear, chamomile flowers, wild rose. The resulting mixture is poured with boiling water, insisted for at least six hours, filtered and taken orally up to five times a day. The infusion helps relieve inflammation, restore damaged tissues, strengthen the immune system.
2. Lotions made from a mixture of propolis, milk and honey. It is possible to apply cabbage leaves previously soaked in vinegar to the inflamed area. Another effective lotion recipe is a mixture of honey, aloe pulp and red wine, taken in equal amounts. The prepared mixture relieves pain and an unpleasant feeling of heaviness in the scrotum.
3. Compresses from bean flour or flax seeds. Flour is mixed with a small amount of vinegar until a thick slurry is formed. It is applied to a cotton napkin and applied to the scrotum. Flax seeds are placed in a gauze bag and lowered for a few seconds in boiling water. After cooling slightly, apply a compress to the sore spot.
4. Soothing hop decoctions, lemon balm teas. They eliminate signs of irritation, relieve pain, relieve sexual overexcitation. To prepare a decoction, 100 grams of hop plants are poured into 0.5 liters of boiling water and infused for 30 minutes. Take half a glass 3-4 times a day.

Before using any traditional medicines, it is necessary to coordinate their use with a doctor.

Complications

If the acute form of the disease is not treated in time, the patient may develop various negative and health-threatening consequences:

• development of severe chronic forms with frequent repetitions;
• the appearance of large and small purulent foci with a gradual spread throughout all tissues of the organ;
• the spread of inflammation to the epididymis;
• reduction in size or partial shrinkage of the organ;

The last complication usually occurs with bilateral orchitis and leads to inability to fertilize in 50% of cases.

Prevention

Orchitis is a disease that is prone to relapse. To avoid the repetition of unpleasant signs, certain rules should be observed:

• avoid hypothermia;
• lead an active lifestyle, exercise regularly;
• avoid promiscuity, interrupted sexual intercourse;
• regularly perform exercises to prevent congestion in the pelvic area;
• timely detect and treat infectious diseases of the genitourinary system, as well as other inflammatory diseases (tonsillitis, bronchitis, sinusitis, pyelonephritis);
• adhere to the rules of rational nutrition, include foods rich in protein and vitamins in the menu;
• avoid physical and mental overload.

Orchitis is a pathological condition characterized by inflammation of the testis. This reproductive organ has a complex structure, 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 a timely referral to a urologist: detailed diagnostics 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 secondarily against the background of other diseases and conditions. There are the following factors that 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, sluggish, has a microbial origin).

2. Infection of bacterial, fungal or viral origin. The focus of pathology can even be remote, such as pneumonia, otitis media, sinusitis. Often there is mumps orchitis - inflammation of the testicle on the background of viral pathology - mumps.

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

3. Congestion inside the pelvic cavity (a common cause of these is irregular sexual activity, a sedentary, sedentary lifestyle).

4. Transferred injuries of the perineum, small pelvis, inguinal region.

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 urine outflow, 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 body resistance, which may be due to the presence in it 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 organs of the reproductive sphere: for example, after surgical treatment of varicocele. Also, testicular inflammation develops as a complication of standard urological manipulations of a therapeutic or diagnostic plan - cystoscopy, catheter placement, bougienage.

Orchitis in children occurs against the background of respiratory diseases, complicates mumps and flu. Also, the cause of testicular inflammation in boys is increased motor activity inherent in children. As in the case of the disease of adult patients, at this age the likelihood of infertility and atrophy of the affected testicle is high.

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 are somewhat different 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 syndrome. An unpleasant sensation extends to the lower abdomen, sacrum, lumbar region, groin. A characteristic difference in pain in orchitis is that it intensifies when the patient tries to change the position of the body. A similar sensation is due to excessive stretching of the tunica albuginea (one of the 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, has a glossy appearance. Tension of the skin is caused by excessive effusion of pathological fluid. Also, inflammation of the organ causes redness, a local increase in body temperature.

The general condition of the patient also changes, which is explained by the general intoxication of his body. The characteristic signs of this phenomenon are nausea, lack of appetite, weakness, body aches, desire and need to take a horizontal position, limit motor activity. If the condition is not treated at this stage, the likelihood of a transition to a chronic course or the development of infertility is high.

chronic orchitis

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

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

The severity of pathology in one form or another may vary in different patients. Of decisive importance is the individual sensitivity of a man to pain, the presence of concomitant diseases, age, stability of sexual life and other criteria.

The disease has an ICD 10 code:

1. N45.9 - Orchitis without mention of abscess.
2. A54.2 - Orchitis with gonococcal infection.
3. A56.1 - Orchitis with chlamydial infection.
4. N45.0 - Orchitis complicated by abscess.

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

Diagnosis of orchitis in men

To plan a therapeutic approach and know which orchitis treatment is most effective in a particular clinical case, a thorough diagnosis of the patient's condition will be required. The following activities are carried out:

General blood analysis. In the material sample, an increase in the concentration of leukocytes and ESR is detected, 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 it, which is associated with the nuances of the procedure. The analysis will determine which pathogenic microorganism caused the disease, antibiotics of which pharmacological group will help eliminate the infection.
A smear from the urethra for bacteriological examination. The results of this analysis help to understand the degree of the inflammatory process, to identify and specify the pathogen.

Testicular ultrasound. An informative, accurate and fast way to research. It helps to identify the spectrum of inflammatory lesions, the localization of the focus, 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, to understand the preliminary prognosis regarding 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 sexual intercourse, 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, refusal of intimate life until recovery and recommend limiting the mobility of the inflamed area (advise 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 due to the need and importance of the early relief of the inflammatory process, which can cover the epididymis. Then the condition will acquire a complicated form and will be defined as orchiepididymitis. Preferred antimicrobial options include:

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

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

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

Surgery is the preferred treatment option for orchitis if:

1. Inflammation of the testicle occurred after suffering damage to the scrotum, groin.
2. The shells of the testis are subject to a purulent process with abundant formation of the corresponding masses (phlegmon, abscess).
3. Lack of therapeutic effect after a 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 severe violations of the general condition of the patient.
5. If areas of tissue compaction have formed inside the testicular membranes, which are painful when trying to probe them, and the treatment does not bring a positive result.
6. Inflammation of the testicle is of tuberculous origin.
7. The disease has acquired a chronic course and is accompanied by frequent exacerbations.

The decision on the treatment of orchitis by the surgical method is taken by the surgeon, if we are talking about inflammation in a child, then together with his parents.

There are such types of operations for orchitis:

1. Resection of the testicle. 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 an abundant accumulation of purulent masses. In general, the prognosis is favorable.

2. Orchiectomy. The intervention involves the complete excision of the testicle along with the appendage. 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 tissues of the testicle. More often, when orchitis is detected in an advanced stage. The negative side of the intervention is the subsequent male failure due to the inability to reproduce offspring. A secondary hormonal imbalance also develops, as the testicles that synthesize testosterone are eliminated.

3. Surgical intervention, involving the implementation of notches. The advantage of the technique is the ability to timely eliminate the identified purulent focus. The elimination of this is possible under the condition of a small spectrum, which will relieve tension inside the inflamed organ.

4. Puncture of scrotum tissues. 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 produce the desired effect if the purulent focus is quite extensive, and the patient is no longer the first week.

Each of the types 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 follow a number of recommendations.

Avoid:

Damage to the scrotum, perineum;
hypothermia or overheating of the body;
wearing tight underwear;
mental or physical overwork;
casual sexual contacts, which entails infection with dangerous diseases;
malnutrition, bad habits;
interrupted 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 far from it (tonsillitis, otitis media).
2. Prevent the transition of any acute disease into a chronic form.
3. Streamline your sex life, make it stable.
4. Avoid masturbation.
5. Be attentive to your health during the postoperative recovery period.
6. Normalize nutrition (mode and quality).
7. Use special protective equipment when playing sports.
8. Make an active lifestyle, avoiding hypodynamia.

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 moment when the only possible treatment option is complete excision of the inflamed organ.