Orchitis can result from the spread of bacteria through the blood from other locations in your body. It also can be a progression of epididymitis, an infection of the tube that carries semen out of the testicles. This is called epididymo-orchitis.
Both bacteria and viruses can cause orchitis.
- Bacteria that commonly cause orchitis include Escherichia coli, Staphylococcus, and Streptococcus. A prostate infection may occur in conjunction with orchitis. Epididymitis (inflammation of the tube on the back of the testicle) can lead to orchitis, as well.
- Bacteria that cause sexually transmitted diseases (STD), such as gonorrhea, chlamydia, and syphilis, can cause orchitis in sexually active men, usually aged 19-35 years. You may be at risk if you have many sexual partners, are involved in high-risk sexual behaviors such as unprotected sex, if your sexual partner has had an STD, or if you have a history of STDs.
- The virus that causes mumps can cause orchitis, as well. Most common in young boys (rare in boys younger than 10 years), orchitis begins four to six days after mumps begins. A third of boys with mumps will develop orchitis and end up with a condition called testicular atrophy (shrinking of the testicles). That’s why it is so critical for all children, boys especially, to have shots to protect them from getting the childhood disease of mumps.
- You may be at risk for non-sexually transmitted orchitis if you haven’t had proper vaccination against mumps, if you get urinary tract infections, if you are older than age 45, or if you frequently have a catheter placed into your bladder.
With orchitis, you may have a rapid onset of pain in one or both testicles that may spread to the groin.
- One or both of your testicles may appear tender, swollen, and red or purple.
- You might have a "heavy feeling" in the swollen testicle.
- You might see blood in your semen.
- Other symptoms include high fever, nausea, vomiting, pain with urination, or pain from straining with a bowel movement, groin pain, pain with intercourse, and simply feeling ill.
In epididymo-orchitis, the symptoms are similar and may begin rapidly or progress more gradually.
- Orchitis causes a localized area of pain and swelling in the testicle for one to several days.
- Later, infection increases to involve the whole testicle.
- Possible pain or burning before or after urination and penile discharge are also seen.
When to Seek Medical Care
Most cases of orchitis caused by bacteria require antibiotics right away. If you suspect that you have the disease, or notice redness, swelling, pain, or inflammation of the scrotum or testicle, call your health care provider immediately. Do not delay medical care.
Go to a hospital's emergency department if you are unable to contact or see your doctor promptly, or if symptoms worsen despite antibiotic treatment.
Exams and Tests
Your health care provider may perform a series of diagnostic tests.
- An ultrasound of the inflamed testicle (or both testicles) can determine the difference between orchitis and testicular torsion, another painful and potentially dangerous condition.
- With a rectal exam, your doctor checks your prostate for infection. This test is necessary because antibiotic treatment will be used for a longer period of time if the infection involves the prostate.
- A urine sample might be taken to check for STDs and other bacteria that might be responsible for the infection.
- Blood is drawn to test for HIV and syphilis if a sexually transmitted disease is suspected.
Home Remedies for Orchitis
Home care along with the right medical treatment can help improve the symptoms of orchitis.
- Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil or Motrin, for example), naproxen (Aleve, Naprosyn), or acetaminophen (Tylenol) may help with pain.
- Elevating your scrotum with snug-fitting briefs or an athletic supporter can increase comfort.
- Apply ice packs.
- Ice should not be directly applied to the skin because this may cause burns from freezing. Rather, the ice should be wrapped in a thin cloth and then applied to the scrotum.
- The ice packs may be applied for 15-20 minutes at a time, several times a day for the first day or two. This will help keep down the swelling (and pain).
Medical Treatment for Orchitis
The majority of cases of orchitis -- and epididymo-orchitis -- require antibiotics. Antibiotic therapy is necessary to cure the infection and prevent its spread.
- Most men can be treated with antibiotics at home for a minimum of 10 days. Longer courses are often required if the prostate is involved.
- If you have high fever, nausea, vomiting, or are very ill, you may require admission to a hospital for IV antibiotics.
- Mumps orchitis will clear up over one to three weeks. Just treat your symptoms with home care techniques.
- Young, sexually active men need to make sure all of their sexual partners are treated. You should use condoms or do not have sexual relations until all partners have completed their full course of antibiotics and are symptom-free.
Follow-up Care for Orchitis
Return to your health care provider at the end of your antibiotic treatment for reevaluation. Call your doctor or go to the emergency department if symptoms worsen at any time during treatment.
Men older than age 50 should have their prostates examined during their yearly physical exams.
Outlook for Orchitis
For some of the men who have orchitis, the affected testicle will shrink and lose its function. The longer you delay getting treatment, the more likely the testicle will have long-term damage. Untreated orchitis can result in infertility, loss of one or both testicles, and severe illness or death.