Orchitis (Inflammation of the Testicle)

What Is Orchitis?

Orchitis is inflammation of one or both of a man’s testicles, usually because of an infection.

Orchitis can result from the spread of bacteria through your blood from somewhere else in your body. It also can be a progression of epididymitis, an infection of the tube that carries semen out of your testicles. This is called epididymo-orchitis.

Orchitis Symptoms

Most cases of orchitis are acute, which means you have sudden, severe pain in one or both testicles that may spread to your groin (the area where your upper thigh meets your lower belly). You also may have:

  • Testicles that appear tender, swollen, and red or purple
  • A heavy feeling in the swollen testicle
  • Blood in your semen
  • High fever
  • Nausea
  • Vomiting
  • Pain with urination
  • Pain from straining with a bowel movement
  • Pain with intercourse
  • Feeling ill

With epididymo-orchitis, the symptoms are similar and may start quickly (acute) or slowly (chronic).

  • Orchitis causes an area of pain and swelling in the testicle for one to several days.
  • Later, the infection spreads to involve the whole testicle.
  • You may also have discharge from your penis and pain or burning before or after you pee.

When to get medical care

Most cases of orchitis caused by bacteria need treatment right away. If you notice redness, swelling, pain, or inflammation of the scrotum or testicle, call your doctor right away. These can also be symptoms of a serious condition called testicular torsion, which is when one of your testicles is twisted.

Go to your local emergency department if you can’t talk to or see your doctor quickly, or if symptoms get worse even with treatment.

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Orchitis Causes

Bacteria and viruses can cause orchitis.

  • Bacteria that commonly cause orchitis include Escherichia coli, Staphylococcus, and Streptococcus. You can also have a prostate infection along 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 those ages 19 to 35. You may be at risk if you have many sexual partners, if you’re involved in high-risk sexual behaviors such as unprotected sex, if your 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 (but rare in those younger than 10), orchitis begins 4 to 6 days after mumps begins. A third of boys with mumps will get orchitis and then a condition called testicular atrophy (shrinking of the testicles). That’s why it’s important for all children, boys especially, to get the vaccine that protects against mumps.
  • You may be at risk for nonsexually transmitted orchitis if you haven’t had proper vaccination against mumps, if you get urinary tract infections, if you are older than 45, or if you often have a catheter put into your bladder.

Orchitis Diagnosis

Your doctor may do a series of tests including:

  • An ultrasound of the inflamed testicle (or both testicles) to figure out whether you have orchitis or testicular torsion
  • A rectal exam to check your prostate for infection
  • A urine test to look for STDs and other bacteria that might be responsible for the infection
  • Blood tests for HIV and syphilis

Orchitis Treatment

Medical treatment for orchitis

Most cases of orchitis -- and epididymo-orchitis -- need antibiotics to cure the infection and prevent its spread.

  • Most men can be treated with antibiotics at home for at least 10 days. If your prostate is involved, you’ll probably need a longer course of medication.
  • If you have a high fever, nausea, or vomiting, or if you’re very ill, you may need to be admitted to a hospital to get antibiotics directly into a vein (IV).
  • Mumps orchitis will clear up over 1 to 3 weeks. Just treat your symptoms with home care.
  • Young sexually active men should make sure all of their sexual partners are treated. Avoid sex or use condoms until all partners have finished their full course of antibiotics and are symptom-free.

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Home remedies for orchitis

Home care, along with the right medical treatment, can help ease the symptoms of orchitis. Ask your doctor about:

  • Taking over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil or Motrin), naproxen (Aleve, Naprosyn), or acetaminophen (Tylenol)
  • Elevating your scrotum with snug-fitting briefs or an athletic supporter
  • Using ice packs. Don’t put ice directly on your skin, which may cause burns from freezing. Wrap it in a thin cloth and then put it on your scrotum. The ice packs may be applied for 15 or 20 minutes at a time several times a day for the first day or two.

Follow-up care for orchitis

See your doctor again at the end of your antibiotic treatment to make sure you’re healed. Call your doctor or go to the emergency room if symptoms get worse at any time during treatment.

Orchitis Complications

Without treatment, orchitis can lead to serious health issues like:

  • The affected testicle can shrink (testicular atrophy).
  • The infected tissue can fill with pus (scrotal abscess).
  • You may make less testosterone or have problems with fertility.

Orchitis Prevention

You can do a few things to lower your chances of orchitis:

  • Don’t have sex in high-risk situations where you may be exposed to STDs.
  • Use condoms to lower your risk of STDs.
  • Make sure you've been vaccinated against mumps.
  • Get your prostate examined during your yearly physical if you’re over 50.

Outlook for Orchitis

The longer you put off treatment, the more likely you are to have long-term damage. Untreated orchitis can lead to infertility, the loss of one or both testicles, and severe illness or death.

WebMD Medical Reference Reviewed by Neha Pathak, MD on September 21, 2020

Sources

SOURCES: 

National Institutes of Health.

Trojian, T. Am Fam Physician, April 2009.

Mayo Clinic: “Orchitis,” “Groin Pain.”

Urology Care Foundation: “Epididymitis and Orchitis,” “Testicular Torsion.”

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