Orchitis: symptoms and treatment. Acute and chronic orchitis. Orchitis: symptoms and treatment of the disease Orchitis medical history

Orchitis (orchitis; from the Greek orchis - testicle) is an inflammation of the testicle. Orchitis occurs as a result of hematogenous metastasis from the primary infectious focus, as well as lymphogenously, by contact. Orchitis often develops with mumps, brucellosis, less often with typhus, smallpox, and influenza; histiocytic orchitis of unknown origin has been described. Testicular actinomycosis can occur metastatically or with the spread of specific paraproctitis. Trauma and circulatory disorders of the testicle predispose to orchitis. There are specific orchitis (tuberculous, syphilitic) and nonspecific, acute and chronic.

Normal testicle (left); orchitis (right).

With nonspecific orchitis (Fig.), the size of the testicle increases due to swelling of the tunica albuginea, septa, accumulation of exudate in the lumen of the seminiferous tubules, and the development of inflammatory infiltration of the interstitial tissue of the testicle. In smallpox, necrotic changes predominate.

Brucellosis orchitis is usually characterized by the development of specific granulomas, while histiocytic orchitis is characterized by infiltration of the interstitium with histiocytes and plasmacytes.

Orchitis often causes inflammatory changes in the epididymis (orchiepididymitis) and spreads to the membranes of the testicle (periorchitis). Possible reverse development of inflammatory changes, a chronic course of the disease with gradual replacement of the parenchyma by fibrous tissue or purulent melting of testicular tissue, the formation of abscesses and fistulas of the scrotum.

Acute orchitis is characterized by the appearance of sharp pain in the testicular area, radiating along the spermatic cord to the lumbosacral region. The testicle is enlarged and hardened. Its surface is smooth due to the accumulation of exudate in the testicular cavity. The temperature sometimes rises to 40° with chills and vomiting, and lasts for 7-10 days. Leukocytosis and accelerated erythrocyte sedimentation reaction are noted.

With influenza, mumps, and brucellosis, orchitis often progresses favorably. By the end of the 2nd week of the disease, the temperature decreases, the pain calms down, and the effusion resolves. However, for a long time, individual infiltrates can still be felt in the testicle.

Traumatic orchitis and orchitis that occurs metastatically with septicopyemia have a tendency to abscess formation; they are characterized by the persistence of local inflammatory phenomena, hectic-type temperature, and the development of signs of periorchitis: the skin of the scrotum is hyperemic, hot and painful on palpation, especially over the purulent focus.

When an abscess is opened, a fistula is formed through which necrotic tissue is rejected.

Chronic orchitis is manifested by enlargement, hardening of the testicle, pain with low-grade fever. Histiocytic orchitis is often accompanied by dysuria.

A common complication of orchitis is orchiepididymitis. With it, a dense, painful appendage is identified on the posterior surface of the testicle, sometimes merging with the testicle into a single conglomerate. Orchitis can be complicated by funiculitis with thickening and pain of the spermatic cord in the absence of changes in the vas deferens. In cases of inguinal, abdominal dystopia of the testicle, in the presence of a congenital hernia, orchitis can lead to the development of peritonitis.

Chronic nonspecific orchitis and orchiepididymitis should be distinguished from tuberculosis and testicular tumors (see). Recognition of brucellosis orchitis is helped by serological tests; leukopenia with relative lympho- and monocytosis is characteristic.

In doubtful cases of chronic orchitis, a biopsy is indicated.

Treatment. In case of acute orchitis, bed rest, elevated position of the testicles (using a pad or suspensor), cold, novocaine blockade of the spermatic cord (the spermatic cord is infiltrated with 50 ml of 0.5 - 1% novocaine solution with the addition of 300,000 units of penicillin) are required. Anti-inflammatory treatment is prescribed depending on the nature of the infection. For urinogenic infections, furadonin (0.1 g, 3-4 times a day), tetracycline drugs are prescribed; for brucellosis orchitis - vaccine therapy, streptomycin (1 g per day), syntomycin (2 g per day). In patients with mumps, orchitis is treated with a combination of antibiotics, gamma globulin and corticosteroid drugs (50-150 mg of cortisone per day for a week).

For the treatment of chronic orchitis, physiotherapy (sollux, quartz, diathermy) is recommended. In cases of suppuration, opening of the abscess is indicated, and in case of purulent melting of the testicle and chronic orchitis with persistent pain syndrome, hemicastration is indicated (see Castration in men). Long-term orchitis leads to atrophy and loss of testicular function.

The prognosis of orchitis is favorable with vigorous treatment of the initial forms of the disease.

Testicular inflammation(orchitis) is observed in common infectious diseases, quite often in infectious mumps () and, influenza; can also occur when the inflammatory process spreads from the appendage (see). In acute orchitis, the testicle is enlarged, painful, and hard to the touch; increased. These phenomena usually last 8-10 days, then the temperature drops, pain decreases, and the general condition of the patient improves. The outcome of orchitis can be testicular atrophy, with a bilateral process this leads to disruption of the secretory function of the testicle, and in persons who have not achieved it - to (see). When a testicular abscess occurs, chills, fever, and areas of softening in the testicle appear. Treatment: bed rest, antibiotics, opening the abscess. Chronic orchitis occurs more often as a result of the transfer of tuberculosis infection from the appendage. At the same time, in the testicle, it is necessary, along with massive anti-tuberculosis therapy, to undergo surgical treatment - cavernotomy, and in advanced cases (with the destruction of most of the parenchyma) - removal of one testicle.

Inflammation of the testicle (orchitis)

Orchitis is rare. It most often occurs hematogenously as a complication of infectious diseases - mumps, pneumonia, typhus, brucellosis, influenza, and sometimes after testicular trauma. Orchitis can also develop after epididymitis as a result of the transition of the inflammatory process from the epididymis to the testicle, mainly in elderly or weakened patients.

The disease begins rapidly. The temperature suddenly rises. The volume of the testicle quickly increases, it becomes tense and sharply painful. The surface is smooth, there is effusion in the membranes. In hematogenous infection of the testicle, the epididymis and vas deferens remain unchanged.

Acute inflammatory phenomena subside after 10-15 days.

After orchitis, in most cases, sclerosis and testicular atrophy occur. In weakened patients, orchitis can result in purulent melting of the testicular parenchyma with the formation of an abscess, manifested by fluctuation.

Differential diagnosis - with testicular tuberculosis and syphilitic orchitis (see Tuberculosis of the male reproductive system). Brucellosis orchitis is recognized based on the Wright, Heddleson, and Burnet reactions to brucellosis.

Orchitis is inflammation of the testicle. This disease is often encountered in urological practice, but as a rule, it does not occur independently, but is the result of a complication of general infectious processes occurring in the body.

Causes of orchitis

The most common cause of orchitis is the spread of a sexually transmitted infection (STI) from other organs of the genitourinary system to the testicle. Such pathogens include gonococci, trichomonas, chlamydia, mycoplasma, and ureaplasma. The second most common cause of orchitis is the introduction of an infection through the bloodstream; most often, orchitis is caused by the mumps virus, popularly called mumps. In addition to the causative agent of mumps, the cause of orchitis can be the influenza virus, the varicella zoster virus, pneumococcus, and others. In some cases, orchitis occurs as a result of an autoimmune process, such as rheumatoid arthritis. Orchitis can also appear as a result of injury to the testicle or as a complication after surgery in the area of ​​the external genitalia of a man.

Symptoms of orchitis

According to the nature of the course, acute orchitis and chronic orchitis are distinguished; inflammation, as a rule, occurs on one side, but in approximately 10% of cases, symptoms of orchitis appear in both testicles.

Acute orchitis has an abrupt onset. The first symptom of orchitis is severe pain in the testicle, aggravated by movement, the testicle gradually increases in size, the skin of the scrotum over it stretches, becomes smooth, hot and hyperemic, touch causes sharp pain. Acute orchitis is accompanied by a general deterioration of the condition: body temperature rises to 38 - 40°C, fever occurs, headaches, muscle pain, and weakness appear. When taking active therapeutic measures, the symptoms of orchitis disappear within 7-10 days; if the disease is not treated, there are three possible ways for the process to develop: self-healing may occur within 2-3 weeks, the disease may become chronic, or an abscess (purulent inflammation) of the testicle will develop.

Chronic orchitis can be a consequence of untreated acute orchitis, or it can be primary chronic, i.e. the infectious process occurs immediately as a chronic one; this is usually typical for orchitis caused by STIs. In this case, there may be no symptoms of orchitis at all, and the disease is detected by chance during an examination for infertility, which often results from chronic orchitis. The only symptom of orchitis in its chronic form, as a rule, is minor pain in the testicle, usually appearing with a certain body position or palpation.

Diagnosis of orchitis

The diagnosis of orchitis is made based on medical history (previous diseases, injuries, etc.), external examination of the external genitalia and ultrasound examination. Great importance is attached to identifying the causative agent of the disease, since the treatment of orchitis depends on this, therefore studies are being carried out to identify STIs; A general blood and urine test is also taken, a testicular puncture is performed with a laboratory study of the puncture.

Treatment of orchitis

Treatment of acute and chronic orchitis is somewhat different, however, in both cases, the main measures should be aimed at curing the underlying disease that led to orchitis.

In case of acute orchitis, a shock course of antibacterial therapy is prescribed, for which broad-spectrum antibiotics are used, since prompt and vigorous measures are required, and there is no way to wait for the results of bacterial culture. In combination with them, non-steroidal anti-inflammatory and painkillers are prescribed. The patient is prescribed bed rest, and in case of physical activity, it is necessary to wear a suspensor - a special bandage that supports the testicle in a certain position. In cases of severe pain, blockade of the spermatic cord is performed using anesthetic injections. Fatty, fried and spicy foods, as well as alcohol, are excluded from consumption during the treatment period.

Treatment of chronic orchitis must be consistent and persistent, since chronic orchitis is difficult to treat, but can cause infertility in a man. As in the treatment of acute orchitis, antibacterial drugs are prescribed, but they are carefully selected in accordance with the data of bacterial research. As a rule, treatment of chronic orchitis requires several courses of antibacterial therapy with different drugs, in combination with hormonal anti-inflammatory drugs. In parallel, physiotherapeutic methods are actively used: UHF therapy, magnetic therapy, laser therapy, warming compresses and warm sitz baths. The same therapeutic measures are prescribed for the treatment of acute orchitis in the stage of subsiding inflammation, but in shorter courses. Treatment of chronic orchitis also requires following a diet and giving up bad habits.

Complications of orchitis

The most common complication of acute orchitis is the development of pyocele, a purulent inflammation that leads to either melting of the testicle or the formation of a fistula. Such complications are treated surgically, for which the testicle is opened, washed with antiseptics and drained. If a fistula forms, it is excised and sutured. If complete purulent melting of the testicle has occurred, an operation is performed to remove it - orchiectomy.

A complication of chronic orchitis is infertility as a result of decreased secretory function of the testicle; in some cases, the chronic process can lead to testicular atrophy or hydrocele - testicular hydrocele. Untreated chronic orchitis leads to the appearance of other inflammations of the genitourinary system, and, as a constant source of chronic infection, to a decrease in immunity with all the ensuing consequences.

Orchitis prognosis

Acute orchitis has a more favorable prognosis than chronic orchitis with regard to future male health. As a rule, when timely treatment measures are taken, acute orchitis goes away without a trace. Chronic orchitis is difficult to treat and requires persistence from both the doctor and the patient, but sometimes even in case of complete cure, the secretory function of the testicle can be significantly reduced. Particularly dangerous in this sense is bilateral orchitis suffered in childhood and adolescence. To prevent the disease, timely treatment of orchitis as early as possible is of great importance.

Video from YouTube on the topic of the article:

(from the Greek orchis - testicle), inflammation of the testicle in humans. It most often occurs as a complication of an infectious disease: mumps, influenza, gonorrhea, typhoid, etc. (the so-called hematogenous route of infection) or due to testicular trauma. It begins acutely - the testicle quickly increases in size, becomes tense and painful, its surface is smooth due to effusion in the membranes. Body temperature rises. With hematogenous infection, the epididymis and vas deferens remain unchanged. Usually after 2-3 weeks the phenomena subside, although in some cases suppuration and even necrosis of the testicle are possible. Chronic orchitis occurs slowly, with scant symptoms.

Treatment: rest, wearing a jock strap, painkillers, antibiotics. When suppuration occurs, the abscess is opened. In case of long-term, recurrent course, removal of the affected testicle. Orchitis can develop after mumps (mumps), influenza, scarlet fever, chicken pox, pneumonia, brucellosis, and typhoid fever.

But more often it develops with inflammatory diseases of the genitourinary system - urethritis, prostatitis, vesiculitis, epididymitis. Orchitis can also appear after injury. According to its course, it can be acute and chronic. Acute orchitis is usually caused by an acute inflammatory disease, while chronic orchitis is caused by a chronic one.

Classification of orchitis

Depending on which testicle is affected, there is right-sided and left-sided orchitis in men. In 15% of cases in men, bilateral inflammation of the testicles occurs in men. Orchitis is classified according to the following criteria:

Type of pathogen

• specific (trichomoniasis, gonorrhea, tuberculosis);
• nonspecific (bacterial and viral);

Cause

• necrotic (as a result of incomplete torsion of the testicle or hydatid);
• granulomatous;
• congestive (arising due to proctitis, hemorrhoids, varicose veins, dysrhythmia of sexual life, etc.);
• traumatic;

Course of orchitis

• acute orchitis (purulent or serous);
• chronic orchitis (usually occurs after insufficient treatment of the acute form);
• ischemic orchitis;
• recurrent orchitis.

Acute orchitis

Orchitis begins with the appearance of pain in the testicle. The pain can radiate to the groin, perineum, lower back, sacrum. The scrotum on the side of the disease enlarges 2 times or more, its skin becomes smooth, a few days after the onset of the disease, the skin of the scrotum sharply turns red, becomes hot, and may acquire a glossy tint.

The inflamed testicle is enlarged and sharply painful when touched. Simultaneously with pain in the scrotum, general symptoms of inflammation appear - weakness, fever 38-39 ° C, chills, headache, nausea. Usually, even without treatment, the disease goes away on its own within 2-4 weeks. But in some cases, the inflammatory process leads to its suppuration and the development of a testicular abscess. The skin of the scrotum becomes bright red, smooth, and sharply painful when touched. The main complication of acute orchitis is possible suppuration of the testicle and the subsequent development of a secretory form of infertility.

If suppuration is possible, the patient is hospitalized. Therapeutic measures are fundamentally the same as for acute epididymitis: treatment of the underlying disease that led to orchitis, fixed elevated position of the scrotum, local application of cold, antibacterial therapy, and when acute inflammation subsides - physiotherapy, thermal procedures. When a testicular abscess develops, it is opened and drained. In severe cases, when the testicular tissue has completely melted with pus, an orchiectomy is performed - unilateral removal of the testicle.

Chronic orchitis

Chronic orchitis develops with improper or insufficient treatment of acute orchitis or as a complication of chronic inflammatory diseases of the genitourinary system - chronic prostatitis, urethritis, vesiculitis. In a chronic case, often the only manifestation of the disease is some pain in the testicle when touched.

During an exacerbation of the disease, pain appears in the testicle when walking. More often than acute, it leads to a decrease in secretory function and can cause infertility. Treatment of chronic orchitis is long and labor-intensive. Treatment of the underlying disease is mandatory. A course of taking antibacterial drugs is also carried out, and local thermal and physiotherapeutic procedures are actively used. In severe cases with prolonged absence of effect from conservative therapy, unilateral orchiectomy is performed.

Causes of orchitis

Causes of acute orchitis

• testicular injuries
• long-term catheter use
• complications of infectious diseases
• complications of urethritis, prostatitis, epididymitis and vesiculitis

Orchitis in newborns is explained by infection from the umbilical vessels into the testicle.

Causes of chronic orchitis

• ineffective treatment of acute orchitis
• complications of chronic inflammation such as vesiculitis, urethritis, prostatitis and epididymitis.

Symptoms of orchitis

Symptoms of acute orchitis in some cases appear gradually, but sometimes patients may experience sharp pain radiating to the groin, perineum, sacrum or lower back, as well as swelling of the scrotum, which doubles in size. Due to swelling, the skin of the scrotum becomes smooth, all folds are smoothed out. A few days after the onset of the inflammatory process, it turns red (sometimes acquiring a glossy tint) and becomes hot. The main symptoms of acute orchitis include:

• Swelling and enlargement of one or both testicles;
• Redness of one or both testicles;
• Pain of varying severity;
• Discomfort when sitting;
• Discharge from the penis;
• Sharp pain in the testicle when touched;
• Swelling and increased temperature of the scrotum;
• Pain along the spermatic cord.

Pain in the scrotum and swelling are also accompanied by general symptoms, including:

• Fever and chills at a temperature of 38-40°C;
• Weakness;
• Headache;
• Nausea;
• Loss of appetite;
• Signs of inflammation of the salivary glands.

Chronic orchitis is rarely accompanied by pronounced symptoms. Most often, the only sign of the inflammatory process is some pain when touching the testicle. Moreover, during periods of exacerbation, pain may intensify when walking. Chronic orchitis, much more often than the acute form of the disease, leads to the development of secretory infertility in men.

Treatment of orchitis

Uncomplicated acute orchitis is treated on an outpatient basis. The patient should be placed on bed rest and spicy foods should be excluded from the diet. The affected organ requires rest and an elevated position. Treatment is being carried out for the underlying disease, the complication of which is acute orchitis. The patient is prescribed antibiotics, vitamins, absorbable drugs, and enzymes. If there is a threat of suppuration, hospitalization is necessary. After eliminating acute inflammatory phenomena, the patient with acute orchitis is prescribed physiotherapeutic procedures.

In acute orchitis complicated by a testicular abscess, the purulent focus is opened and drained. Complete purulent melting of the testicle is an indication for orchiectomy (removal of the affected testicle).

Treatment of chronic orchitis presents significant difficulties due to the persistent course of the disease. In addition, due to the scant symptoms, patients are often unaware of chronic orchitis and begin to receive treatment when there are already pronounced changes in the testicle. Patients with chronic orchitis are prescribed antibacterial therapy, physiotherapeutic and thermal procedures. If the course is unfavorable and conservative therapy is ineffective, a unilateral orchiectomy is performed.

Treatment of orchitis with folk remedies

A decoction made from flax roots

One tablespoon of carefully crushed raw materials should be poured with 250 milliliters of boiling water, and then kept on low heat for twenty minutes. Next, remove the broth from the heat, and then leave for at least half an hour and strain. Take fifty milliliters before meals three or four times a day.

rue grass

Freshly harvested, carefully crushed rue herb should be mixed with bay leaf crushed to a powder. Prepare medicinal dressings; to do this, spread the mixture on a cotton cloth in an even layer and apply it like a compress to the scrotum.

Bean flour dough

Mix bean flour thoroughly with vinegar until it forms a dough. Prepare medicinal dressings; to do this, spread the mixture on a cotton cloth in an even layer and apply it like a compress to the scrotum.

Larkspur

Larkspur seeds effectively resolve testicular tumors. You need to take three seeds at least three times a day.

Horsetail

Freshly harvested horsetail grass needs to be crushed, medicinal dressings must be prepared, for this, the mixture should be spread on a cotton cloth in an even layer, and applied as a compress to the scrotum.

Honey compresses

You will need to mix honey, wine, and aloe pulp in fairly equal proportions. Again, make a medicinal bandage on the scrotum.

Herbal collection

Prepare a collection consisting of the following plants: St. John's wort, lingonberry leaves, chamomile inflorescences, black elderberry flowers, black poplar buds. During an exacerbation of the disease, you need five tablespoons of the crushed (can be in a coffee grinder) mixture, pour into a thermos and pour half a liter of boiling water, leave overnight. Next, strain.

During an exacerbation, take one glass at least five times a day for two or three weeks. Next, until complete healing, prepare an infusion of 2 tablespoons, just as described above, and also take it five times a day. At the same time, it is recommended to make compresses from flax seeds. The entire course of treatment should be three months. Then there is a break for two weeks. Then you can continue to be treated in some other way. In order to be able to increase the healing effect, as well as improve the taste, it is better to add honey to the prepared infusion.

Compresses from wiki

Fresh vetch grass should be thoroughly chopped using a meat grinder, medicinal dressings should be prepared, for this, the mixture should be placed on a cotton cloth in an even layer and applied as a compress to the scrotum.

Folk recipe for making special propolis candles

You should take 2 or 3 grams of royal jelly, five grams of crushed propolis. Melt cocoa butter or internal rendered fat (lamb) in an enamel bowl. When the butter or fat is completely melted, you should add already prepared royal jelly and crushed propolis to it. Then mix the mixture thoroughly until it thickens to the consistency of dough.

Next, take half or a full teaspoon of this mixture, roll it into tubes and form candles, one end of which is slightly rounded, pack these candles in a special film and store them in the refrigerator. Every day before going to bed, you will need to insert this suppository into the anus, first dipping it a little in rosehip oil or olive oil.

Prevention of orchitis

Prevention comes down to the treatment of chronic inflammatory diseases of the genitourinary organs, careful monitoring of one’s condition during common infectious diseases (mumps, influenza, scarlet fever, pneumonia and others), with trauma to the scrotum, perineum and pelvic area.

Questions and answers on the topic "Orchitis"

Question:A month ago I had orchitis, which seemed to have cured. Everything was normal on the ultrasound. The pain stopped. But two days ago, after physical exercise, veins appeared on the left side of the scrotum and pain (tugging) on ​​both sides + radiated to the groin. The doctor said it was a varicocele. I did an ultrasound, they didn’t reveal a varicocele, but only a predisposition on the left side. After that, he said that it was untreated orchitis and prescribed the antibiotic “Suprax” + Traxevasin (as last time). Does this mean that my orchitis has become chronic? Is this treatment adequate? Aching pain in the groin and lower abdomen begins with long or fast walking

Answer: You do not have epididymitis orchioepididymitis.

Question:Hello. 3 months ago I discovered that I have orchitis. I went to the urologist, they prescribed me a bunch of antibiotics, I had the injection within 2.5 weeks (as the doctor told me). Today I discovered that the testicle had enlarged and there was a slight pain in the groin area and, most importantly, a discharge appeared. I read a lot about orchitis but didn't find anything about discharge. What could this mean?

Answer: Hello! I think you are going through an inflammatory process. Perhaps the antibiotic you injected did not have an effect on the infection, but only “muffled” it. Do a test for sexually transmitted infections (you need to exclude chlamydia in particular), using PCR, ultrasound of the scrotum and prostate gland. Sowing the secretions onto the flora.

Inflammatory processes of the scrotal organs occupy third place in the frequency of diseases of the male genital area, second only to prostatitis and balanoposthitis. Most often, orchitis is a complication of infectious diseases (mumps, influenza, pneumonia, etc.). As a rule, young men suffer from it. Every patient who encounters this problem cannot help but worry about how to recover quickly and prevent complications.

What is orchitis

Orchitis is an infectious inflammation of the testicle. The pathogenic microorganism enters the organ through the blood or lymph flow. Isolated orchitis is relatively rare; most often it occurs in combination with epididymitis (inflammation of the epididymis). Often, an infectious lesion spreads to the testicle from its epididymis, but the opposite situation also happens. In most cases (about 90%), orchitis develops on one side, usually on the right. But bilateral inflammation of both testicles is also possible.

According to the type of course, orchitis can be acute (serous or purulent) and chronic. The first form, with proper and timely treatment, goes away in 2–4 weeks, while the second lasts for months, periodically exacerbating and subsiding. The pathology is manifested by pain in the inflamed testicle, its enlargement, redness, increased body temperature and general malaise.

Orchitis is inflammation of the testicle

Treatment methods for orchitis

Therapy for orchitis should be comprehensive and include both internal administration of medications prescribed by a doctor, as well as local and physiotherapeutic procedures. In the acute period of the disease, the patient must remain in bed. Complete rest of the affected organ, lack of physical activity and sexual abstinence are important.

It is recommended to elevate the inflamed testicle. This is necessary to facilitate the outflow of lymph, reduce swelling and improve blood circulation in the affected organ. For this purpose, you can place a small pillow or roll of fabric under it. A special bandage will also work. It is better to avoid loose underwear for the duration of treatment; with the help of tight-fitting sports pants, on the contrary, the sore testicle will be securely fixed.

Therapeutic testicular bandage will support the organ in an elevated position

When orchitis is of mumps origin, there is no specific therapy; the disease is treated according to the usual regimen.

Treatment of chronic testicular inflammation consists of the use of local absorbable agents, the prescription of antibacterial drugs and physical therapy.

Drug therapy

On the first day of the acute form of the disease, the patient is prescribed broad-spectrum antibacterial drugs:

• penicillins - Ampicillin, Amoxicillin, Amoxiclav;
• cephalosporins - Cefotaxime, Ceftriaxone, Cefuroxime;
• macrolides - Azithromycin;
• tetracyclines – Tetracycline, Doxycycline;
• fluoroquinolones - Ciprofloxacin, Moxifloxacin, Levofloxacin;
• aminoglycosides - Gentamicin, Streptomycin.

Together with them, you can use pain-relieving suppositories based on non-steroidal anti-inflammatory drugs (Voltaren, Ibuprofen, Diclofenac).

A good therapeutic result is achieved by novocaine blockade of the spermatic cord with the addition of a single dose of penicillin antibiotics. The course of treatment lasts at least 2–3 weeks. For chlamydial orchitis, antibiotics are used:

• Erythromycin;
• Rifampicin;
• Clindamycin;
• Tetracycline;
• Chloramphenicol.

Dimexide has proven itself well in the arsenal of topical agents. Penetrating deep into the tissue, it delivers medications directly to the inflammatory focus through the skin. Dimexide applications with antibiotics, absorbable and enzyme preparations can be used from the first days of the disease until the infiltrates in the testicle completely disappear.

Dimexide applications have a beneficial effect on inflamed testicular tissue

If necessary, the patient is prescribed Canephron, a plant-based anti-inflammatory diuretic. This drug is not an antibiotic.

Drug therapy for chronic orchitis requires a lot of time, patience and perseverance from the patient. The doctor selects medications taking into account the sensitivity of the pathogen to them. Treatment should consist of several consecutive courses of different antibacterial drugs in combination with anti-inflammatory and hormonal drugs (for example, Prednisolone). If recovery is delayed, the patient is additionally prescribed sulfonamides (Biseptol, Sulfadimezin).

Contrary to popular belief, Vishnevsky ointment is completely useless in the treatment of orchitis. Moreover, such products must be handled very carefully: they can irritate the delicate skin of the scrotum.

Traditional methods

Along with drug therapy, in consultation with your doctor, you can use traditional medicines.

Local warm lotions and compresses will help after acute inflammatory phenomena have subsided, during which only cold should be used. Gauze or soft cloth is moistened in the product and loosely wrapped around the sore testicle. Keep the compress until it cools down. People use healing infusions for warm wraps for orchitis, prepared from the following plant materials:

• lemon balm;
• flax-seed;
• bean flour;
• cabbage leaves;
• common hop;
• chamomile or calendula flowers;
• poplar buds;
• lingonberry leaves;
• black elderberry flowers;
• St. John's wort herb.

It is believed that for inflammatory diseases of the male genital organs, one of which is orchitis, an infusion of wintergreen (meadow lily of the valley), taken orally, helps well. To prepare it you need:

1. Finely chop 1 tbsp. l. plants.
2. Pour the resulting raw material with 1 cup of boiling water.
3. Let it brew for 3 hours, then strain.

Wintergreen infusion is taken 2 tbsp. l. 2 times a day. Duration of use of the product is 1 month.

The healing properties of wintergreen have long been used in folk medicine to treat male diseases.

Physiotherapy

Cold compresses or ice are applied locally to the scrotal area. Exposure to low temperatures reduces the severity and extent of the inflammatory process, which has a positive effect on the patient’s well-being. It must be remembered that prolonged ice applications can cause necrosis of the delicate skin of the scrotum. Therefore, cold local procedures should be intermittent: ice packs are applied to the sore testicle for no longer than 1.5–2 hours, then you need to take a break for 30 minutes.

Applying an ice pack to the sore testicle will relieve swelling and reduce pain.

With adequate treatment, the first relief occurs within 3–4 days. After reducing pain and swelling, normalizing the temperature and eliminating signs of general intoxication, instead of cold, they begin to apply heat locally to resolve the resulting infiltrates. An ordinary heating pad will do.

The following physiotherapeutic procedures have a good therapeutic effect when acute inflammatory phenomena subside:

• local electrophoresis of drugs;
• UHF sessions on the corresponding side of the scrotum;
• warm healing lotions and wraps;
• peloidotherapy - treatment with healing mud;
• diathermy - deep heating of the testicle with high-frequency electric currents.

Diet food

Orchitis does not require the patient to follow any special diet. But to reduce the load on the digestive tract, it would be advisable to limit the diet of spicy, smoked, fatty and salty foods.

In addition, during orchitis, like any other infectious process, the body experiences an increased need for fluid to quickly release microbes through the urine. Suitable drinks include fruit juices, fruit drinks, tea with lemon, dried fruit compote, and jelly.

It goes without saying that during treatment the patient should not drink alcoholic beverages or smoke.

Surgery

The essence of treatment for patients with testicular inflammation is to prevent purulent complications. If they do occur, the patient must be hospitalized in time to open and drain the abscess. This is necessary to maintain the functionality of the intact part of the organ. Early surgical intervention can prevent serious complications.

The operation consists of opening the scrotum above the abscess cavity. The location of the latter is determined by palpation or using an ultrasound machine. The abscess is cut, areas of purulent tissue melting are excised and removed, and the resulting wound is drained.

Ultrasound in acute orchitis visualizes an enlarged testicle with reactive hydrocele of the membranes

For moderate and severe disease, an active surgical approach is required; in these cases, you should not waste time on less effective measures. A timely operation allows preserving the viability of the remaining part of the testicle in almost 90% of patients.

For older men, in the absence of positive results from conservative therapy, it is advisable to remove the affected testicle (orchiectomy). This radical intervention is absolutely indicated for the following complications:

• multiple ulcers;
• fistula formation;
• complete purulent melting of the testicle;
• increasing intoxication of the body;
• threat of sepsis.

Features of treatment in children

In boys under 15 years of age, orchitis usually develops as a common complication of mumps (mumps). Through the blood and lymphatic vessels, the infection from the salivary glands located in the parotid region spreads to the testicle. The symptoms of orchitis in children are the same as in adults. If they appear, you should immediately call a doctor who will prescribe medications approved for children.

The child should remain in bed for the first few days. During treatment, it is important to avoid hypothermia and avoid physical exertion. You can offer him to read a book, and if he is still too young, engage him in a quiet game.

In the first days of the disease, the boy should remain in bed

The boy can get out of bed and walk only after the temperature drops and the inflammation in the genitals subsides. Under the testicles in the underwear you need to place a piece of soft cloth folded several times. It will slightly interfere with movements, but will provide rest to the sore spot and ease the tension of the spermatic cord, thereby reducing the risk of inflammation spreading to the epididymis.

After suffering from orchitis, the child is exempt from school physical education lessons for a month. At this time, he should not get involved in outdoor games or participate in sporting events.

Possible side effects and consequences

The consequences of orchitis depend on the course of the underlying infectious disease and the depth of inflammatory changes. The most unfavorable prognosis is observed with purulent-destructive and bilateral processes. After orchitis, accompanied by abscesses, testicular tissue atrophies and undergoes scar deformation, which negatively affects the production and quality of sperm and can lead to impotence and infertility.

Serous forms of orchitis, as a rule, are cured completely and do not leave negative consequences.

Will there be infertility after mumps orchitis?

Separately, it is worth mentioning the consequences of mumps orchitis. In men who have suffered this complication of mumps, spermatogenesis is impaired to one degree or another. The number of germ cells varies in 1 ml of seminal fluid - from a slight decrease in their number to complete absence. At the same time, the number of immobile and degenerative forms of sperm increases.

Thus, every fifth man who has had bilateral mumps is at risk of infertility in the future. Testicular atrophy develops after orchitis in most of these patients, and it is observed:

• in 30% of men - during the first two months after illness;
• in 45% – after 4–10 months;
• in 25% - after 3–4 years.

The cause of testicular atrophy is compression of the organ tissue due to edema resulting from the intractability of the protein membrane, as well as the direct effect of the mumps virus on the epithelium of the seminiferous tubules.

About 20% of men who have had mumps orchitis will never be able to have children. Orchitis is a purely male disease characterized by inflammation of the testicular tissue. The presented pathology began to occur more and more often among representatives of the stronger sex. Previously, only 5% of the population suffered from this disease, today this figure has risen to 15%.

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

What it is?

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

The testes or testes are a male reproductive organ that synthesizes sex hormones and produces sperm that ensure procreation. The testicles are located in the scrotum, have an ovoid firmament and are laterally flattened.

Causes

The causes of testicular inflammation are infections. Depending on the causative agent, orchitis can be specific (caused by pathogens of tuberculosis, syphilis), or nonspecific (caused by any other infection).

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

Among the factors predisposing to the development of orchitis are:

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

In the case of acute or chronic urethritis and prostatitis, the infection enters the testicle through a descending hematogenous and lymphogenous route, developing inflammation. With mumps, the mechanism of the disease is somewhat different and is 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 tissue.

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

Symptoms of acute orchitis

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

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

Symptoms of chronic orchitis

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

Pain in the testicle is intermittent and aching in nature, intensifying after long walking, physical exertion, and hypothermia. In this case, the testicle is somewhat compacted and enlarged. The testicle is slightly painful when touched. Symptoms of general intoxication are not pronounced, 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 testicle is significantly impaired, which often becomes the cause of male infertility.

Complications

The consequences of this disease are quite serious. The danger of the inflammatory process is that it can penetrate into neighboring organs, multiplying the infection. If orchitis is not treated promptly, the following may occur:

1. Necrosis of testicular tissue (cell death);
2. Complete removal of the testicle through surgery;
3. Infertility, which in the future cannot be treated.

It is important to understand that orchitis can be successfully treated with antibiotics and there is an adaptive drug for every pathogenic agent. Therefore, you should not hesitate with treatment.

Diagnosis of orchitis

The diagnosis of orchitis is made by a doctor based on examination and the presence of an infectious disease or injury in the patient. Upon examination, the urologist can observe an enlargement of the scrotum; upon palpation, the skin of the scrotum is hot, swollen, the testicle is greatly enlarged in size, swollen and sharply painful.

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

• microscopic examination of a smear from the urethra;
• general urine analysis;
• antibiotic sensitivity testing, urine culture;
• seeding of 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 hydrocele of the testicle, scrotum or periorchitis. A testicular biopsy may also be performed.

How to treat orthiasis in men?

Treatment of orchitis consists of prescribing medications that are aimed at eliminating the source of inflammation. First of all, antibiotics are recommended. Paracetamol is most often prescribed to reduce fever. To eliminate pain and improve the outflow of sperm, antispasmodics are prescribed.

Treatment regimen for orchitis:

1. Pathogenetic treatment - the use of anti-inflammatory drugs "Indomethacin", "Ibuprofen", painkillers "Baralgina", "Ketorola", 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 an anti-inflammatory, local immunostimulating and restorative effect. Patients with chronic orchitis are prescribed UHF therapy, magnetic therapy, laser therapy, acupuncture, electrotherapy, physical therapy, mud and mineral baths.
4. Patients with an acute form of the disease are advised to have bed rest, a minimum of movements, rest and an elevated position of the scrotum, and the use of a support 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, a compress is applied to the scrotum for 10 minutes. Treatment of orchitis includes following a diet 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 required results, then the question of surgical intervention is raised.

Indications for its implementation are:

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

Depending on the complexity of the case, surgical intervention can be performed using several methods. With the least consequences for functioning, resection is performed - removal of the inflamed part of the testicle. If the operation is insufficiently thorough and in the case of a number of other factors, complications and relapses are possible.

In case of severe purulent lesions - orchiectomy - removal of the testicle and epididymis. If the operation affects both organs, this leads to a significant decrease in the level of male sex hormones and infertility. The attending physician may also suggest other surgical techniques.

Prevention

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