Orchitis is the inflammation of one or both testicles. Orchitis treatment will depend on whether it is caused by a bacterial or viral infection. It can occur alone or with epididymitis, an inflammation of the epididymis (a coiled tube at the back of the testicle where sperm is stored).
Treatment ranges from antibiotics (for bacterial orchitis) to simple symptom relief--such as scrotal elevation and coldpacks.
Treating Viral Orchitis
Isolated viral orchitis is usually the result of the mumps virus and occurs without inflammation in the epididymis. Symptoms usually start to diminish on their own within three to 10 days after the start of the infection, but may take several weeks to go away completely.
Antibiotics don’t work against viruses, so treatment can only relieve the symptoms rather than attack the infection at its source. This approach incluedes
- Pain medication (such as ibuprofen or naproxen)
- Bed rest
- Elevation of the scrotum
- Hot or cold packs applied to the affected testicle for 10 to 15 minutes, several times per day
- Avoiding strain, such as that caused by lifting heavy objects
Treating Bacterial Orchitis
Bacterial orchitis, which is caused by infections such as gonorrhea, Chlamydia, or E. coli, can be treated with a course of antibiotics. Symptoms generally start to decrease within three to 10 days of starting the antibiotics. And in the meantime, the symptom-relieving methods recommended for viral orchitis can help ease the pain.
Preventing Orchitis
The only way to prevent viral orchitis is to be immunized against the mumps virus. This is generally done in children after their first year, with a booster shot given between ages four and six. While there are other viruses that can cause viral orchitis (such as varicella, echovirus, infectious mononucleosis, or coxsackievirus), they're much less common.
Some types of bacterial orchitis are difficult to prevent. But many cases of bacterial orchitis are related to sexually-transmitted infections (STIs), and the best way to prevent these is to practice safe sex. This includes having intercourse with only one partner, using a condom during sex, and seeking treatment for STIs as soon as possible.
Outcomes and Complications Associated with Orchitis
Most cases of viral orchitis and medicated bacterial orchitis go away without any complications within three to 10 days.
Some cases of orchitis, however, may result in complications such as:
- Testicular atrophy (in viral orchitis)
- Recurrent epididymitis (in bacterial orchitis)
- Pus in the scrotal tissue (abscess)
- Reduced fertility
- Infertility, if both testicles are affected
References
Gazibera B, Gojak R, Drnda A, et al. (2012). Spermiogram part of population with the manifest orchitis during an ongoing epidemic of mumps. Med Arh.
Trojian T. et al. (2009). Epididymitis and orchitis: An overview. Am Fam Phys.
Dogra V, Bhatt S. (2004). Acute painful scrotum. Radiol Clin North Am.
Kaver I, Matzkin H, Braf ZF. (1990). Epididymoorchitis: a retrospective study of 121 patients. J Fam Pract.
