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Inflammation of the testicle (orchitis)

Orchitis overview

Orchitis is inflammation of one or both testicles in men, usually caused by an infection.

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

Orchitis causes

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.
  • Bacteria that cause sexually transmitted infections (STI), such as gonorrhea, chlamydia and syphilis, can cause orchitis in sexually active young men, usually aged between 19 and 35 years.  You may be at risk if you have many sexual partners, are involved in high-risk sexual behaviour, if your sexual partner has had an STI, or if you have a history of STIs.
  • The virus that causes mumps can also cause orchitis. Most common in young boys (though rare in boys younger than ten years old), orchitis begins four to six days after mumps begins.  Some boys will develop orchitis from mumps and end up with a condition called testicular atrophy (shrinking of the testicles).  That is why it is so critical for all children, boys especially, to have injections to protect them from getting the childhood disease of mumps.
  • You may be at risk of non-sexually transmitted orchitis if you have not had proper vaccination against mumps, if you get urinary tract infections, if you are older than 45, or if you frequently have a catheter placed into your bladder.

Orchitis symptoms

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 may come on and progress more gradually.

  • Orchitis causes a localised 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 sensation before or after urination and penile discharge are also seen.

When to seek medical care

Most cases of orchitis caused by bacteria require antibiotics. If you suspect that you have the disease, or notice redness, swelling, pain, or inflammation of the scrotum or testicle, seek medical advice. Do not delay medical care.

Go to a hospital's A&E department if you are unable to contact or see your doctor promptly, or if symptoms worsen despite antibiotic treatment.

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