Hodenentzündung

Testicular inflammation: description

The orchitis (orchitis) is a mostly caused by viruses inflammation of the testicular tissue. It can occur unilaterally or bilaterally. In most cases, the inflammation also extends to the epididymis. The combined inflammation of the testes and epididymides is called epididymorchitis.

Testicular inflammation occurs mainly in boys after puberty and men. It is less common in children. In most cases, the disease can be treated successfully.

Testicular inflammation: symptoms

Depending on the cause of the testicular inflammation, there are slightly different symptoms. When a virus infection occurs within a few hours suddenly pain and swelling in the testes area. Touch, tight clothing and movements are painful. The testicle is red. Very often, mumps viruses are the cause of the testicular inflammation. Patients then usually have swelling of the parotid gland and pain in the face and neck, especially when chewing.

Bacterial syndrome is also associated with severe pain, redness and swelling. However, the symptoms develop over a few days and not within hours. In a bacterial inflammation, the epididymis is usually affected.

With a testicle inflammation, fever can also occur.

Testicular inflammation: causes and risk factors

The most common cause of testicular inflammation is infection with mumps viruses. These pathogens are highly contagious and, like the flu viruses, they are distributed over the smallest droplets in the room, for example when sneezing or coughing. An inflammation of the testicles occurs as a consequence of mumps often in adolescents and men. Children rarely develop orchitis.

Also in the context of other virus infections may develop a testicular inflammation, such as infections with varicella (pathogens of chickenpox and shingles), Ebstein-Barr virus (pathogens of mononucleosis = glandular fever) or coxsackie viruses.

Likewise, bacterial infections can trigger an orchitis, such as salmonellosis or brucellosis. Also, as a result of a sexually transmitted disease such as gonorrhea or syphilis, the testes can become inflamed.

Sometimes patients first suffer from epididymitis (epidiymitis), for example, from ascending germs in a urinary tract infection. Subsequently, the pathogens can spread from the epididymis to the testicles.

An orchitis can also be the result of trauma.

Testicular inflammation: examinations and diagnosis

From the description of the symptoms and the careful examination of the testicle, the doctor can usually very quickly conclude a testicular inflammation. An important diagnostic sign is the so-called Prehn sign: in a testicular inflammation, the pain often subsides when the testes are raised slightly. Using a special ultrasound examination (Doppler sonography), the doctor also checks the blood flow to the testicle. Inflammation increases blood circulation.

Delineation to testicular torsion

Both examinations (Prehn’s sign and Doppler sonography) are also important to rule out testicular torsion (testicular torsion) as the cause of the pain. Here, the testicles twisted on the spermatic cord, which interrupts the blood supply (visible in Doppler sonography). In addition, the Prehn sign is negative in a testicular torsion, that is, the pain does not diminish when raising the testicle. The exact distinction between scrotum and testicular torsion is very important, because the latter is an emergency that needs immediate surgery!

laboratory tests

If there is a suspicion of mumps orchitis and no mumps vaccination has taken place, a blood test can help detect the disease. For this purpose, in the blood for specific antibodies against the mumps virus is sought.

If necessary, accompanying urinary tract infections can be detected in a urine test.

If a sexually transmitted disease is suspected, its pathogen can be detected in a urethral swab. If the suspicion is confirmed, the partner should be included in the treatment to avoid mutual infection of the partners.

Testicular inflammation: treatment

The treatment of a testicle inflammation depends on whether bacteria or viruses are the trigger.

Viral conditional orchitis

In a virus infection such as mumps orchitis, the therapy is usually in the relief of the symptoms. Part of this symptomatic therapy is:

• bed rest
• Cool the testicles with wet envelopes
• Upload testicles
• Painkiller for the pain

Bacterial orchitis

If the testicle inflammation is caused by bacteria, a causal treatment with antibiotics is added to the symptomatic therapy described above. Depending on the patient, age and pathogen group, there are different groups of active ingredients that are used. Frequently, tetracyclines (such as doxycycline), fluoroquinolones (such as ciprofloxacin), cephalosporins (such as ceftriaxone) or macrolides (such as azathioprine) are used.

Testicular inflammation: Disease course and prognosis

A testicular inflammation is usually very painful and unpleasant. But in general it can be treated successfully.

In mumps orchitis, the symptoms last about a week (three to ten days). Bacterial inflammation may also last for several days, depending on the response to the antibiotics.

After a viral testicular inflammation, sperm production is usually impaired for several months. In rare cases, the testicular tissue is damaged so that permanently too few or too slow sperm are produced – the patient remains infertile. This affects one to two percent of patients with mumps orchitis.

As a complication of a Hodenentzündung may be an abscess (formed by tissue fusion, encapsulated pus). He has to be eliminated surgically.