Orchitis

What is orchitis?

Orchitis (or-KY-tis) is swelling or inflammation of one or both of your testicles (testes). Your testicles are part of your reproductive system — they make reproductive cells (sperm) and testosterone, which is a hormone. Most people assigned male at birth (AMAB) have two testicles.

What is the difference between orchitis and epididymitis?

Epididymitis is a condition that causes swelling and inflammation in your epididymis. The epididymis is a tube at the back of your testicles that carries and stores sperm.

Epididymo-orchitis is when you have epididymitis and orchitis at the same time.

How common is orchitis?

Orchitis alone isn’t common — it usually appears alongside other conditions like epididymitis. When it does appear on its own, it usually results from a mumps infection.

What are the symptoms of orchitis?

The main symptoms of orchitis are testicular pain, tenderness and swelling. The pain usually starts in one testicle. But it can spread to your other testicle or affect your entire scrotum. Your scrotum is the pouch of skin behind your penis that holds your testicles.

Other orchitis symptoms may include:

• Feeling very tired (fatigue)
• Signs of infection, including fever, chills and headache
• Discoloration in your scrotum (red, purple, brown or black)
• Muscle pain
• Nausea and vomiting
• Blood in your pee (hematuria)
• Pain when you ejaculate (dysorgasmia or orgasmalgia)
• Blood in your semen (hematospermia)
• Leaking fluid (discharge) from your penis
• Rapid heartbeat (tachycardia)

What is the main cause of orchitis?

Orchitis develops as a result of a viral or bacterial infection. Most cases occur because of:

• Urinary tract infections (UTIs)
• Sexually transmitted infections (STIs), including chlamydia, gonorrhea and syphilis

Can you get orchitis without an STI?

Yes, you can get orchitis without an STI. Viral infections that can cause orchitis include:

• Chickenpox
• Cytomegalovirus (CMV)
• Hand, food and mouth disease (HFMD)
• Rubella

Bacterial infections that can cause orchitis include:

• Escherichia coli (E. coli)
• Staphylococcus (staph)
• Streptococcus (strep)
• Prostate infections (prostatitis)

Epididymitis can also cause orchitis.

Who does orchitis affect?

Anyone who has testicles, at any age, can get orchitis. But the following factors increase your risk of developing orchitis:

• Having unprotected sexual intercourse with multiple partners
• Autoimmune disease, especially conditions that attack your sperm cells
• Bladder outlet obstruction, such as benign prostatic hyperplasia (BPH) or urethral stricture
• Using a Foley catheter
• Previous cases of epididymitis

What are the complications of orchitis?

Orchitis complications may include:

• Scrotal abscess. Your scrotum may fill with pus. Pus is thick, usually yellow-white fluid that contains white blood cells, dead tissue and pathogens (bacteria or viruses).
• Testicular atrophy. Your affected testicle may shrink and lose function.
• Hydrocele. Fluid builds up in your scrotum.

In rare cases, if orchitis affects both of your testicles, it may lead to infertility.

How is orchitis diagnosed?

A healthcare provider will perform a physical exam to check for tenderness and swelling in your testicles. To confirm their diagnosis, they may also order additional tests.

What tests will be done to diagnose orchitis?

A healthcare provider may order the following tests to diagnose orchitis:

• Blood tests, urinalysis (pee test) and/or urine culture. These tests check for bacterial and viral infections, including STIs.
• Pelvic ultrasound. This noninvasive imaging test measures blood flow to your testicles. It helps rule out testicular torsion, which cuts off blood flow to your testicles and causes sudden, intense testicular pain.

How do you get rid of orchitis?

Getting rid of orchitis depends on its exact cause. In Treatment options may include:

• Antibiotics. Antibiotics kill bacterial infections. If an STI causes orchitis, your sexual partners must also receive treatment. If they don’t, you may continue passing the STI to each other.
• Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs can help reduce pain and inflammation. Not everyone can take NSAIDs, so it’s a good idea to talk to a healthcare provider before you take them.
• Ice. Apply ice or cold packs to help reduce pain and swelling. Don’t apply ice directly to your scrotum. Wrap ice or cold packs in a towel. Don’t apply ice for more than 15 minutes at a time.
• Rest. Lay down as much as possible. Put pillows underneath your hips and buttocks (butt) to elevate your scrotum. Wear a jockstrap to support and immobilize your scrotum when you must get up.

What antibiotics treat orchitis?

It depends on the exact cause of your orchitis. A healthcare provider may prescribe:

Be sure to complete your entire course of antibiotics. If you don’t, orchitis may come back and be harder to treat.

What happens if orchitis is untreated?

Without treatment, you’re more likely to have complications or long-term damage, including severe illness, infertility or the loss of a testicle.

How long does it take for orchitis to clear up?

Orchitis symptoms typically start to go away a few days after you start treatment. But it can take weeks or even months for the swelling to go away completely.

Can orchitis be prevented?

You can reduce your chances of developing orchitis by getting the measles, mumps and rubella (MMR) vaccine and wearing condoms during sexual intercourse. If you’re sexually active and have multiple partners, it’s also a good idea to get an STI test at least every three to six months.

What can I expect if I have orchitis?

With proper diagnosis and treatment, the outlook for orchitis is good. Infertility and other long-term problems are rare.

How long does bacterial orchitis last?

In most cases, it takes about a week for antibiotics to clear a bacterial infection. You should avoid having sexual intercourse for at least seven days. If you have intercourse, use condoms to protect your partner(s) from infection.

When should I see a healthcare provider?

Reach out to a healthcare provider if you have orchitis symptoms. Contact a provider if you receive treatment for orchitis and your symptoms don’t start to go away after you finish your full course of medication.

What questions should I ask a healthcare provider?

Questions you may want to ask your provider include:

• What caused orchitis?
• Do I have epididymo-orchitis?
• What treatment do you recommend?
• Are there any steps I can take to ease my symptoms?
• Should I look out for signs of complications?