Orchitis
Orchitis is called inflammation of the tissues of the male testicle.
reasons
Orchitis can have an infectious and non-infectious (traumatic) origin.
In the first case, the cause of its occurrence is the ingress of pathogenic microorganisms into the testicular tissues. Representatives of the banal pyogenic flora cause nonspecific inflammation, and pathogens of infectious diseases – specific. In practice, the most common inflammatory processes are complications of influenza, typhus, mumps, brucellosis or tuberculosis.
In most cases, the infection penetrates into the testicular tissues with the flow of passing blood, that is, hematogenically. But another way of infection is also possible – the penetration of the pathogen from neighboring organs (more often – the appendages of the testicle).
Predispose to the development of the disease: a decrease in the general resistance of the patient’s body, hypothermia, impaired blood flow in the tissues of the testicle, wearing tight, uncomfortable underwear, irregular sex life.
With a traumatic origin, the cause of the development of the inflammatory process is trauma and a violation of the structure of the testicular tissues, accompanied by microscopic hemorrhages or the formation of a hematoma.
SYMPTOMS
Acute inflammation begins with a sudden rise in body temperature to high limits, the appearance of severe pain in the affected testicle, spreading to the groin, perineum, and lower back, which increases with movement, walking. The testicle increases in size, the skin above it turns red. There are signs of general intoxication: headache, chills, decreased appetite.
As a rule, acute phenomena persist for one to two weeks, then the pain subsides, the temperature decreases. But the swelling remains for a long time.
With the chronization of the inflammatory process, the patient notes a periodic “causeless” increase in body temperature, the appearance of minor pain sensations in the projection of the affected testicle, which may increase with the exacerbation of the process. With a long course, there is often a disorder of erectile function, a change in the chemical and physical properties of sperm, infertility. It is possible to reduce the size of the testicle due to atrophy of its tissues.
diagnostics
The basis for the diagnosis is the patient’s complaints, the data of an objective examination and the results of an additional examination:
clinical analysis of urine and blood;
microscopic examination of smears of urethral contents;
bacteriological seeding of urine and semen with the preparation of an antibioticogram;
ultrasound examination of the scrotum organs;
testicular scintigraphy;
puncture of the testicle followed by cytological analysis of the resulting contents.
The results of the examination of sperm and urethral contents by polymerase chain reaction and direct immunofluorescence are important.
BASIC PRINCIPLES OF TREATMENT
Patients with acute orchitis are subject to hospitalization. It is mandatory to strictly observe bed rest and wearing a bandage. To reduce the severity of edema and pain, cold is applied to the scrotum area.
Assigned:
antibacterial drugs;
nonsteroidal anti-inflammatory drugs;
physiotherapy procedures (UVF, electrophoresis, amplipulstherapy);
paraffin applications.
With intense pain syndrome, novocaine blockade of the spermatic cord is performed.
With a chronic course, it is advisable to use additional immunomodulators, biogenic stimulants, resorption therapy.
If conservative treatment is ineffective, surgical intervention (removal of the testicle) is performed.
