Orchitis – Symptoms and Causes

Overview

Orchitis is a medical condition that causes swelling and pain in one or both testicles. It happens when the testicle gets infected or inflamed. The most common causes are sexually transmitted infections and the mumps virus.

Many cases of orchitis occur alongside epididymitis, which is an infection of the epididymis. The epididymis is a tube at the back of each testicle that stores sperm. When both conditions happen together, doctors call it epididymo-orchitis.

Treatment options include:

• Supportive underwear
• Cold packs to reduce swelling
• Anti-inflammatory medications for pain
• Antibiotics (for bacterial infections)

Important facts about orchitis:

• Symptoms include testicle pain and swelling
• Recovery can take several weeks or even months
• Severe cases, especially in younger patients, may affect fertility
• Proper diagnosis and treatment are important for recovery

Healthcare providers can diagnose orchitis through physical examination and sometimes lab tests to determine the specific cause.

Signs and Symptoms

Orchitis usually begins with sudden symptoms. These may include:

• Testicle swelling (one or both)
• Pain (mild to severe)
• Fever
• Nausea and vomiting
• General feeling of illness

The swelling can make the affected testicle feel firm and tender to touch. Pain may range from uncomfortable to extremely painful, often making daily activities difficult.

When Medical Care Is Needed

Seek immediate medical attention if you experience sudden pain or swelling in the scrotum. Many conditions can cause testicle pain, and while some resolve without treatment, others require prompt medical care.

Twisting of the spermatic cord (testicular torsion) can cause pain similar to orchitis but needs emergency treatment.

What Causes Orchitis?

Bacterial Infections

Bacterial orchitis typically develops as a complication of epididymitis—inflammation of the tube that carries sperm from the testicle. The infection often starts in the urinary tract (bladder or urethra) and spreads to the epididymis, eventually reaching the testicle.

Common bacterial causes include:

• Urinary tract infections
• Prostate infections
• Sexually transmitted infections (less common in adults)

The bacteria travel through connected structures, creating inflammation and pain as they spread to the testicle.

Viral Infections

Mumps virus is the most frequent cause of viral orchitis. About one-third of males who contract mumps after puberty develop orchitis as a complication. This typically occurs 4-7 days after mumps symptoms begin.

Important note: Mumps-related orchitis has become less common due to childhood vaccination programs. The MMR (measles, mumps, rubella) vaccine has significantly reduced cases of mumps and its complications.

In some cases, doctors cannot identify a specific cause of orchitis despite testing.

Risk Factors

Several factors can increase your chance of developing orchitis:

• Untreated urinary blockages such as prostate enlargement or urethral stricture (scar tissue in the urethra)
• Medical procedures involving the urethra, like catheter insertion or bladder scopes
• Lack of mumps vaccination, which specifically increases risk for mumps-related orchitis

Sexual behaviors that raise the risk of sexually transmitted orchitis include:

• Having multiple sexual partners
• Engaging in intercourse with someone who has an STI
• Not using condoms during sexual activity
• Having previously contracted an STI

Complications

Orchitis typically resolves with proper care, though complete recovery may take several weeks or months. In rare cases, patients may experience more serious complications.

Testicular shrinkage (atrophy) can occur over time in the affected testicle. This happens as inflammation damages the tissues.

Some patients develop scrotal abscesses, where pockets of pus form within the infected tissue. This requires prompt medical attention.

When both testicles are affected, fertility problems may develop. The inflammation can interfere with sperm production or reduce testosterone levels (hypogonadism).

These fertility issues are less common when only one testicle is affected, as the healthy testicle can usually maintain normal function.

Prevention

Getting the mumps vaccine is critical. Mumps is the main cause of viral orchitis. This simple step provides important protection.

Practice safe sex to avoid sexually transmitted infections. These infections may lead to bacterial orchitis. Using condoms correctly helps reduce this risk.

See a doctor if you experience urination problems. Difficulty urinating might indicate a blockage or condition. This could develop into orchitis if left untreated.