Orchitis

What is orchitis?

Orchitis (or-KY-tis) is swelling or inflammation of one or both testicles (testes). The testicles are part of the male reproductive system. They make sperm and testosterone (a hormone). Most men have two testicles that sit inside a sac called the scrotum.

What is epididymo-orchitis?

Epididymo-orchitis is having orchitis and a condition called epididymitis at the same time.

Epididymitis (ep-eh-did-uh-MY-tis) inflames and swells the epididymis, causing testicle pain. The epididymis is a tube at the back of the testicles that carries and stores sperm.

How common is orchitis?

Orchitis rarely occurs as the only problem affecting the testicles. When it does, it’s usually related to a mumps infection. A standard childhood vaccine — the Measles, Mumps, Rubella (MMR) — protects against mumps.

Approximately 600,000 boys and men have epididymitis every year. Many of them — almost six in 10 — have epididymo-orchitis.

What causes orchitis?

Orchitis develops because of a viral or bacterial infection. Most cases of orchitis occur because of urinary tract infections, or a sexually transmitted infection (STI), such as chlamydia, gonorrhea or syphilis. Having epididymitis can cause orchitis.

Other viral infections that cause orchitis include:

• Chickenpox (varicella).
• Cytomegalovirus (CMV).
• Hand, foot and mouth disease (coxsackie virus).
• Rubella.

Other bacterial infections that cause orchitis include:

• E. coli, Staphylococcus (staph) and Streptococcus (strep) infections.
• Prostate infections (prostatitis).
• Urinary tract infections (UTIs).

Who is at risk for orchitis?

Anyone who has testicles, at any age, can get orchitis.

Orchitis risk is higher if you have any of these factors:

• Autoimmune disease.
• Bladder outlet obstruction, such as benign prostatic hyperplasia (BPH) or urethral stricture.
• Foley catheter (a device that drains urine from your bladder into an external bag).
• Multiple sex partners and unprotected sex.
• Previous episodes of epididymitis.

What are the symptoms of orchitis?

Orchitis causes mild-to-severe testicle pain and swelling. The condition often begins in one testicle. But it can spread to the other testicle or affect the scrotum.

Other symptoms of orchitis include:

• Fatigue.
• Fever and chills.
• Headaches.
• Muscle pain.
• Nausea.
• Rapid heartbeat (tachycardia).

How is orchitis diagnosed?

Your healthcare provider will perform a physical exam to check for swollen testicles and tenderness. You may also get these tests:

• Blood tests, urinalysis and urine culture to check for bacterial and viral infections, including STDs.
• Ultrasonography to measure blood flow in the testicles. This test helps rule out testicular torsion, an emergency situation that cuts off blood flow to the testicles.

How is orchitis managed or treated?

Orchitis symptoms typically start to ease within a couple of days without treatment. But it can take weeks or months for the swelling to go away completely.

If a bacterial infection or STD causes orchitis, you’ll need treatment. This may involve 10 to 14 days of oral antibiotics. If the infection is an STD, then your partner will need STD treatment, too.

How can I treat orchitis at home?

While you’re recovering, avoid having sex or lifting heavy objects. These steps can aid recovery:

• Alternate applying an ice pack wrapped in a towel and a heating pad to the scrotal area.
• Rest as much as possible.
• Take nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve swelling and pain.
• Wear a jockstrap to support and immobilize the scrotal area.

How can I prevent orchitis?

You can lower your chances of developing orchitis by getting the mumps vaccine and wearing condoms when having sex. Seeking treatment for BPH or urethral stricture can help prevent orchitis.

What are the complications of orchitis?

Orchitis after puberty that affects both testicles may decrease sperm count. Rarely, orchitis leads to infertility. Orchitis doesn’t affect testosterone production.

Orchitis may also cause:

• Abscess (painful collection of pus) in the scrotum.
• Hydrocele (fluid buildup in the scrotum).
• Testicular atrophy (shrunken testicle).

What is the prognosis (outlook) for people who have orchitis?

Most people with orchitis have a full recovery. Infertility and other long-term problems are rare.

When should I call the doctor?

You should call your healthcare provider if you experience:

• Fever and chills.
• Swollen, painful testicles or scrotum.
• Unexplained muscle pain.

What questions should I ask my doctor?

You may want to ask a healthcare provider:

• What caused orchitis?
• What is the best treatment for me?
• Are there any steps I can take to ease symptoms?
• Should I look out for signs of complications?

A note from Cleveland Clinic

Orchitis causes swollen testicles and testicle pain. The condition often improves with at-home treatments. Some people need antibiotics to treat an STD or other infection. If an STD led to orchitis, you should notify your partners so they can get treatment, too. Your testicles may be swollen for a few months, although testicle pain should diminish. Your healthcare provider can offer suggestions for easing discomfort.