It can often be treated with testosterone replacement therapy. If there is an underlying cause of hypogonadism, such a pituitary condition, treating that problem may resolve the symptoms of hypogonadism. Orchitis is inflammation of one or both testicles. Most of the time, it is caused by bacterial or viral infection.
The mumps is a common cause of orchitis. Sexually transmitted infections, such as gonorrhea and chlamydia, can both lead to orchitis when they cause epididymitis an infection of the epididymis , which in turn can lead to orchitis. This type of orchitis is called epididymo-orchitis.
Signs and symptoms of orchitis include testicular and scrotal pain and tenderness and infertility. Most of the time, it can be treated with medication and home remedies. Spermatocele, otherwise known as spermatic cyst, is a fluid filled cyst that forms in the epididymis. Small cysts do not normally cause pain. Large cysts can cause pain or a heavy feeling in the affected testicle and swelling above and behind the testicle. If you have a large spermatocele and have pain or other symptoms, surgery may be an option.
Many testicular and scrotal conditions can cause testicular pain. Other conditions, like kidney and ureteral stones, infections, and inguinal hernias can also cause pain that can be felt in or around the testicles and scrotum. If you have testicular pain, you should contact your doctor right away.
And if you experience a sudden onset of testicular pain, you should seek emergency medical care to rule out serious conditions like testicular torsion. If the mumps virus are the cause, pain in the testis can appear up to 7 days after glands in the face swell.
An "acute" case is most often caused by an infection from bacteria. The e-coli bacteria are a common cause for infection. A "chronic" case may result after acute epididymitis. It doesn't seem to go away. It can also happen without acute symptoms or known infection. In this case, the cause is unknown. Orchitis alone is mostly from a mumps virus or other virus infection.
In some cases of mumps, interferon can be given to prevent orchitis. This infection doesn't spread to the epididymis. Acute epididymo-orchitis is most often from a bacterial infection. It can also be caused by a tuberculous infection of the epididymis, but this is rare. Rarely, it can start in the testis and spread to the epididymis.
Your health care provider will ask about your past health and examine you. In acute epididymitis the urine is often infected. In chronic epididymitis the urine typically is not infected. If your provider thinks you have urethritis, they may test a swab of fluid from your urethra. Ultrasound is a non-invasive test. It uses sound waves bouncing off structures in your body to make a picture. Ultrasound can measure the blood flow in the epididymis, examine the inside of the testis and see other changes in that area of the body.
Treatment often starts with a week course of antibiotics. Most cases can be treated out of the hospital with pills. The best medicine for you will depend on the type of bacteria found. The most common antibiotics used are:.
For bad cases of infection, you may need to stay in the hospital for treatment. These are cases with pain that's hard to control with vomiting, high fever and if you are not getting better with antibiotics given by mouth.
Occasionally, for bad cases, narcotics are needed for a few days. Tuberculosis epididymitis is more serious but is very rare. It is treated with anti-tuberculous drugs. If damage is bad, surgery may be needed to take out the testis and the epididymis "orchiectomy". Epididymitis caused by amidarone is treated by limiting or stopping the drug.
Your health care provider will tell you what to do. Epididymitis care involves rest for 1 — 2 days with the scrotum raised if possible. The aim is to get the inflamed area above the level of the heart. This helps blood flow, which lowers swelling and pain, and helps with healing. Putting ice on the scrotum now and then can also help.
In cases due to infection, it helps to drink fluids. Anti-inflammatory pills like ibuprofen or naproxen help ease pain. They also ease the swelling that causes the pain. If the pain is severe, a short-term narcotic pain medicine may help but is only used for a short period of time at best in most situations. Chronic epididymitis is mainly treated with drugs and comfort to ease pain. Pain medicine and applying heat are the standard treatments. If symptoms don't go away, your health care provider may suggest other pain medicine.
Or, recommend a pain management specialist. If all else fails, the epididymis can be surgically removed "epididymectomy". The testis can be left in place.
Antibiotics are often the best treatment for bacterial infections. Pain medicine may help reduce symptoms. For infectious cases, it takes two to three days to start feeling better. If you don't, and if the redness doesn't begin to fade, call your provider. Discomfort can last for weeks to months after the full course of antibiotics is taken in some cases. It can take months for the swelling to ease. Rest with the scrotum raised for a day or two helps speed healing. Cases of tuberculous epididymitis without surgery may need months to heal with medicine.
The testis may shrink after treatment. Symptoms for chronic epididymitis go away eventually or may come and go. Anti- inflammatory medicine may be needed on and off for a months or years. This is more likely in younger men under 35 years old. If testing shows that your epididymitis is caused by a STI, it may be recommended that your current or recent sexual partners are also tested for STIs. Lumps in the testicles can be a sign of testicular cancer. This is easier to treat if it's found early.
Many sexual health clinics also offer a walk-in service, where you do not need an appointment. Find a sexual health clinic. This could be caused by your testicle becoming twisted and needs to be treated in hospital as soon as possible. If you have an infection, you'll usually be given antibiotics.
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