Many times when people think about infections, the testes are usually one of the last body parts to come to mind. You may not be aware, but it is very possible to get an infection down there.
In this article, we will be considering a common type of infection called epididymo-orchitis.
What is epididymo-orchitis?
This term refers to inflammation of the epididymis and testicles, often due to an infectious cause.
The epididymis is a part of the male reproductive system where sperm cells are first stored to mature after they have been released from the testes.
The testes are two (normally) ball-like organs which are normally situated in the scrotum of a man. The testis is the manufacturing site for sperm.
When microorganisms get into the body and cause infection of the testes and epididymis, epididymo-orchitis results.
It possible for there to be only orchitis (inflammation of the testis alone) without involvement of the epididymis. However, because both organs are connected, they regularly get infected at the same time.
How does epididymo-orchitis occur?
Like the central nervous system, the testis is considered a ‘sanctuary site’ in the body because its anatomy makes it difficult for most organisms and molecules to pass through. However, disease-causing organisms can still penetrate the organ and cause infection and inflammation.
Factors that increase the risk of this include:
- Urinary tract infection: The urinary and reproductive systems are intricately linked in males. Therefore, a UTI can easily track up to affect the testis and epididymis.
- Older age: As men age, the likelihood of developing prostate enlargement increases. BPH is a risk factor for urinary tract infections which can cause epididymo-orchitis.
- Penetrative injury through the scrotum.
- Having a urinary catheter.
- Mumps infection: The viral infection typically causes parotid gland swelling (a salivary gland in the mouth) and epididymo-orchitis. Research has shown that 1 in 5 boys with mumps will develop epididymo-orchitis.
- Any surgery to the testes or scrotal area increases the risk of developing the infection.
- Sexually transmitted infections like gonorrhoea.
Symptoms of testicular infection
Epididymo-orchitis can cause the following symptoms:
- Testicular or scrotal pain
- Scrotum/testis that feels warm to touch
- A heavy, pulling or dragging sensation in the testis/scrotum
- Swollen testis
- Urethral discharge (if there is co-existing urinary tract infection or STI)
These symptoms typically affect one testis at a time. It is unusual for the infection to affect the two testes at the same time.
How is epididymo-orchitis diagnosed?
Your doctor will ask you some questions and examine you to help arrive at the diagnosis.
Tests like urine microscopy/culture/sensitivity and other blood tests may be done. Scrotal ultrasound scan is also not out of place.
How is epididymo-orchitis treated?
Treatment of the infection typically involves:
- Use of antibiotics to treat the infection
- Treating any co-existing STI
- Use of pain killers to subdue the pain
- Sexual abstinence is usually required until the infection subsides.
A simple case of epididymo-orchitis may get complicated if adequate treatment is not given on time.
Some of these complications include:
- Chronic scrotal pain: Pain that persists even after the infection has resolved.
- Testicular abscess: Pus can form in the infected site.
- Sub-fertility or infertility: Fertility problems can arise if the infection is not well managed.
- Chronic inflammation of the affected testis.
- Testicular gangrene: The affected testis may die off and require surgical removal.
A word from Healthfacts
Epididymo-orchitis is a treatable infection of the testes and epididymis of a man. It is important to seek treatment early, to avoid complications.
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