Useful for Nursing Students

1. UNIT-V (Adult II)
Orchitis
Mr Yogendra Mehta
Lecturer, HOD(Adult Health Nursing)
TU, IOM, BNC

2. Introduction
• 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.
• Inflammation of the testicle unilaterally or bilaterally usually caused by
viruses and bacteria.
• Orchitis causes one or both testicles to swell and become painful.
• Orchitis symptoms typically improve over time with at-home care.
• The condition rarely affects fertility, although the testicles may shrink.
• Approximately 600,000 boys and men have epididymitis every year. Many
of them — almost six in 10 — have epididymo-orchitis.

3. Introduction(Contd…..)
• Epididymitis is inflammation of epididymis, a tube at the back of your
testicle that carries sperm.
• This swelling can cause intense pain in your testicle.
• It can occur at any age, though it happens most often in people between
the ages of 14 and 35.

4. Causes of Orchitis
• Orchitis develops because of a viral or bacterial infection.
• Most cases of orchitis occur because of a STI such
as chlamydia, gonorrhea or syphilis.
• Epididymitis can cause orchitis.
• Other viral infections that cause orchitis include:
• Chickenpox (varicella).
• Cytomegalovirus (CMV).
• Hand, foot and mouth disease (coxsackie virus).
• Rubella.

5. Contd….
• Other bacterial infections that cause orchitis include:
• E. coli, Staphylococcus (staph) and Streptococcus(strep) infections.
• Prostate infections (prostatitis).
• Urinary tract infections (UTIs).

6. Risk Factors
• 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.

7. Clinical Features
• mild-to-severe testicle pain and swelling.
• begins in one testicle. But it can spread to the other testicle or affect the
scrotum.
• Fatigue
• Fever and chills
• Headaches
• Muscle pain
• Nausea
• Rapid heartbeat

8. Diagnosis & Test
• Physical exam to check for swollen testicles and tenderness.
• 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.

9. Management
• 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, it needs treatment.
• It may involve 10 to 14 days of oral antibiotics.
• If the infection is an STD, then your partner will need STD treatment, too.

10. Home Management
• While 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 NSAIDs to relieve swelling and pain.
- Wear a jockstrap to support and immobilize the scrotal area.

11. Prevention
• getting the mumps vaccine.
• wearing condoms when having sex.
• Seeking treatment for BPH or urethral stricture can help prevent orchitis.

12. Complications
• decrease sperm count.
• infertility
• Abscess (painful collection of pus) in the scrotum.
• Hydrocele (fluid buildup in the scrotum).
• Testicular atrophy (shrunken testicle).

13. Prognosis
• Orchitis have a full recovery.
• Infertility and other long-term problems are rare.

14. Epididymitis
• Epididymitis is inflammation of your epididymis, a coiled tube at the back
of your testicle that stores and carries sperm.
• This swelling can cause intense testicular pain.
• Epididymitis can occur at any age, though it happens most often in people
between the ages of 14 and 35.
• There are an estimated 600,000 cases of epididymitis in the United States
each year.
• Epididymis can spread through sexual contact.

15. Causes
• Most cases of epididymitis are caused by an infection called E. coli. Some
cases happen from bacteria called Mycoplasma or Chlamydia.
• These infections often come by way of sexually transmitted infections.
• Mumps virus and rarely, Tuberculosis, can also cause epididymitis.
• Sometimes, epididymitis occurs when pee (urine) flows backward into your
epididymis.
• Heavy lifting

16. Causes
• Other epididymitis causes include:
- Blockage in your urethra (the tube that carries pee from your body).
- An enlarged or infected prostate gland (a muscular, walnut-sized gland that
surrounds part of your urethra).
- Use of a catheter (a tube that drains your bladder).
- Surgery on the prostate, urethra or bladder.
- Traumatic groin injury.

17. Clinical Features
Epididymitis symptoms may include:
• Pain in your scrotum, sometimes moving to the rest of your groin.
• Swelling and redness in your testicle.
• Blood in your semen
• Fever and chills
• Dysuria (painful urination)

18. Diagnosis
• Examine scrotum to look for a tender area or lump.
• Urinalysis to look for bacteria
• Ultrasound

19. Management
People with epididymitis can also relieve their symptoms by:
• Resting.
• Elevating their scrotum.
• Applying ice packs to the affected area.
• Drinking fluids.
• NSAIDs for pain.
• Antibiotics:
- The most common medications: doxycycline, ciprofloxacin levofloxacin or
trimethoprim-sulfamethoxazole.

20. Management & Complications
- Antibiotic treatment usually lasts about one to two weeks.
- Most people who are treated for epididymitis start to feel better after
three days.
- Though discomfort and swelling may last weeks or even months after
finishing antibiotic treatment.
Complications
• Abscess
• Fertility problems

21. Prevention
To reduce your risk of epididymitis, you should:
• Use condoms during sex.
• Avoid strenuous lifting or physical activity.
• Minimize long periods of sitting.