Orchitis is an inflammation of one or both testicles usually caused by viral or bacterial infections, leading to swelling and pain, with symptoms often improving with at-home care. Epididymitis, which can accompany orchitis, is the inflammation of the epididymis and most commonly affects young men aged 14 to 35. Effective management may include antibiotics for infections, rest, and pain relief, with a low risk of long-term complications such as infertility.

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.