Introduction
Orchitis is the inflammation of one or both testicles. Bacterial or viral infections can cause orchitis. Orchitis is most often the result of a bacterial infection, such as a sexually transmitted infection. In some cases, the mumps virus can cause orchitis. In some cases, bacterial orchitis will be associated with epididymitis — an inflammation of the coiled tube (epididymis) at the back of the testicle that stores and carries sperm.
Orchitis causes pain and can affect fertility. Medication can treat the causes of bacterial orchitis and can ease some signs and symptoms of viral orchitis. But it can take several weeks for scrotal tenderness to disappear.
Signs & symptoms
- Swelling in one or both testicles
- Pain ranging from mild to severe
- Fever
- Nausea and vomiting
- General feeling of unwellness (malaise)
Causes
Orchitis can be caused by a bacterial or viral infection. Sometimes a cause of orchitis can’t be determined.
Bacterial orchitis
Most often, bacterial orchitis is associated with epididymitis. Epididymitis usually is caused by an infection of the urethra or bladder that spreads to the epididymis.
Often, the cause of the infection is a sexually transmitted infection. Other causes of infection can be related to having been born with abnormalities in the urinary tract or having had a catheter or medical instruments inserted into the penis.
Viral orchitis
The mumps virus usually causes viral orchitis. Nearly one-third of males who contract the mumps after puberty develop orchitis, usually four to seven days after onset of the mumps.
Orchitis which is not sexually transmitted can develop in people:
- Not being immunized against mumps
- Having recurring urinary tract infections
- Having surgery that involves the genitals or urinary tract
- Being born with an abnormality in the urinary tract
Risk of sexually transmitted orchitis include:
- Multiple sexual partners
- Sex with a partner who has a sexually transmitted disease
- Sex without a condom
- A personal history of sexually transmitted disease
Pathophysiology
Orchitis is one of the genitourinary infections to result mostly from a viral pathogen. Mumps orchitis occurs in many of the adults infected with the mumps virus. Other viruses that can cause the disease include coxsackie B, mononucleosis and varicella. Unlike the majority of genitourinary infections, viral particles are spread to the testicle by the hematogenous route. Granulomatous orchitis is rare and results from hematogenous dissemination of tuberculosis, fungi and actinomycosis.
Medical history
Physical examination
STI screening test
Urine examination
USG
Treatments
Treatment solely depends on the cause of orchitis.
Bacterial orchitis
Antibiotics are needed to treat bacterial orchitis and epididymo-orchitis. If the cause of the bacterial infection is an STI, your sexual partner also needs treatment.
Viral orchitis
Treatment is aimed at relieving symptoms and it includes:
- Nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin IB etc) or naproxen sodium (Aleve)
- Bed rest and elevating your scrotum
- Cold packs
Prognosis
Most cases of both viral and bacterial orchitis show excellent prognosis with treatment without any complications.
Complications
- Testicular atrophy
- Scrotal abscess formation
- Infertility
Disease & Ayurveda
Kurandaroga
Nidana
Causative factors for the vitiation of Pittadosha
Purvaaroopa
Not mentioned
Samprapti
Due to causative factors, Pittadosha gets vitiated and circulate in the system. When it gets lodged in the vrushana/phalakosa, kurandaroga develops.
Lakshana
Pain and swelling in the testicles
Divisions
Not mentioned
Prognosis
Chikithsa
Samana
Lepanam with Rookshana dravyas
Saindhavadi lepa
Erandatailadi taila intake
Intake of yogas with Indravaruni
Lepana with eeswarimuladi yoga
Sodhana
Siravedha
Virechana
Commonly used medicines
Punarnavadi kashayam
Amrutotharam kashayam
Brands available
AVS Kottakal
AVP Coimbatore
SNA oushadhasala
Vaidyaratnam oushadhasala
Home remedies
Rest in bed
Lie down so that your scrotum is elevated
Apply cold packs to your scrotum as tolerated
Avoid lifting heavy objects
Diet
- To be avoided
Heavy meals and difficult to digest foods – cause indigestion.
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Carbonated drinks – makes the stomach more acidic and disturbed digestion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)
Milk and milk products – increase kapha, cause obstruction in channels and swelling
Curd – causes vidaaha, inflammation and thereby many other diseases
- To be added
Light meals and easily digestible foods
Green gram, soups, fresh fruits and vegetables
Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc
Behaviour:
Protect yourself from extreme climate changes.
Better to avoid exposure to excessive sunlight wind rain or dust.
Maintain a regular food and sleep schedule.
Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.
Avoid a sedentary lifestyle. Be active
Wear loose and cotton clothing, especially innerwears.
Yoga
Regular stretching and mild cardio exercises are advised in mild cases, if the person is comfortable. Also, specific yogacharya including naadisuddhi pranayama, bhujangaasana, pavanamuktasana is recommended.
Regular exercise helps improve bioavailability of the medicine and food ingested and leads to positive health.
Yoga can maintain harmony within the body and with the surrounding system.
Pavanamuktasana
Nadisudhi pranayama
Bhujangasana
All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.
Research articles
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