ORHIT - testicular inflammation. More common with epidemic parotiditis, influenza, tuberculosis. Tuberculous orchitis usually develops as a result of the spread of the inflammatory process from the epididymis to the testicle. Aseptic orchitis occurs after testicular injury.
Acute non-specific orchitis begins with a sharp pain in the testicle, increasing its size, increasing body temperature. The testicle is painful on palpation, the skin of the scrotum above it is hot to the touch, swollen, hyperemic. There may be severe pain along the spermatic cord, the body temperature rises to 39-40 ° C, there is a chill, leukocytosis is detected in the blood , ESR increases. Quite often, acute orchitis is complicated by testicular abscess. In this case, at the site of the coagulation of the testicle with the skin of the scrotum, the center of softening is determined, after some time an opening of the abscess may occur.
Acute specific orchitis (for example, with mumps) in adults develops more often than in children. Its onset is acute: there are sharp pains in the testicle, an increase in body temperature, fever usually persists for 3 to 4 days.
Acute post-traumatic orchitis is characterized by long duration of the disease, persistent local manifestations of inflammation, more frequent abscess formation of the testicle.
In chronic orchitis, the pain in the testicle is moderate. It is increased in size, with palpation determined focal seals, moderate pain. Periodically increases body temperature (within the subfebrile). With prolonged disease, testicular atrophy may occur, and sexual dysfunction is often noted. The outcome of chronic bilateral orchitis can be infertility .
Treatment for acute non-abscessing orchitis is conservative. Assign bed rest, the elevated position of the testicle with the help of the suspension, topically cold for 2 - 3 days. In cases of bacteriuria and leukocyturia, antiseptic preparations are prescribed (furagin, nitroxoline, gramurin , biseptol), antibiotics, taking into account the sensitivity of the pathogen to them. If the pathogen is unknown, broad-spectrum antibiotics (cephalosporins, aminoglycosides) are prescribed. After 4 - 5 days after the normalization of body temperature and the subsidence of acute phenomena, warming compresses, UHF-therapy, electrophoresis of sodium iodide solution are used.
When abscessing a testicle, surgical treatment is necessary in a urological or surgical hospital.
For the treatment of orchitis in mumps prescribe a combination of broad-spectrum antibiotics: penicillin in combination with aminoglycosides or cephalosporins.
For the treatment of chronic orchitis, mainly physiotherapeutic procedures are used: ultraviolet radiation, UHF-therapy, paraffin baths. Antibacterial therapy is carried out in cases of bacteriuria and leukocyturia. Surgical treatment - orchiectomy - is indicated for frequent recurrences of chronic orchitis accompanied by atrophy of the testicle (especially in older men), or for suspected testicular swelling.
The prognosis for reproductive function in the early and complex treatment of acute orchitis is generally favorable; in chronic, especially bilateral orchitis - often unfavorable.