Testicular infections

Epididymo-orchitis constitutes the most frequent infection of the infectious processes of the male urogenital system. The most frequent affectation is epididymitis, which if it progresses usually affects the testicle and is called orchiepididmitis. If the duration is less than 6 weeks it is called acute, while if it lasts more than 3 months it is called chronic.

It is generally produced by ascending infection from the lower urinary tract. In people under 35 years of age, up to 80% of cases are caused by C. trachomatis and 25% by N. Gonorrhoeaea, related to sexually transmitted diseases. In men over 35, E coli is the most common germ.

A special orchitis is urlian, produced by the mumps virus, being typical of children.

Symptoms

Symptoms are highly variable and depend on the degree of involvement. It usually produces pain and swelling testicular with irradiation to the inguinal tract. Associated fever and typical voiding symptoms with stinging and frequency may appear. Physical examination reveals an increase in testicular size with pain on palpation of the epididymis.

Diagnosis

The diagnosis should be made through the medical history and physical examination and confirmed by a urine culture. It must be differentiated especially from testicular torsion, testicular tumors, trauma, and inguinal hernias.

Treatment

Treatment involves antibiotic therapy for 21 days depending on the age of the patient and the risk of sexually transmitted disease with different antibiotics. It will always be associated with anti-inflammatory treatment and testicular jockstrap.

Chronic epididymo-orchitis is defined as scrotal, testicular or epididymal discomfort or pain as a result of a chronic inflammatory process produced by different types of germs. They must be performed urine and semen cultures, as well as testicular ultrasound to rule out other scrotal pathologies and start antibiotic treatment according to antibiogram, as well as anti-inflammatory treatment.

Tuberculous orchiepididimits is rare and occurs as a result of the blood dissemination of tuberculosis bacilli, and may or may not be associated with renal tuberculosis. It may be the first and only sign of genitourinary tuberculosis. In 70% of cases there is a previous history of tuberculosis. Diagnosis is made by Ziehl-Nielsen staining of urine and semen. The treatment is carried out with the combination of Rifampicin, Isoniazid and ethambutol.