Orchitis is swelling (inflammation) of one or both of the testicles.
Orchitis may be caused by an infection. Many types of bacteria and viruses can cause this condition.
The most common virus that causes orchitis is mumps. It most often occurs in boys after puberty. Orchitis most often develops 4 to 6 days after the mumps begins.
Mumps is a contagious disease that leads to painful swelling of the salivary glands. The salivary glands produce saliva, a liquid that moistens food...Read Article Now Book Mark Article
Orchitis may also occur along with infections of the prostate or epididymis.
Gonorrhea is a common sexually transmitted infection (STI).Read Article Now Book Mark Article
Chlamydia is an infection caused by the bacteria Chlamydia trachomatis. It is most often spread through sexual contact.Read Article Now Book Mark Article
Risk factors for sexually transmitted orchitis include:
- High-risk sexual behaviors
- Multiple sexual partners
- Personal history of gonorrhea or another STI
- Sexual partner with a diagnosed STI
Risk factors for orchitis not due to an STI include:
- Being older than age 45
- Long-term use of a Foley catheter
- Not being vaccinated against the mumps virus
- Problems of the urinary tract that were present at birth (congenital)
- Repeated urinary tract infections
- Surgery of the urinary tract (genitourinary surgery)
- BPH (benign prostatic hyperplasia) - enlarged prostate
- Urethral stricture (scarring inside urinary tract that causes narrowing of the passageway)
Exams and Tests
A physical exam may show:
- Enlarged or tender prostate gland
- Tender and enlarged lymph nodes in the groin (inguinal) area on the affected side
- Tender and enlarged testicle on the affected side
- Redness or tenderness of scrotum
Tests may include:
Treatment may include:
- Antibiotics, if the infection is caused by bacteria. (In the case of gonorrhea or chlamydia, sexual partners must also be treated.)
- Anti-inflammatory medicines.
- Pain medicines.
- Bed rest with the scrotum elevated and ice packs applied to the area.
Getting the right diagnosis and treatment for orchitis caused by bacteria can most often allow the testicle to recover normally.
You will need further testing to rule out testicular cancer if the testicle does not completely return to normal after treatment.
Mumps orchitis has no effective treatment, and the outcome can vary. Men who have had mumps orchitis can become sterile.
Some boys who get orchitis caused by mumps will have shrinking of the testicles (testicular atrophy).
Orchitis may also cause infertility.
Infertility means you cannot get pregnant (conceive). There are 2 types of infertility:Primary infertility refers to couples who have not become preg...Read Article Now Book Mark Article
Other potential complications include:
- Chronic epididymitis
- Death of testicle tissue (testicular infarction)
- Fistula on the skin of the scrotum (cutaneous scrotal fistula)
- Scrotal abscess
Acute pain in the scrotum or testicles can be caused by twisting of the testicular blood vessels (torsion). This is a medical emergency that requires immediate surgery.
Acute means sudden. Acute symptoms appear, change, or worsen rapidly. It is the opposite of chronic.Read Article Now Book Mark Article
A swollen testicle with little or no pain may be a sign of testicular cancer. If this is the case, you should have a testicular ultrasound.
When to Contact a Medical Professional
See your health care provider for an exam if you have testicle problems.
Get emergency medical help if you have sudden pain in the testicle.
Things you can do to prevent the problem include:
- Get vaccinated against mumps.
- Practice safer sex behaviors to decrease your risk for STIs.
Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Mason WH, Gans HA. Mumps. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 275.
McGowan CC. Prostatitis, epididymitis, and orchitis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 110.
Pontari M. Inflammatory and pain conditions of the male genitourinary tract: prostatitis and related pain conditions, orchitis, and epididymitis. In: Partin AW, Domochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 56.