Orchitis

Orchitis

1. Ratheesh.R SLMGNC Orchitis

2. Introduction: Orchitis is an inflammation of 1 or both testicles. It is usually caused by an infection or by bacteria that come via the blood from other parts of the body. Orchitis may be caused by the virus that causes Mumps, STDs or other causes. At least one-third of males who contract mumps after puberty often develop orchitis . If both testicles are inflamed, the inflammation and infection may reduce fertility.

3. Definition: It is inflammation or Infection of the testicle.

4. Etiology: Pyogenic bacteria Gonococci Tubercle Bacilli or Viruses. Trauma Infections Mononucleosis Prostatectomy Epididymitis Catheterization or UTI Influenza Mumps and Syphilis .

5. Pathophysioplogy : Due to the etiological factor Inflammatory fluid seeks the testicle into the serus membrane (lining epididymis and the testicles) Unilateral or Bilateral Swelling

6. Clinical Manifestation: Hydrocele is associated with orchitis . Nausea and Vomiting Testicular Atrophy Pain radiating to inguinal hernia Infertility Chills Fever Infection

7. Diagnostic Evaluation: A physical examination 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 Tests may include: Complete blood count (CBC) Testicular ultrasound Tests to screen for Chlamydia and gonorrhea (urethral smear) Urinalysis Urine culture (clean catch) -- may need several samples, including initial stream, midstream, and after prostate massage

8. Medical Management: Broad spectrum antibiotic therapy Anti inflammatory Anti pyretic drugs Mumps Vaccine Gamma globulin – Who is exposed to mumps Warm and cold compression – reduce swelling and increase comfort.

9. Surgical Management: Aspiration – If hydrocele is present the fluid may be aspirated to reduce pressure on the testis. Surgical Tapping –It is done when edema is persistent and it decreases a chance of getting testicular Atrophy when done with first 2 days. Surgical Excision – The tunica albuginea must be excised surgically to improve circulation the testicles.

10. Complication: Some boys who get orchitis caused by mumps will have shrinking of the testicles (testicular atrophy). Orchitis may also cause infertility. 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 Torsion, which is a surgical emergency. If you have sudden pain in the scrotum or testicles, get immediate medical attention.

11. Nursing Management: Pain medication and bed rest with the scrotum elevated on an ice pack. Patient educated to reduce discomfort from gonodal swelling and alleviate systemic symptoms. During the acute phase of gonodal swelling, the scrotum may be supported with scrotal bridge or folded towel. Rest and an increased fluid intake are encouraged for all patients. Warm or cold compression may be applied to reduce swelling and increase is under control. Local heat or sitz bath later infection may hasten resolution of the inflammatory process.

12. Prevention: Getting vaccinated against mumps will prevent mumps-associated orchitis . Safer sex behaviors, such as having only one partner at a time (monogamy) and condom use, will decrease the chance of developing orchitis as a result of a STI.