Orchitis

Orchitis (orchitis; from the Greek. orchis - testicle - is an inflammation of the testis. Orchitis occurs in the hematogenous metastasis of primary infection hearth, and lymphogenous, contact way. Orchitis occurs more frequently when mumps, brucellosis, rarely with fever, smallpox, influenza; described gistiotitarnaya O. unexplained. The actinomycosis testicle may occur metstaticski or when the distribution of specific paraproctitis. Predispose O. injury, disorders of blood circulation of the testis. There are a orchitis specific (tuberculosis, syphilis) and non-specific, acute and chronic.

orchitis
Normal testicles (left); orchitis (right).

In non-orchitis (Fig) the size of the testicle increase due to the swelling of the tunica, partitions, accumulation of exudate in a lumen of the seminiferous tubules, development of inflammatory infiltration interstitial tissue of the testis. When smallpox prevail necrotic changes.
For brucellosis of orchitis is usually characterized by the development of specific granulomas, for gistiotitarnaya orchitis - infiltration interstice the histiocytes and plasma cells.
Often orchitis causes inflammation of the epididymis (orchoiepididymitis)extends to the shell of the egg (priorit). Perhaps the reverse development of inflammatory changes, chronic disease with the gradual replacement of parenchyma fibrous tissue or purulent fusion, testicular tissues, the formation of abscesses and fistulas scrotum.
Acute orchitis is characterized by the appearance of a sharp pain in the testicles, radiating along the spermatic cord, in the lumbar-sacral region. Egg increased, hardened. Its surface is smooth due to the accumulation of fluid in the private cavity of the testis. The sometimes temperature rises to 40 degrees chills, vomiting, lasts for 7-10 days. Marked leukocytosis, Express sed rate.
With influenza, mumps, brucellosis orchitis often occur favorably. By the end of the 2nd week of the disease, the temperature decreases, pains calm down, absorbed effusion. However, for a long time in the testicle still felt separate infiltrates.
Traumatic orchitis and orchitis arising metstaticski if septicopyemia, have a tendency to abscess formation; they are characterized by resistance local inflammation, temperature hectic type, the development of signs of priority: scrotal skin redness, hot and painful to palpation, especially over purulent foci.
At the opening of abscess formed a fistula through which rejected necrotic tissue.
Chronic orchitis is manifested by the increase, the seal of the testicle pain with subfebrile temperature. Gistiotitarnaya the orchitis is often accompanied by dysuria.
A frequent complication of orchitis - orchoiepididymitis. Under him on the back of the testicle is determined tight, painful appendage, sometimes merged with the egg into a single conglomerate. Orchitis may be complicated by funikulior with a thickening, pain in testicles in the absence of changes VAS duct. In cases groin, abdominal dystopia egg, in the presence of congenital hernia orchitis may lead to the development of peritonitis.
Chronic nonspecific orchitis and orhoepididimit should be distinguished from tuberculosis, syphilis and tumors of the testis (see). Detection of brucellosis O. help serological reactions, typical of leukopenia with relative limfo-, monocytosis.
In doubtful cases of chronic orchitis shown biopsy.
Treatment. In acute orchitis need bed rest, elevated position of the testicles (using pads or jockstrap), cold, novocaine blockade of the spermatic cord (seed cord infiltrate 50 ml of 0.5 - 1% solution novokaina with the addition of 300,000 UNITS of penicillin). Anti-inflammatory treatment is prescribed depending on the nature of the infection. When urinogenny infection appointed furadonin (0.1 g 3-4 times a day), drugs tetracycline; brucellosis orchitis - vaccine therapy, streptomycin (1 g / day), syntomycin (2 g per day). In patients with mumps orchitis is stopped by using a combination of antibiotics, gamma globulin, and corticosteroid drugs (50-150 mg cortisone a day during the week).
For the treatment of chronic orchitis is recommended physiotherapy (Solux, quartz, diathermy). In cases of festering shown lancing of abscess, and in introducing fusion of egg and chronic orchitis with persistent pain - semicastrate (see Castration of men). For a long period of orchitis leads to atrophy and loss of function of the testis.
Forecast orchitis favorable with vigorous treatment of the early stages of the disease.

Inflammation of the testes (orchitis) is observed in the overall infectious diseases, often in infectious parotitis (mumps), and brucellosis, typhus, the paratyphoid, sepsis, avian influenza; may occur, and the spread of the inflammatory process in the epididymis (see Epididymitis). In acute orchitis egg enlarged, painful tightly to the touch; the body temperature is raised. These phenomena are usually kept 8-10 days, then the temperature falls, decrease pain, improves the General condition of the patient. Outcome orchitis may be atrophy parenchyma testicles with bilateral process that leads to violation of the secretory function of the testis, infertility, and in persons who have not reached puberty,to the evnuhoidizm (see). At occurrence of testicular abscess appears chills, fever, pockets of softening in the testicle. Treatment: in bed, jockstrap, antibiotics, opening an abscess. Chronic orchitis occurs more frequently in the transition tuberculosis infection of the epididymis. In the testis are formed cavitieswhere it is necessary along with the massive anti-TB therapy surgical treatment - governatore, and in advanced cases (in the destruction of much of the parenchyma) - remove one testicle.

Inflammation of the testes (orchitis)

Orchitis (orchitis) is rare. It occurs most often hematogenous as a complication of infectious diseases - mumps, pneumonia, fever, brucellosis, influenza, sometimes after injury testicle. Orchitis may develop also after epididymitis in the transition of the inflammatory process in the epididymis to the testicles, mainly in elderly or debilitated patients.
The disease begins rapidly. Suddenly the temperature rises. Testicular volume increases rapidly, it becomes tense and sharply painful. The surface is smooth, the effusion in the shells. When hematogenous infection testicular the epididymis and vas deferens remain unchanged.
Acute inflammation in 10-15 days subside.
After orchitis in most cases comes sclerosis and testicular atrophy. The weakened patients orchitis may end purulent meltdown parenchyma of the testicle with the formation of an abscess, manifested by fluctuation.
Differential diagnosis of tuberculosis of the testis and syphilis orchitis (see Tuberculosis reproductive system of man). Brucellosis orchitis is recognized on the basis of the reactions Wright, Huddleson, Byrne for brucellosis.
Treatment. Recommended bed rest, wearing jockstrap, compresses and antibiotics. In the formation of an abscess testicular shows opening and draining an abscess or remove the testicle (orchidectomy).