Testicular Inflammation - Specialists and Information

The symptoms of testicular inflammation vary depending on the cause of the infection. If the infection is viral, swelling and pain in the testicular area develop within a few hours. In addition, touch, tight clothing, and movement can cause discomfort. The testicle may also appear red.

Bacterial testicular inflammation also causes redness and painful swelling of the affected testicle. Unlike with a viral infection, however, the symptoms develop over the course of several days. In this form of the disease, the epididymis is also very often affected.

In most cases, viruses cause the inflammation, though bacteria can sometimes be the cause as well. These pathogens enter the testicles via the bloodstream or through adjacent structures. 

Very rarely, testicular inflammation can also result from trauma due to an injury.

Viruses that can cause testicular inflammation include:

• Paramyxoviruses (the causative agents of mumps, the most common cause of testicular inflammation)
• Epstein-Barr virus (the pathogen responsible for mononucleosis)
• Influenza virus (flu virus)
• Varicella virus (the virus that causes chickenpox)

LCM virus (the pathogen responsible for lymphocytic choriomeningitis, a form of meningitis transmitted by rodents)

The following bacterial diseases or pathogens can lead to testicular inflammation:

• Urethritis (inflammation of the urethra)
• Prostatitis (inflammation of the prostate)
• Epididymitis
• Syphilis
• Gonorrhea
• Group A streptococci (causes of scarlet fever)
• Pneumococci (especially in children; cause of pneumonia and salmonellosis)

The inflammation can usually be diagnosed relatively easily based on the testicle’s external appearance. During a physical examination by a doctor, the painful testicles are often found to be swollen and hard.

Typically, the pain subsides as soon as the doctor lifts the testicle. This is known as Prehn’s sign.

In addition, a blood test is performed, which shows elevated inflammatory markers in affected individuals.

These include:

• An increased number of leukocytes (white blood cells)
• A higher CRP level (a protein level that rises in the blood during inflammation)

The blood test can also provide insight into the underlying cause.

In some cases, it can be difficult to distinguish testicular inflammation from other possible conditions.

This is because similar symptoms can occur with epididymitis, testicular tumors, or testicular torsion (twisting of the testicle around its longitudinal axis). In such cases, an ultrasound examination is recommended to make a more precise diagnosis.

Sometimes, however, even this cannot definitively confirm whether testicular torsion is responsible for the symptoms. In this case, doctors must surgically expose the testicle to determine the exact cause of the symptoms.

This is particularly important in the case of testicular torsion, as this is a medical emergency. You should seek immediate treatment for this condition.

The subsequent treatment for testicular inflammation varies depending on whether bacteria or viruses are responsible.

Comparison of healthy and inflamed testicles @ Dee-sign /AdobeStock

Treatment for orchitis caused by viruses involves measures to relieve symptoms. 

These include:

• Bed rest
• Elevating the testicles 
• Cooling the testicles
• Pain relievers 
• Anti-inflammatory medications

Since mumps viruses are the most common cause of testicular inflammation, vaccination against mumps is recommended as a preventive measure.

In cases of bacterial testicular inflammation, doctors use the same measures to relieve symptoms as they do for the viral form. In addition, antibiotics are usually prescribed.#

In rare cases, surgery is necessary if:

• The testicles are severely swollen due to the inflammation, or 
• purulent abscesses have formed

During surgery, doctors then remove the infected areas to minimize the strain on the testicles.

In most cases, testicular inflammation heals within about a week without any further consequences. However, complications can sometimes occur. This is especially true if the testicle becomes inflamed repeatedly or if treatment is inadequate.

The inflammation can then spread to the epididymis or lead to the formation of abscesses. In most cases, sperm production is impaired for several months following testicular inflammation. However, it usually recovers.

Due to swelling and pressure, testicular tissue may be destroyed in some cases. This leads to a loss of germ tissue in the testicle, which can result in reduced testicular function.

If both testicles are affected, this can lead to impaired fertility. The reduction in sperm production is permanent.

However, complete infertility due to testicular inflammation is very rare.