Testicular infection or torsion

Definition

Causes

Disorders associated with testicular infection or pain include epididymitis, orchitis, testicular trauma, and testicular torsion.

Epididymitis is an inflammation of the epididymis, the structure that is the first part of the duct draining the testicle. Orchitis is an inflammation of one or both of the testicles. These disorders may be caused by numerous bacterial and viral organisms. Epididymitis is the most common cause of scrotal or testicular pain in individuals over 18 years of age.

Testicular torsion is a twisting of the spermatic cord, artery and vein, which cuts off the blood supply to the testicle and surrounding structures within the scrotum. If not corrected promptly, the tissues of the testicle will die.

Diagnosis and surgery should take place within 6 hours. If surgery is delayed more than 6 hours, the testicle will often need to be removed. Testicular torsion is the most common cause of scrotal or testicular pain in boys and non-sexually active adolescents. The majority of cases of testicular torsion are in boys less than 6 years of age.

Symptoms

• Sudden onset of testicle pain (in one or both testicles) with or without a previous event
• Scrotal swelling
• Extreme tenderness to pressure on the testis

Specific to orchitis and epididymitis:

• Fever
• Chills or chilling sensation
• Discharge (fluid) from penis

Additional symptoms that may occur:

• Testicle lump
• Blood in the semen
• Nausea and vomiting
• Light-headedness or fainting
• Blood in the semen
• Pain with urination
• Pain with intercourse or painful ejaculation
• Groin pain

Exams and Tests

Physical examination is often enough to diagnose testicular torsion, orchitis, and epididymitis. Radiographic tests may be required to tell the difference between testicular torsion and infectious causes of testicular pain. Often, tests will be needed to determine the cause of infection.

Treatment

If the cause is bacterial, epididymitis and orchitis may respond to antibiotics. Pain medications and other treatments may be recommended.

Prompt surgery is required for testicular torsion.

Outlook (Prognosis)

With appropriate diagnosis and adequate treatment, normal function of the testicle is usually preserved. If the infection is severe or testicular torsion is not surgically corrected promptly, infertility and testicular atrophy (shrinkage) may result.

Possible Complications

• Loss of testicular function (infertility)
• Severe infection

When to Contact a Medical Professional

Any time there is persistent or severe testicular pain, with or without any of the other symptoms listed above, call your health care provider promptly.

Prevention

Epididymitis and orchitis are frequently, but not always, associated with sexually-transmitted diseases.

There are no special preventive measures for testicular torsion. Paying attention to symptoms, and getting early diagnosis and treatment may prevent loss of a testicle.

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Illustrations and Images

Male reproductive anatomy

Male urinary tract

Blood in semen

Male reproductive system

Testicular torsion repair - series

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Review Date: 10/20/2005
Reviewed By: David R. Knowles, M.D., Advanced Urologic Surgeons, Mt. Vernon, IL. Review provided by VeriMed Healthcare Network.

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