orchitis
Introduction
Introduction to orchitis Orchitis is a testicular inflammatory disease caused by various pathogenic factors and can be classified into non-specific, viral, fungal, spirochete, parasitic, and damaging. The testicle itself rarely develops bacterial infections. Because the testicles are rich in blood and lymph supply, they are more resistant to bacterial infections. Bacterial orchitis is mostly caused by inflammation of the adjacent epididymis, so it is also called epididymis-orchitis. Common pathogens are Staphylococcus, Streptococcus, Escherichia coli and the like. The virus can directly invade the testes, most commonly the mumps virus, which mainly invades the parotid glands of children. However, this virus also invades the testes, so viral orchitis often occurs shortly after the onset of mumps. basic knowledge The proportion of illness: 0.02% Susceptible people: male Mode of infection: non-infectious Complications: varicocele prostatitis
Cause
Cause of orchitis
Acute non-specific orchitis (35%):
Acute non-specific orchitis often occurs in patients with urethritis, cystitis, prostatitis, prostatic hyperplasia and long-term indwelling catheter, infection of the lymphatic or vas deferens to the epididymis causing epididymal orchitis, the common pathogen is Escherichia coli, Proteus, Staphylococcus and Pseudomonas aeruginosa, bacteria can be disseminated to the testes by blood, causing simple orchitis, but testicular blood supply is rich, has strong resistance to infection, so this is less see.
Pathologically, the gross observation was mainly testicular enlargement, congestion, tension, small abscess seen when the testis was cut, focal necrosis of histology, connective tissue edema and granulocyte infiltration of the lobule, inflammation of the seminiferous tubule, bleeding, Necrosis, severe testicular abscess and testicular infarction.
Chronic non-specific orchitis (20%):
Chronic orchitis is often caused by incomplete treatment of non-specific acute orchitis. It can also be caused by mold, spirochete, parasitic infections, such as testicular syphilis, previous testicular trauma, granulomatous orchitis, local or whole testicular Radioactive isotope phosphorus irradiation can also cause testicular inflammation and damage testicular tissue.
Pathologically, the testicular swelling or cirrhosis atrophy, the basement membrane of the seminiferous tubules is glassy and degenerative, the spermatogenic epithelial cells disappear, and there may be sclerosis around the seminiferous tubules, and small foci can also be formed.
Acute mumps orchitis (15%):
Mumps is the most common cause of orchitis. About 20% of patients with mumps are complicated with orchitis. It is more common in late adolescence. The testis is highly enlarged and purple-blue. When the testis is cut, the interstitial reaction And edema, testicular tubules can not be extruded, histological observation see edema and vasodilation, a large number of inflammatory cells infiltration, spermatogenic tubules have varying degrees of degeneration, when orchitis heals, testicles become smaller, soft, spermatogenic tubules are serious Atrophy, but the testicular interstitial cells are preserved, so the secretion of testosterone is not affected.
Prevention
Orchitis prevention
It is now widely accepted that orchitis should be treated with a large number of broad-spectrum effective antibiotics to control inflammation in the early stage to reduce the occurrence of suppurative orchitis and testicular abscess, especially attention to acute mumps orchitis. Bilateral lesions of acute mumps orchitis can cause irreversible destruction of spermatogenic activity and even testicular atrophy, leading to male infertility. Therefore, the key to preventing orchitis is that children under one year of age can be vaccinated, and the use of live attenuated mumps virus vaccine can prevent mumps and concurrent orchitis. Mumps hyperimmune globulin can alleviate the disease. Development, routine use of estrogen or adrenal glucocorticoids may have a role in preventing orchitis in children with mumps, but there is still debate.
1. Middle-aged men should pay attention to their own testicular maintenance. Testicular maintenance is an important means of solving male dysfunction. Men can massage the testicles in their hands during bathing or before going to bed. The thumb is lightly pinched and the testicles are massaged for 10 minutes in a timely manner.
2. If you have a different pain during massage, it may be orchitis or epididymitis, please go to the hospital for examination.
3. Acute mumps orchitis can cause irreversible destruction of spermatogenic activity and even testicular atrophy, leading to male infertility.
4. Should eat more fresh vegetables and fruits, increase the intake of vitamin C and other ingredients to improve the body's anti-inflammatory ability.
5. Eat less so-called "hair" such as pig's trotters, fish soup, and mutton, so as not to cause an increase in secretions in the inflamed area, and further infiltration and aggravation of orchitis.
6. Be careful not to eat spicy food, do not smoke or drink, do not stand for a long time, do not over-sex life, do not masturbate frequently.
Expert tips
In orchitis, a large number of broad-spectrum effective antibiotics should be used in early intravenous control to control inflammation to reduce the occurrence of suppurative orchitis and testicular abscess. In particular, attention should be paid to acute mumps orchitis, where bilateral lesions can cause irreversible destruction of spermatogenic activity and even testicular atrophy, leading to male infertility. Therefore, the key to prevention of this disease is that children under 1 year old can be vaccinated, and the use of live attenuated mumps virus vaccine can prevent mumps and concurrent orchitis. Mumps hyperimmune globulin can Reduce the development of the disease. Routine application of estrogen or adrenal glucocorticoid may have a role in preventing orchitis in children with mumps, but there is still debate.
Common orchitis is non-specific and mumps. Any suppurative sepsis can be complicated by acute suppurative orchitis and even cause testicular abscess. Most of the pathogenic bacteria are Escherichia coli, Streptococcus, Staphylococcus and Pseudomonas aeruginosa. In fact, the most common cause of suppurative orchitis is the infection caused by the spread of epididymitis, so it should actually be epididymal orchitis. Patients often have testicular pain and radiate to the groin. They have obvious feeling of falling, accompanied by high fever, nausea, vomiting, and elevated white blood cells. At the same time, testicular swelling and tenderness are very obvious, and the scrotal skin is red and swollen. If you find this situation, you need to go to the hospital for treatment.
Mumps orchitis is caused by a viral infection. Due to the implementation of planned immunization in China, the incidence of this disease has been significantly reduced in recent years due to the injection of measles, rubella and mumps vaccines in childhood. The disease is less common before puberty, orchitis often occurs 4-6 days after the occurrence of mumps, but it can also be free of symptoms of parotid inflammation. About 70% of the testis is unilateral, and 50% of the affected testicles are atrophied. Orchitis can be cured, as long as the disease is found to be timely and systematic, effective treatment to prevent testicular damage can still be done. On weekdays, male friends should also pay attention to reproductive health and hygiene to prevent the occurrence of orchitis.
Complication
Orchitis complications Complications varicocele prostatitis
1. Induced serious diseases: varicocele, sedative, prostatitis, endocrine diseases, nephritis and other kidney diseases, urinary infections, malignant tumors, etc.
2. Causes male sexual function to decline, or even completely lose sexual function.
3. Lead to death, infertility, loss of fertility, and transmission of inflammatory pathogens to spouses, causing gynecological diseases.
4. Testicular disease for a long time to cure the loss of kidney loss, vital energy loss, limb cold, back pain, early aging.
Symptom
Symptoms of testicular inflammation Common symptoms Male abdominal pain, chills, high fever, nausea, deficiency, testicular, large one, small parotid swelling, testicular varicose veins, testicular sag, foreskin edema
Acute high fever, chills, testicular pain to the groin, accompanied by nausea and vomiting.
Orchitis often occurs 3-4 days after the occurrence of mumps, high fever can reach 40 °C often with collapse, scrotum redness, testicular swelling, hydrocele, obvious tenderness, such as mumps can also find parotid swelling Big.
Examine
Test for orchitis
Testicular self-test
Relax the scrotum so that it can touch hard blocks and abnormalities. When checking, stand with your feet and feel if there is a lump or other abnormality. The normal testes are oval in shape, smooth in surface and medium in hardness.
2. Local inspection
After the masses in the bilateral scrotum, the benign and malignant lesions can be roughly distinguished. After suspected testicular tumor, it is not suitable for local biopsy of testicular tumor, because it is easy to cause tumor metastasis. The diagnosis of testicular tumor properties depends on the pathological report after surgery.
3.B-ultrasound
Can accurately determine the size, morphology and presence of tumors. For patients with cryptorchidism, you can understand the testicular development and whether it is swollen or malignant.
4. Blood test
Tumor markers human chorionic gonadotropin (HCG, normal <5 g/L) and alpha-fetoprotein (AFP normal value <25 g/L) were examined beyond normal and should be further examined.
5. Chest X-ray examination
Includes perspective or chest radiographs.
6. Computed tomography (CT) and magnetic resonance imaging (MRI).
A more accurate understanding of the presence or absence of post-peritoneal metastasis is particularly beneficial in patients who have not undergone cryptorchidism and may have been malignant.
Diagnosis
Diagnosis and differentiation of orchitis
Diagnose based on
1. High fever, chills, testicular pain.
2. The local scrotum is red and swollen and the testicles are swollen.
3. Blood leukocytes rise.
Differential diagnosis
The disease should be differentiated from testicular torsion, incarcerated sputum and testicular tumor. There is inflammation in orchitis. There is redness and heat pain in acute attacks. It can be identified by means of imaging such as B-ultrasound or CT.
