Acute
orchitis is usually caused by hematogenous infection or by infection of lymph. It might emerge with many kinds of acute infectious diseases. For example, during the course of epidemic parotitis, it might induce acute orchitis when the virus is discharged with urine.
1. The Clinical Signs and Manifestations of Acute Orchitis
Acute non-specific orchitis usually arise among the crowds who are suffering from urethritis, bladder infection,
prostatitis or hyperplasia of prostate. Due to the infection of lymph or spermatic duct, it might influence the epididymis and induce
epididymitis, of which the common pathogenic bacteria include colon bacillus, bacillus proteus, staphylococci and pseudomonas aeruginosa, etc. The pathogenic bacteria could spread to testes by hematogenous infection and induce simple orchitis simply. In case of acute attack, its manifestations include swelling and pain of testes, redness and swelling of scrotum, no obvious signs of urinary tract, and that body temperature could reach up to 138F.
Pathologically, it will discover enlarging, hyperemia and tension of testes by macroscopic observation. Slitting the testes, it will discover micro-abscess, and histologically, focal necrosis, edema of connective tissue, infiltration of segmented neutrocyte. Besides, it will emerge the symptoms of infection, bleeding and necrosis of seminiferous tubule that might induce abscess and infarct of testes in severe cases.
2. The Diagnosis of Acute Orchitis
First, as regards physical signs, it is usually manifested by epidemic parotitis or other acute infectious diseases. One or both sides of testes become swelling and enlarging with obvious tenderness. There is no clear boundary between testes and epididymis. Sometime it could be followed by acute dropsy of testicular tunica vaginalis.
Secondly, by laboratory examination, it will discover that the quantity of white blood cells has increased obviously, and that the result of urine routine test is within normal limits and that sometime it could discover protein or blood in urine under the microscope. Besides, epidemic parotitis always does some certain harm to the normal function of kidney and specific virus could be found in urine.
Then, according to the above-mentioned physical signs, clinical manifestations and results of laboratory examination, it can be diagnosed with acute orchitis definitely. In addition, it is necessary to make a fine distinction between acute orchitis and acute epididymitis clinically. In the case of acute orchitis, during the early stage, inflammatory epididymis could be felt by laying hands on it, while in the later stage, the epididymis has no clear boundary with testes. Usually, there is no excretion or pus in urethral canal as well as generalized infectious diseases. These manifestations can help to make a definite diagnosis clinically. In several cases, if the disease of orchitis is not cured thoroughly, it would induce atrophy of testes and then disadvantage reproductive function, due to the fibrosis of and damages to seminiferous tubule.
Key words: orchitis; acute orchitis; orchitis tests; orchitis treatment
