Testicular inflammation and injury

Testicular inflammation and injury 

Updated: 01/28/2021

© Jun Wang, MD, PhD

Infectious epididymitis and orchitis
  • Sexually active men < 35 years of age: Commonly Chlamydia trachomatis and Neisseria gonorrhoeae
  • > 35 years:  E. coli and Pseudomonas
  • Gonorrhea: Extends from posterior urethra if untreated
  • Mumps: 20 to 30% of postpubertal males one week after parotiditis, commonly unilateral, may cause infertility
  • Tuberculosis: Begins in epididymis and spreads to testis
  • Syphilis: Arises in testis before epididymis
Granulomatous orchitis
  • Rare
  • Likely autoimmune process
  • Tender testicular mass with sudden onset
  • Need microbiology studies to rule out infection (AFB, fungal)
Torsion
  • May cause testicular infarct
  • Usually occurs in first year of life
  • May be caused by trauma or violent movement
  • Associated with incomplete testicular descent, absent scrotal ligaments, absent gubernaculum testis or testicular atrophy causing testis to be abnormally mobile
  • Treatment: Untwist and fix testis to dartos muscle, or orchiectomy
  • Opposite testis fixed to dartos muscle as preventive measure


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