Orchitis is caused by various disease-causing factors, including non-specific bacteria, viruses, spirochetes, injury, chemicals, fungi, and Chinese Taxillus Herb parasitic diseases. This section focuses only on non-specific bacterial orchitis.

Non-specific orchitis is mostly acute and unilateral, often accompanied by systemic fever, shivering, nausea, and vomiting, secondary to systemic bacterial sepsis. Pathogens include staphylococci, streptococci, large intestine bacilli, pneumococci, and Pseudomonas aeruginosa, with hematogenous and lymphatic spread being the most common routes. It can also invade the testis retrograde from the urethra, seminal vesicles, vas deferens, or epididymis. The onset is sudden, with redness and swelling of the scrotal skin and significant tenderness. Pathological changes include testicular enlargement by 1–2 times, edema of the scrotal wall, congestion and redness of the visceral layer of the tunica vaginalis, serofibrinous exudate in the tunica vaginalis cavity, focal necrosis in the testicular section, infiltration of polymorphonuclear leukocytes, destruction and shedding of the seminiferous tubule epithelium, and sometimes the entire testis being occupied by a pus-filled cavity. In the chronic stage, the tunica vaginalis wall thickens, the tunica vaginalis cavity becomes obliterated, the testis undergoes fibrotic atrophy, the basement layer of the seminiferous tubules shows hyaline degeneration and degenerative changes, and the spermatogenic epithelial cells disappear.

bubble_chart Diagnosis

Diagnosis primarily relies on medical history and local signs, but it must be differentiated from acute epididymitis, spermatic cord torsion, and incarcerated inguinal hernia.

Apply cold compresses locally to the scrotum during the acute inflammatory phase. Once the inflammation is controlled and enters the chronic phase, switch to warm compresses to accelerate absorption. Elevate the scrotum. Use antibiotics with high blood concentration, preferably administered intravenously. If an abscess has formed, incision and drainage are necessary. If the testis is completely destroyed, perform an orchiectomy.