Post Date December, 03 2023
"The testicle is an important reproductive organ in men, affecting sperm production and quality issues. If orchitis occurs, do not ignore it. Pay attention to it, take timely treatment measures, and listen to doctors' suggestions.".
Acute nonspecific orchitis often occurs in patients with urethritis, cystitis, prostatitis, prostatitis, and prostatectomy, as well as in patients with long-term indwelling catheters. Infections spread to the epididymis through the lymph or vas deferens, causing epididymitis. The common pathogenic bacteria are Escherichia coli, Proteus, Staphylococcus, and Pseudomonas aeruginosa. Bacteria can spread through the bloodstream to the testis, causing simple orchitis. However, the testis is rich in blood supply and has a strong resistance to infection, so this situation is relatively rare.
Symptoms of acute nonspecific orchitis: Pathologically, macroscopic observations mainly include enlargement, hyperemia, and tension of the testis. When the testis is cut, small abscesses are seen. Histologically, focal necrosis, edema of connective tissue, and infiltration of lobulated nuclear granulocytes are seen. Inflammation, hemorrhage, and necrosis of the seminiferous tubules can occur. In severe cases, testicular abscesses and testicular infarction can form.
The diagnosis is mainly based on clinical symptoms such as high fever, chills, testicular swelling and pain, redness of the scrotum, and edema. Of course, attention should be paid to distinguishing acute epididymitis, parotitis, orchitis, torsion of the spermatic cord, and incarcerated hernia. Early diagnosis, timely administration of antibiotics, and removal of the cause are important means to protect good function in the future. A few cases of orchitis can cause testicular atrophy and affect fertility due to fibrosis and damage to the seminiferous tubules after treatment.
Chronic orchitis is often caused by incomplete treatment of non specific acute orchitis. It can also be caused by fungal, spirochete, or parasitic infections, such as testicular syphilis. Granulomatous orchitis can occur in patients with previous testicular trauma. Local or systemic radioisotope phosphorus irradiation of the testis can also lead to orchitis and damage to testicular tissue.
Symptoms of chronic nonspecific orchitis: Pathologically, the testicles are swollen or sclerotic, with hyaline and degenerative changes in the basement membrane of the seminiferous tubules, and the seminiferous epithelial cells disappear. There may be sclerosis around the seminiferous tubules, and small proliferative foci may also form. The testicles are chronically swollen, hard and smooth in texture, with slight tenderness, and loss of normal sensitivity. "Some testicles gradually atrophy, and in severe cases, the testicles are almost invisible, indicating a relatively enlarged epididymis. In most cases, inflammation spreads from the epididymis to the testicles, with unclear boundaries. Bilateral chronic orchitis can often cause infertility.". Treatment is mainly aimed at the etiology of chronic orchitis.
Epidemic mumps is the most common cause of orchitis, with about 20% of mumps patients complicated with orchitis, most commonly seen in late adolescence.
Symptoms of acute parotitic orchitis: The naked eye can see that the testicles are highly swollen and appear purplish blue. During testicular incision, due to interstitial reaction and edema, the testicular tubules could not be extruded. Histological observations showed edema and vasodilation, a large number of inflammatory cells infiltrating, and varying degrees of degeneration of the seminiferous tubules. "When orchitis heals, the testicles become smaller and softer, and the seminiferous tubules have severe atrophy. However, testicular interstitial cells are preserved, so the secretion of testosterone is not affected.".
The main treatment for this disease is to nourish the vital energy and treat it according to syndrome differentiation: the liver governs the release of qi, the stagnation of qi, or the infusion of dampness and heat can cause sperm aggregation; The spleen is the acquired foundation, which transports water and grains, moisturizes the skin and moisturizes the hair. The spleen is vigorous and free from evil during the four seasons. The healthy movement of the spleen can enhance the immune system of the body and inhibit abnormal immunity; The strength of Wei Qi is an external manifestation of the body's immune function, and reinforcing lung Qi can also strengthen the role of immune regulation. Through the overall regulation of the patient's physical condition, the goal of balancing yin and yang is achieved, in order to facilitate the patient to express their best genetic genes and produce healthy and excellent offspring.
(Intern Editor: Huang Jiazhen)
