Testicular Infections - Causes & Treatment

Medically Reviewed by Dr Sravya, MBBS, MS

Abstract:

Testicular diseases come in a very large variety of forms. The most well-known ailment is probably testicular cancer, but there are a variety of benign diseases that can affect the testes and scrotum and can be anything from unnoticeable to fatal. Testicular infection can be painful and scary, but it is also usually not a sign of anything serious. Still, it's important to know what your options are when it comes to treatment and when you should look for medical attention for testicular infection. It's important to understand that the testicle is a sensitive part. All types, causes, symptoms, and treatment options will be covered in this article for testicular infections.

Table of Contents

Introduction:

A multitude of conditions can cause testicular infection: ovarian cancer. Similar to other cancers, testicular cancer develops when testicular cells experience mutations that lead them to “act up.” The cells could proliferate irrationally and enter places they shouldn’t be. This procedure typically results in a slow-growing, painless lump or hardness in one testis in testicular cancer. The guys themselves typically become aware of it at an early stage.

Testicular cancer is virtually usually treatable if a guy seeks medical assistance at an early stage. Epididymitis is an irritation of the epididymis, which causes pain, swelling, and fever. Hydrocele is a fluid buildup around the testicles, causing swelling in the scrotum and groin area. Testicular torsion is a medical emergency involving a twisted spermatic cord cutting off blood supply to the testicle. Varicocele causes low sperm production and reduces the quality of sperm, which leads to male infertility. Hypogonadism is a condition where the testicles don’t produce enough testosterone, leading to issues like erectile dysfunction, infertility, osteoporosis, depression, fatigue, and hot flashes. Orchitis is inflammation of the testicles, often caused by bacterial or viral infections.

Types of Testicular Infections:

A common ailment, but there are numerous additional minor disorders of the testes and
scrotum that can be anywhere from unnoticeable to fatal. The testicular infections affecting
the testicles and scrotum can take many different forms. Perhaps the most common type of
cancer is testicular cancer. Some of the more common testicular infections and conditions
that affect the testicles and scrotum are:

Epididymitis is an inflammation or infection of the epididymis, causing symptoms like pain, swelling, nausea, vomiting, and fever, often caused by sexually transmitted diseases or vasectomy complications.
Hydrocele is a fluid buildup around the testicles, causing swelling in the scrotum and groin area. It's usually in infants with an opening between the abdomen and the scrotum but can occur later in life. Men often suffer from injury, inflammation, testicle infection, or epididymitis.
Testicular torsion is a medical emergency involving a twisted spermatic cord cutting off blood supply to the testicle, requiring immediate treatment. Symptoms include severe pain, swelling, tenderness, fever, nausea, and vomiting, often necessitating testicle removal.
Varicocele, enlarged veins in the scrotum, can cause low sperm production and reduced quality, potentially leading to male infertility. Symptoms include pain and swelling.
Hypogonadism is a condition where the testicles don't produce enough testosterone, leading to issues like erectile dysfunction, infertility, osteoporosis, depression, fatigue, and hot flashes. Treatment often involves testosterone replacement therapy.
Orchitis is inflammation of the testicles, often caused by bacterial or viral infections. Common causes include mumps and sexually transmitted infections like gonorrhea and chlamydia. Symptoms include pain, tenderness, and infertility, which can be treated with medication and home remedies.
Spermatocele, or spermatic cysts, are fluid-filled cysts in the epididymis, causing pain, swelling, and potentially requiring surgery for severe symptoms.
Testicular pain can be caused by various conditions, including kidney stones, infections, and inguinal hernias. It's crucial to seek medical attention immediately if experiencing a sudden onset of pain.
Testicular swelling can occur due to various conditions like varicocele, testicular torsion, orchitis, epididymitis, and hydrocele.
Scrotal conditions like scrotal wall cellulitis, scrotal abscess, Fournier's gangrene, and Henoch-Schonlein purpura should be evaluated by a doctor, as not all require treatment.

Testicular Infection Causes:

Causes can be bacterial or viral infections, or sexually transmitted infections (STIs). Bacterial
infection from the affected ipsilateral epididymis spreads locally. In a few cases, the mumps
virus can cause orchitis. We will see the causes of the following testicular infections:

Epididymitis: Bacterial infections, particularly gonorrhea and chlamydial, are the primary cause of urethra, prostate, and bladder infections, with E. coli and similar bacteria being more prevalent in older men.
Hydroceles: Hydroceles form before birth when testicles descend from the stomach into the scrotum, either non-communicating or communicating. In older individuals, they may form due to scrotum injury or inflammation.
Testicular torsion: Testicular torsion, a condition where the testicle rotates on the spermatic cord, can be caused by various factors such as vigorous activity, injury, sleep, cold temperature, or puberty growth.
Varicocele: The testicles receive oxygen-rich blood from two testicular arteries and two testicular veins, while oxygen-depleted blood is transported back to the heart. A varicocele is the enlargement of the pampiniform plexus, caused by valve malfunctions and a slightly different path of the left testicular vein. When oxygen- depleted blood backs up, veins widen, creating the varicocele.
Hypogonadism: Hypogonadism is a condition where the testes, the sex glands in men, produce minimal or no hormones, while the ovaries, the sex glands in women, produce no hormones.- Hypogonadism, a condition affecting the testes or pituitary glands, can be caused by various factors including autoimmune disorders, genetic and developmental disorders, infection, iron excess, liver and kidney disease, radiation, surgery, and trauma. - Central hypogonadism, caused by various factors like anorexia nervosa, bleeding, medications, genetic issues, infections, and menopause, disrupts the brain's hypothalamus and pituitary centres.
Orchitis: Orchitis, a condition primarily caused by mumps, can also occur alongside prostate or epididymis infections and sexually transmitted infections, especially in men aged 19-35.
Spermatocele: Spermatoceles occur when sperm accumulates in the epididymis, with potential causes including blockage or inflammation. They often appear without injury or infection.
Swollen testicles can be caused by trauma, medical conditions, or diseases like testicular torsion, abnormal veins, orchitis, hydrocele, hernia, epididymitis, congestive heart failure, and scrotal skin inflammation or infection. Seek medical care if experiencing severe pain or fever.

Testicular Infection Symptoms:

These are common symptoms that occur when a person is having any testicular infection:

Scrotal swelling, discoloration, or heat.
Testicular pain and tenderness are usually unilateral and often develop slowly. Pain when urinating.
Urgent or frequent need to urinate. Discharge from the penis.
Pain or discomfort in the lower abdomen or pelvic area.
There is blood in the semen. Rare fever.

If the testicles are swollen, other symptoms may also occur, such as:

A person with epididymitis may experience symptoms such as:

Slight fever, cold.
Pain in the pelvic area, and pressure in the testicles.
Testicular pain and tenderness, scrotal redness and warmth.
Enlarged lymph nodes in the groin.
Pain during intercourse and ejaculation.
Pain during urination or defecation.
Urgent frequent urination.
Abnormal penile discharge, blood in semen.

Treatments for testicular infections:

Home remedies for testicular infection: Alternating towel-wrapped ice packs and heating pads on the scrotal area. Rest as much as possible. Take a non-steroidal anti-inflammatory drug (NSAID) to reduce swelling and pain. Wear jockstraps to support and secure the scrotal area.
Epididymitis treatment typically involves antibiotics like doxycycline, ciprofloxacin, levofloxacin, or trimethoprim-sulfamethoxazole, which typically last 1-2 weeks.
Hydroceles are untreatable and typically resolve within six to 12 months. If they persist, surgical repair is necessary to prevent further complications.
Testicular torsion necessitates orchiopexy surgery to restore blood flow and secure the testicle to the scrotum's inner wall, potentially involving groin incisions.
Varicoceles, often untreated in males with fertility issues, pain, slow testicle growth, or abnormal semen analysis, require surgery, with non-surgical options like embolization.
Hypogonadism, caused by pituitary gland tumors, can be treated with medication, radiation, or surgery. Female hypogonadism involves hormones, alternative family building, FSH injections, estrogen therapy, and sperm harvesting.
Orchitis treatment varies based on cause, requiring antibiotics for bacterial orchitis and nonsteroidal anti-inflammatory drugs for viral orchitis. It may require rest, support, ice packs, pain medication, and cold packs.

Conclusion:

Acute scrotal pain in children or adult males should always be treated as an acute condition. Timely diagnosis and surgical treatment of spermatic torsion are essential to avoid permanent ischemic damage to the testicle. Fortunately, most medical conditions that cause this syndrome are not urgent. An accurate diagnosis can be made based on medical history, physical examination, and imaging.