Diagnosis

Your doctor is likely to start with a physical exam to check for enlarged lymph nodes in your groin and an enlarged testicle on the affected side. Your doctor may also do a rectal examination to check for prostate enlargement or tenderness.

After that, your doctor may recommend:

  • STI screening. A narrow swab is inserted into the end of your penis to obtain a sample of discharge from your urethra. The sample is checked in the laboratory for gonorrhea and chlamydia.
  • Urine test. A sample of your urine is analyzed for abnormalities in appearance, concentration or content.
  • Ultrasound. This imaging test may be used to rule out testicular torsion. Ultrasound with color Doppler can determine if the blood flow to your testicles is lower than normal — indicating torsion — or higher than normal, which helps confirm the diagnosis of orchitis.
  • Nuclear scan of the testicles. A radioactive tracer is inserted into your bloodstream. The scanner then maps blood flow to your testicles, which can indicate torsion or orchitis.

Treatment

Treatment depends on the cause of orchitis.

Treating bacterial orchitis

Antibiotics are needed to treat bacterial orchitis and epididymo-orchitis. If the cause of the bacterial infection is an STI, your sexual partner also needs treatment.

Be sure to take the entire course of antibiotics prescribed by your doctor, even if your symptoms ease sooner, to ensure that the infection is gone.

It may take several weeks for the tenderness to disappear. Resting, supporting the scrotum with an athletic strap, applying ice packs and taking pain medication can help relieve discomfort.

Treating viral orchitis

Treatment is aimed at relieving symptoms. Your doctor may recommend:

  • Nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin IB, others) or naproxen (Aleve, others)
  • Bed rest and elevating your scrotum
  • Cold packs

Most people with viral orchitis start to feel better in three to 10 days, although it may take several weeks for the scrotal tenderness to disappear.

Treating idiopathic orchitis

Your doctor may recommend antibiotics and anti-inflammatory medications.

Lifestyle and home remedies

To ease your discomfort:

  • Rest in bed
  • Lie down so that your scrotum is elevated
  • Apply cold packs to your scrotum as tolerated
  • Avoid lifting heavy objects

Preparing for your appointment

You may be referred to a doctor who specializes in urinary issues (urologist).

To get all the information you need from your doctor, it helps to be well-prepared for your appointment. Here's how.

What you can do

  • Make a list of your symptoms, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Give your doctor a history of your childhood illnesses and immunizations. Also, be sure to let your doctor know about any recent illnesses, especially STIs.
  • Make a list of all medications, vitamins or supplements that you're currently taking.
  • Write down questions to ask your doctor.

Preparing questions ahead of time will help you make the most of your time with your doctor. List your questions from most important to least important. For orchitis, some basic questions to ask your doctor include:

  • What's the most likely cause of my symptoms?
  • Are there any other possible causes?
  • What kinds of tests do I need? What's involved in those tests?
  • What treatments are available for orchitis?
  • How long will it take before I start to feel better?
  • Will this affect my ability to have children?
  • Are there any restrictions on sexual activity that I need to follow?

Don't hesitate to ask other questions that arise during your appointment.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:

  • When did you first begin experiencing symptoms?
  • How severe are your symptoms?
  • What treatments have you tried on your own?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • Have you had mumps or mumps vaccine? If so, when?
  • Have you had an STI?
  • Do you practice safe sex, such as using a condom?
Sept. 09, 2014
References
  1. Ferri FF. Ferri's Clinical Advisor 2015: 5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2015. https://www.clinicalkey.com. Accessed July 18, 2014.
  2. AskMayoExpert. What are the causes or types of scrotal masses? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2013.
  3. Wein AJ, et al. Campbell-Walsh Urology. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2011. http://www.clinicalkey.com. Accessed July 22, 2014.
  4. AskMayoExpert. What evaluation and treatment are indicated for orchitis as a cause of pediatric testicular or scrotal pain? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2014.
  5. Eyre RC, et al. Evaluation of the acute scrotum in adults. http://www.uptodate.com/home. Accessed July 18, 2014.
  6. Schaeffer AJ. Complications of urinary bladder catheters and preventive strategies. http://www.uptodate.com/home. Accessed July 18, 2014.
  7. Castle EP (expert opinion). Mayo Clinic, Phoenix, Ariz. Aug. 13, 2014.