Diagnosis

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

Your doctor might recommend:

  • STI screen. If you have discharge from your urethra, a narrow swab is inserted into the end of your penis to obtain a sample of the discharge. The sample is checked in the laboratory for gonorrhea and chlamydia. Some STI screens are done with a urine test.
  • Urine test. A sample of your urine is analyzed to see if anything's abnormal.
  • Ultrasound. This imaging test is the one most commonly used to assess testicular pain. 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.

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.

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 might recommend:

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

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

Lifestyle and home remedies

To ease 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 might be referred to a doctor who specializes in urinary issues (urologist). Here's some information to help you prepare for your appointment.

What you can do

Make a list of:

  • Your symptoms and when they began
  • Your childhood illnesses and immunizations, and any recent illnesses, especially STIs or mumps
  • All medications, vitamins or other supplements you take, including doses
  • Questions to ask your doctor

For orchitis, basic questions to ask your doctor include:

  • What's the most likely cause of my symptoms?
  • Are there any other possible causes?
  • What tests do I need?
  • What treatments are available?
  • How long will it take before I start to feel better?
  • Will this affect my ability to have children?
  • Do I need to restrict my sexual activity?

Don't hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask you a number of questions, including:

  • How severe are your symptoms?
  • What treatments have you tried?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • Do you practice safer sex, such as using a condom?
Oct. 10, 2018
References
  1. Ferri FF. Orchitis. In: Ferri's Clinical Advisor 2019. Philadelphia, Pa.: Elsevier; 2019. https://www.clinicalkey.com. Accessed Sept. 29, 2018.
  2. AskMayoExpert. Scrotal mass (adult). Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2017.
  3. Orchitis. Merck Manual Professional Version. https://www.merckmanuals.com/professional/genitourinary-disorders/penile-and-scrotal-disorders/orchitis. Accessed Sept. 29, 2018.
  4. Condition: Epididymitis/Orchitis. American Pediatric Surgical Association. https://www.eapsa.org/parents/conditions/a-e/epididymitis-orchitis/. Accessed Sept. 29, 2018.
  5. Wein AJ, et al., eds. Urologic evaluation of the child. In: Campbell-Walsh Urology. 11th ed. Philadelphia, Pa.: Elsevier; 2016. https://www.clinicalkey.com. Accessed Sept. 29, 2018.