Post Date December, 02 2023
Causes of orchitis pain
1. The common pathogenic bacteria of orchitis mainly include Escherichia coli, Proteus, Staphylococcus, and Pseudomonas aeruginosa
Pathogenic bacteria enter the urinary tract through the urethra, causing urethritis, cystitis, and prostatitis, which invade the epididymis and testis through the lymphatic system or through the lumen of the vas deferens, causing epididymitis and orchitis.
2. In tonsillitis and parotitis
(Epidemic mumps is the most common cause of orchitis, with some patients suffering from mumps complicated by orchitis), epididymitis caused by bacteria or viruses that can enter the blood circulation during tooth or systemic infections, often occurs when the body's immune capacity decreases.
3. Chronic orchitis is often caused by incomplete treatment of non specific acute orchitis
It can also be caused by mold, spirochete, and parasitic infections. The epididymis hardens due to fibrous hyperplasia. Histologically, extensive scarring and epididymal tube occlusion, as well as infiltration of lymphocytes and plasma cells can be seen. Male infertility can occur if bilateral epididymitis is present.
4. Chronic nonspecific orchitis
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.
Pathologically, the testis is swollen or sclerotic and atrophic, the basement membrane of the seminiferous tubules presents hyaline and degenerative changes, and the seminiferous epithelial cells disappear. There may be sclerosis around the seminiferous tubules, and small proliferative foci may also form.
5. Acute nonspecific orchitis
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 testes, causing simple orchitis. However, testicular blood supply is abundant and has strong resistance to infection, so this situation is relatively rare.
Pathological observations with the naked eye were mainly testicular enlargement, hyperemia, and tension. A small abscess was seen when the testicles were cut open. Histologically, there is focal necrosis, edema in connective tissue, and infiltration of granulocytes in lobulated nuclei. Inflammation, hemorrhage, and necrosis of the seminiferous tubules can occur. In severe cases, testicular abscess and testicular infarction can form.
6. Acute parotitic orchitis
Epidemic mumps is a common cause of orchitis, with about 20% of mumps patients complicated with orchitis. It is commonly seen in late adolescence. The naked eye can see a highly swollen testicle with a purplish blue color. 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.". "The seminiferous tubules have severe atrophy, but testicular interstitial cells are preserved, so the secretion of testosterone is not affected.".
