Testicular infection or torsion

Definition

Testicular infection or torsion is a group of disorders in which testicular pain is a primary symptom.

Causes, incidence, and risk factors

Disorders associated with testicular infection or pain include epididymitis, orchitis, testicular trauma, and testicular torsion.

Epididymitis is an inflammation of the epididymis (the structure that is the first part of the duct draining each testis). Orchitis is an inflammation of one or both of the testicles. These disorders may be caused by numerous bacterial and viral organisms. Epididymitis is the most common cause of scrotal or testicular pain in individuals over 18 years of age.

Testicular torsion is a twisting of the spermatic cord, artery and vein, which cuts off the blood supply to the testicle and surrounding structures within the scrotum. If not corrected promptly, the tissues of the testicle will die.

Diagnosis and surgery should take place within 6 hours. If surgery is delayed more than 6 hours, the testicle will often need to be removed. Testicular torsion is the most common cause of scrotal or testicular pain in boys and non-sexually active adolescents. The majority of cases of testicular torsion are in boys less than 6 years of age.

Symptoms

• Sudden onset of testicle pain (in one or both testicles) with or without a predisposing event
  
• Scrotal swelling
  
• Extreme tenderness to pressure or traction on the testis
  

Specific to orchitis and epididymitis:

• Fever
  
• Chills or chilling sensation
  
• Discharge (fluid) from penis
  

Additional symptoms that may occur:

• Testicle lump
  
• Blood in the semen
  
• nausea/vomiting
  
• Light headedness or fainting
  
• Blood in the semen
  
• Pain with urination
  
• Pain with intercourse or painful ejaculation
  
• Groin pain
  

Signs and tests

Physical examination is often sufficient to diagnose testicular torsion, orchitis, and epididymitis. Radiographic tests may be required to differentiate testicular torsion from infectious causes of testicular pain. Often, tests will be needed to determine the causative organism for infections.