What are the treatments for acute orchitis?

Acute orchitis threatens male reproductive health and fertility health. It is important to take correct medication according to the doctor's advice. If it develops into testicular infarction, surgery is required, so you must not deal with it blindly.

Internal Medicine Treatment

Since the cause of epididymitis is bacterial rather than urine reflux, drug treatment should be used. The pathogens of acute epididymitis are often caused by intestinal bacteria or Pseudomonas aeruginosa, which is more common in middle-aged and elderly men. The choice of antibacterial drugs should be determined according to bacterial culture and antibacterial drug sensitivity tests. If you are sensitive to trimethoprim-sulfamethoxazole (cotrimoxazole), you should take it orally twice a day for 4 weeks, especially for those with bacterial prostatitis. If the local redness and swelling are obvious, the white blood cell count increases, and the body temperature rises, antibiotics should be dripped intravenously until the body temperature returns to normal, and then oral antibiotics should be taken. The urogenital tract of these patients should be examined.

Other general supportive care:

During acute epididymitis, patients should rest in bed. Using an artificial scrotum support can relieve pain. If epididymal pain is severe, 20 ml of 1% lidocaine can be injected locally through the spermatic cord at the upper end of the testicle to relieve discomfort. Oral analgesics and antipyretics can also be used. In the early stage, ice packs can be placed on the epididymis to prevent swelling. In the late stage, hot compresses can be used to accelerate the disappearance of inflammation and relieve patient discomfort. Sometimes the use of indomethacin (indomethacin) can also relieve symptoms. Avoid sexual intercourse and physical activities during the acute stage, both of which can aggravate the symptoms of infection. In the acute stage, mix the Chinese medicine Ruyi Jinhuang Powder with sesame oil (vinegar can also be used, which is very irritating to the skin), apply it on the scrotum, and cover it with gauze. It has a good anti-inflammatory and analgesic effect. If hot compresses are applied at the same time, the effect will be better.

Surgical treatment

Most cases of acute epididymitis disappear on their own after drug treatment, but 3% to 9% of cases develop abscesses within one month of the acute phase. In a group of 610 patients with acute epididymitis, 19 underwent epididymo-orchiectomy due to purulent epididymo-orchiitis. A small number of cases of acute epididymitis (1%) develop into testicular infarction and require orchiectomy. Some people advocate surgical exploration of uncontrollable acute epididymo-orchiitis. If the testicles are not involved, epididymo-orchiectomy may be sufficient.