The culprit behind male infertility

Orchitis is a common inflammation of the male reproductive system. It can be caused by a variety of pathogenic factors. It can be divided into non-specific, viral, fungal, spirochetal, parasitic, damaging, chemical and other types. The infection route is mostly through the blood and lymphatic vessels, and can also invade the testicles retrogradely through the urethra, seminal vesicle, vas deferens, and epididymis. Clinically, non-specific orchitis and mumps orchitis are common, which is one of the common causes of male infertility. Mumps orchitis is caused by viruses. Orchitis complicated by sexually transmitted diseases such as gonorrhea, non-gonococcal urethritis, and syphilis accounts for about 40-60% of the total incidence and is one of the common complications of male sexually transmitted diseases.

There are many causes of orchitis, such as infection, trauma, and tumors. It is also one of the common diseases in men's outpatient clinics. When patients describe their symptoms, due to different types of diseases, the nature of their pain varies, such as bloating, falling pain, and knife-like pain; the degree of pain also varies, such as dull pain and severe pain. In addition to the pain caused by the testicular lesions themselves, the epididymis and spermatic cord lesions and inflammation in the scrotum often cause testicular pain. As mentioned earlier, if a football hits the key part of a man's testicles, the severe blow will cause severe testicular pain, and in severe cases, it will cause shock. Lesions in other parts such as the bladder and prostate can also radiate to the scrotum and testicles, causing pain.

Orchitis often occurs in patients with urethritis, cystitis, prostatitis, after prostatectomy and long-term indwelling catheters. The infection spreads to the epididymis through the lymph or vas deferens, causing epididymal orchitis. Common pathogens are E. coli, Proteus, Staphylococcus and Pseudomonas aeruginosa. Bacteria can spread to the testicles through the bloodstream, causing simple orchitis. However, the testicles have rich blood supply and strong resistance to infection, so this situation is relatively rare. Pathologically, the main macroscopic observation is enlarged, congested and tense testicles. Small abscesses are seen when the testicles are cut open. Histology shows focal necrosis, connective tissue edema and lobed granulocyte infiltration, inflammation, hemorrhage and necrosis of seminiferous tubules, and in severe cases, testicular abscess and testicular infarction may occur. The diagnosis is mainly based on clinical symptoms such as high fever, chills, testicular pain, scrotal redness, and edema. Of course, it should be distinguished from acute epididymitis, mumps orchitis, spermatic cord torsion, and incarcerated hernia. Early and clear diagnosis, timely administration of antibiotics, and removal of the cause are important means to protect good function in the future. In a few cases of orchitis, after being cured, testicular atrophy may occur due to fibrosis and damage to the seminiferous tubules, affecting fertility.

【Common sense of prevention of orchitis】

For orchitis, a large amount of broad-spectrum effective antibiotics should be used intravenously in the early stage to control inflammation in order to reduce the occurrence of purulent orchitis and testicular abscess. Special attention should be paid to acute mumps orchitis, whose bilateral lesions can cause irreversible damage to spermatogenesis and even testicular atrophy, leading to male infertility. Therefore, the key to preventing this disease is that susceptible children under 1 year old can be vaccinated.