Infections caused by bacteria, mycoplasma and viruses can all cause testicular damage, including primary testicular inflammation and inflammation of other systems, such as upper respiratory tract infection, oral infection and accessory gonad infection. The most common is orchitis caused by mumps, which can cause serious damage to spermatogenic epithelium. About 65,438+08% occurred on the 4th to 7th day, and 5% could cause testicular atrophy. Unilateral testicular injury still has spermatogenic ability, and bilateral testicular injury can cause oligozoospermia or azoospermia. Infection of seminal vesicle or prostate, whether caused by bacteria, chlamydia, mycoplasma or virus, will affect the survival rate of sperm. Gonococcal epididymitis can lead to bilateral epididymal duct obstruction and azoospermia.
There are three ways to cause orchitis, namely, preventing infection, lymphatic infection and direct spread through epididymis. There are two common types: nonspecific orchitis and mumps orchitis.
1) Nonspecific orchitis. Any suppurative septicemia can be complicated with acute suppurative orchitis and even cause testicular abscess. The pathogens are Escherichia coli, Streptococcus, Staphylococcus and Pseudomonas aeruginosa. But the most common cause of suppurative orchitis is inflammation spread from epididymis, so it is actually epididymal orchitis. Patient testicular pain radiated to groin with high fever, nausea and vomiting. Testicular swelling tenderness is obvious, scrotal skin is red and swollen. If the lesion is early and the epididymis can be touched, it can be diagnosed as epididymitis and orchitis. This disease should be differentiated from testicular torsion, incarcerated hernia and testicular tumor. Treatment with acute epididymitis. Early incision of the white membrane to prevent testicular atrophy and gonadal insufficiency.
2) Mumps and orchitis, caused by virus infection, is rare before puberty. Testitis often occurs 4-6 days after the appearance of mumps, but it can be without the symptoms of mumps. About 70% are unilateral and 50% participate in testicular atrophy. Bilateral testicular infection can lead to infertility.
According to the clinical manifestations and signs, laboratory examination can make a definite diagnosis. But it needs to be differentiated from acute epididymitis in clinic. Inflammatory epididymis can be seen in the early stage of acute orchitis, and the boundary with Fuwan is unclear in the later stage. There is no systemic infectious disease in the five secretions of urethra and pyuria, which is helpful for diagnosis.
3) treatment
1. western medicine treatment.
① General treatment: bed rest, local hot compress and raising scrotum.
② Antibiotics are ineffective in treating viral orchitis, and traditional Chinese medicine should be used. Oral flugualic acid, 0.2 g each time, 3 times a day; Or tiribitol, 0.2g each time, twice a day for 5-7 days. Penicillin is injected intravenously for 6.4 million u/ day, twice in the morning and evening for 3-5 days. People who are allergic to penicillin can be given ciprofloxacin lactate injection intravenously, 200 mg for adults each time, every 12 hours 1 time, and the course of treatment is 3-5 days. You can also inject gentamicin intramuscularly, 80,000 U each time, twice a day, and the course of treatment is 3-5 days.
2. Chinese medicine treatment
① Damp-heat downward flow: fever and aversion to cold, testicle swelling and pain, hard texture, red and astringent urine, dry stool, red tongue and yellow greasy coating, and slippery pulse.
Treatment: clearing away dampness and heat, detoxifying and eliminating carbuncle.
Prescription: Radix Scutellariae, Fructus Gardeniae, Caulis Akebiae, Herba Plantaginis (parched), Rhizoma Alismatis, Radix Angelicae Sinensis and Radix Rehmanniae each 65,438 00g, Radix Bupleuri 6 g, Radix Glycyrrhizae 65,438 02g, Radix Gentianae 65,438 05g, Flos Lonicerae and Fructus Toosendan 20g.
② Qi stagnation and blood stasis: the testicles are gradually swollen, hard and slightly painful, with ecchymosis on the dark side of the tongue, thin and white fur and slippery pulse.
Treatment: promoting qi and blood circulation, and dispersing stagnation.
Prescription: orange pit, radix aucklandiae, fructus aurantii immaturus, cortex Magnoliae officinalis, fructus Toosendan, peach kernel, rhizoma corydalis10g, kelp, seaweed15g, akebiae 6g, radix rehmanniae, radix scrophulariae, chrysanthemum, dandelion15g, and deer grass 30g.
③ Congestion block: swelling and pain caused by testicular trauma, or swelling and heat pain, ecchymosis on the green edge of tongue, and unsmooth pulse.
Treatment: promoting blood circulation, removing blood stasis and relieving pain.
Prescription: Radix Bupleuri, Radix Angelicae Sinensis, Semen Persicae and Squama Manis each10g, Flos Carthami and Radix et Rhizoma Rhei each 8g, Radix Trichosanthis15g, Herba Taraxaci and Flos Lonicerae each 20g.
4) Prevention and aftercare
1. Stay in bed, drink plenty of boiled water and avoid spicy and greasy food.
2. No sexual intercourse.
If you are satisfied with the above answer, please don't live up to my kindness and click "adopt as the answer" in time.
Stay in bed, drink plenty of boiled water and avoid spicy and greasy food.
Drink plenty of boiled water properly, and avoid spicy, irritating and greasy food.