Acute Non-Specific Orchitis

　　1. Etiology

　　Acute nonspecific orchitis (acutenon-specific orchitis) is caused by bacterial invasion of the testicle, with the main route of infection being retrograde infection (from the vas deferens or epididymis), which often occurs in patients with lower urinary tract infection, prostatitis, transurethral surgery, and long-term indwelling urinary catheters, causing epididymo-orchitis. It can also spread to the testicle through hematogenous dissemination, causing simple orchitis. However, due to the rich blood supply of the testicle, this situation is rare. Common pathogenic bacteria include Escherichia coli, Proteus, Staphylococcus, Enterococcus, Pseudomonas aeruginosa, and Neisseria gonorrhoeae, etc.

　　2. Pathogenesis

　　grossly, the testicle appears to be enlarged, congested, and tense to varying degrees. When the testicle is incised, small abscesses can be seen. Under the microscope, multiple focal necrosis, edema of connective tissue, and infiltration of segmented neutrophils can be observed. The seminiferous tubules have inflammation, hemorrhage, and necrosis. In severe cases, orchitis and orchitis infarction may occur.

　　1. Chronic Prostatitis Chronic prostatitis is mainly manifested by urgency, frequency, burning pain and discomfort of the urethra, white cloudy fluid discharged at the end of urination, discomfort or涩痛in the perineum, lower abdomen, testicles, and urethra. The white blood cells in the prostatic fluid increase, and the lecithin bodies decrease. The treatment of chronic prostatitis should be both offensive and defensive, combined with comprehensive treatment, and attention should be paid to the adjustment of life and diet, which is helpful to improve the efficacy.

　　1. Chronic Prostatitis Chronic prostatitis is mainly manifested by urgency, frequency, burning pain and discomfort of the urethra, white cloudy fluid discharged at the end of urination, discomfort or涩痛in the perineum, lower abdomen, testicles, and urethra. The white blood cells in the prostatic fluid increase, and the lecithin bodies decrease. The treatment of chronic prostatitis should be both offensive and defensive, combined with comprehensive treatment, and attention should be paid to the adjustment of life and diet, which is helpful to improve the efficacy. The etiology and pathogenesis of chronic prostatitis are that pathogenic factors enter from the outside to the inside, leading to disharmony of the internal organs and imbalance of Qi and blood, causing damage to the collaterals of the seminal vesicle, and blood leakage outside the pulse. The treatment of traditional Chinese medicine often focuses on the treatment of 'blood', using methods such as 'cooling blood and stopping bleeding', 'nourishing blood and stopping bleeding', 'tonifying Qi and controlling blood', and 'activating blood and stopping bleeding', which has a good effect on the majority of patients with seminal vesiculitis.

　　1. Medical History

　　There is a history of sepsis, epididymitis, or the use of urethral instruments for examination, as well as a history of trauma.

　　2. Symptoms

　　Pain in the scrotum radiates to the inguinal region, accompanied by nausea, vomiting, fever, and chills.

　　3. Physical Examination

　　The scrotal skin is red and swollen with marked tenderness. The testicle and epididymis are enlarged with tenderness, and the inguinal lymph nodes are often enlarged with hydrocele of the tunica vaginalis of the testicle.

　　For patients with urinary tract infection and prostatitis, thorough and effective anti-infection treatment must be carried out to prevent the displacement of pathogens and infection of the testicular tissue. If necessary, ligation of the ipsilateral vas deferens can be performed to prevent recurrence. At the same time, attention should be paid to urogenital hygiene, young men should avoid excessive masturbation and frequent sexual activity, as sexual excitement can cause urethral dilation and congestion, which is easy to cause orchitis due to retrograde infection.

　　1. Routine blood tests:Neutrophil增多, blood culture may have bacterial growth.

　　2. Ultrasound examination:The testicle is enlarged, and the internal echo is medium-sized, fine, dense dots, distributed evenly.

　　Diet should be light and nutritious, and attention should be paid to dietary balance. Spicy and刺激性 foods should be avoided to prevent recurrence of the condition, such as seafood, chicken, dog meat, etc. At the same time, do not ban spicy foods. Eat more fresh vegetables and fruits, which contain a large number of nutrients needed by the human body. Eat more foods that enhance immunity to improve the body's ability to resist diseases.

　　First, Treatment

　　1. The main treatment is medication, bed rest, elevation of the scrotum, and local cold or hot compresses can be used to relieve symptoms. Due to the early use of antibiotics, especially intravenous点滴antibiotics, purulent orchitis and orchitis abscess have become rare. At the same time, a traditional Chinese medicine called 'Ruyi Jinhuang San' can be mixed with sesame oil and applied to the scrotum, which can also achieve good results.

　　2. Acute nonspecific orchitis is actually mostly epididymo-orchitis, so the treatment is the same as that for acute epididymitis. Under drug control, the epididymis can be removed if necessary, and secondary orchitis can gradually recover. Those who develop orchitis due to long-term indwelling catheter in the urethra should remove the catheter as soon as possible.

　　Second, Prognosis

　　After appropriate medication treatment, most patients with epididymitis can be cured without complications. However, more than 60% of patients with epididymitis may have varying degrees of atrophy of the affected testicle. It is reported that 7% to 13% of patients may have impaired spermatogenic function. However, unilateral epididymitis generally does not lead to infertility.