Mumps Orchitis
Review literature: (Manson, 1990).
Definition of Mumps Orchitis
Mumps orchitis is an acute viral orchitis as a complication of epidemic parotitis.
Epidemiology
Mumps orchitis develops in 30% of patients with mumps after puberty
Etiology of Mumps Orchitis
Mumps virus is a paramyxovirus with a single-stranded RNA.
Signs and Symptoms
- Incubation period: 14–25 days
- Fever, headache
- parotid inflammation (more common bilateral), cloudy saliva
- Orchitis: the scrotal symptoms occur after 4–6 days with a painful testicular swelling, in 10–30% bilateral.
- Spontaneous improvement of symptoms after 1–2 weeks
Diagnostic Work-Up of Mumps Orchitis
- Ultrasound and Doppler-Sonography of the testis
- In cases of clinical doubt about the diagnosis, serological diagnosis of mumps is possible.
Differential Diagnosis of Orchitis
- Septic spread of bacterial diseases (typhoid fever, brucellosis, tuberculosis
- Continuous bacterial spread of bacterial epididymitis
- Viral infections (mumps)
- Malaria
Treatment of Mumps Orchitis
General measures:
- Bed rest
- Testicular elevation and cooling
- Non-steroidal anti-inflammatory drugs (e.g. diclofenac)
Experimental Approaches:
Leuprorelin (Vicari and Mongioì, 1995) and interferon-α (Ku et al, 1999) was successfully used to treat mumps orchitis and to prevent testicular atrophy.
Prognosis of Mumps Orchitis
- In bilateral disease, the development of testicular atrophy with the risk of infertility is possible.
- Hypergonadotropic hypogonadism is possible in severe bilateral mumps orchitis.
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References
- Ku, J. H.; Kim, Y. H.; Jeon, Y. S. & Lee, N. K.
- The preventive effect of systemic treatment with interferon-alpha2B for
infertility from mumps orchitis.
BJU Int, 1999, 84, 839-842. - Manson 1990 MANSON, A. L.:
- Mumps orchitis.
In: Urology
36 (1990), Nr. 4, S. 355–8
- Vicari, E. & Mongioì, A.
- Effectiveness of long-acting gonadotrophin-releasing hormone agonist treatment in
combination with conventional therapy on testicular outcome in human
orchitis/epididymo-orchitis.
Hum Reprod, 1995, 10, 2072-2078
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Last update
Dr. med. Dirk Manski
man...@urologielehrbuch.de