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Review literature: (Manson, 1990).
Definition of Mumps Orchitis
Mumps orchitis is an acute viral orchitis as a complication of epidemic parotitis.
Mumps orchitis develops in 30% of patients with mumps after puberty, 10–30% have bilateral manifestation.
Etiology and Pathogenesis of Mumps Orchitis
The mumps virus is a neurotropic paramyxovirus with single-stranded RNA. Orchitis leads to infiltration of lymphocytes, damage to the blood-testis barrier, edema with rise of intratesticular pressure with pressure atrophy (caused the inelastic tunica albuginea). Infertility, subfertility and hypogonadism may develop, depending on the extent of the (bilateral) disease.
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 Workup of Mumps Orchitis
- Ultrasound and Doppler-Sonography of the testis
- In cases of clinical doubt about the diagnosis, serological diagnosis of mumps is possible.
- Surgical exploration is necessary, if testicular torsion or tumor cannot be excluded.
Differential Diagnosis of Orchitis
- Septic spread of bacterial diseases (typhoid fever, brucellosis, urogenital tuberculosis
- Continuous bacterial spread of bacterial epididymitis
- Viral infections (mumps)
Treatment of Mumps Orchitis
- Bed rest
- Testicular elevation and cooling
- Non-steroidal anti-inflammatory drugs (e.g., diclofenac)
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.
Index: 1–9 A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
ReferencesKu, 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.
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
Deutsche Version: Mumps Orchitis