Orchitis Treatment & Management

Updated: Jan 26, 2023
  • Author: Nataisia Terry, MD; Chief Editor: Erik D Schraga, MD  more...
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Emergency Department Care

Supportive treatment includes the following:

  • Bed rest

  • Hot or cold packs for analgesia

  • Scrotal elevation

Most importantly, the physician must rule out testicular torsion.

Second, the physician should consider epididymo-orchitis and, if highly suspected, treat appropriately. This usually involves starting empiric antibiotic therapy.

If torsion is likely or if several hours have passed before the patient arrives in the ED, operative exploration is indicated.

Orchitis complicated by a reactive hydrocele or pyocele may require surgical drainage to reduce the pressure in the tunica.

If torsion is likely, urologic consultation is required for urgent surgical exploration.

If a significant hydrocele is detected or suspected, urologic consultation is necessary to evaluate the need for a surgical tapping to relieve the pressure on the tunica.

Follow-up care with a urologist is appropriate for an uncomplicated presentation of orchitis.


Medical Care

Symptoms of isolated orchitis usually resolve spontaneously in approximately 3-10 days, whereas epididymitis will usually resolve in a similar time frame after initiation of antibiotic treatment.

Supportive therapy includes the following:

  • Bed rest

  • Scrotal support

  • Analgesics

  • Hot or cold packs for analgesia: Elevation of the scrotum and placement of ice on the affected testis are specific comfort measures that should be recommended to the patient with orchitis; the patient should put a small pillow or a towel between the legs to elevate the scrotum and place ice on the affected testis for 10-15 minutes, 4 times a day, until pain resolves

Patients with a suspected sexually transmitted disease should be referred to their private physician or local health department for HIV testing.

Treatment can usually be performed as an outpatient with close follow-up. Indications for admission include the following:

  • Inability to take oral antibiotics

  • Suspicion of abscess formation

  • Failure of previous outpatient therapy

  • Signs of sepsis