Mumps Orchitis

What Is Mumps Orchitis?

Mumps orchitis is when the testicles get swollen and sore because of the mumps virus. It mostly happens to older boys and men who get the mumps. The virus first goes to the facial glands, but then it can travel in the blood to the testicles, triggering significant inflammation. A long time ago, before the shot, this was the main reason young men had sore testicles. Now, there are fewer cases, but if too few people get vaccinated, mumps orchitis can still spread and cause problems.

How Does Mumps Lead to Orchitis?

Mumps is caught from other people's germs, usually when they cough or sneeze. It can also spread by sharing cups or getting spit on your hands. The virus grows in the throat and then travels everywhere in the blood. It can cause problems in:

• Parotid salivary glands
• Pancreas
• Central nervous system
• Testes (in males)

When the virus reaches the testes, it triggers significant inflammation, fluid accumulation, and cellular damage. This leads to swelling, pain, and in severe cases, compromised blood supply to the testicular tissue.

Timing of Onset

Orchitis usually appears:

• 4–10 days after parotid gland swelling
• Sometimes, even before classic facial swelling
• Rarely months after infection (very uncommon)

Symptoms of Mumps Orchitis

Mumps orchitis typically begins suddenly and is usually preceded by general mumps symptoms.

Early Symptoms (Related to Mumps)

• Fever
• Headache
• Fatigue
• Swollen cheeks (parotitis)
• Muscle pain
• Loss of appetite

Symptoms of Orchitis

Orchitis usually affects one testicle, though both can be affected in some cases. Key symptoms include:

• Severe testicular pain
• Swelling of the scrotum (may double in size)
• Redness and warmth of the scrotal skin
• Pain radiating to the groin or abdomen
• High-grade fever
• Nausea or vomiting
• Testicular tenderness
• Difficulty walking due to pain

Testicular Atrophy (Long-term Result)

Some patients may later experience:

• Shrinking of the affected testicle
• Reduced firmness or volume
• Discomfort during physical activities

How Is Mumps Orchitis Diagnosed?

If testicular swelling occurs, doctors need to act quickly. The diagnosis involves:

1. Medical History

The physician verifies recent mumps exposure, reviews the child's vaccination status, and determines the duration of pain and fever.

2. Physical Examination

The doctor examines the scrotum carefully to see if it looks swollen, hurts when touched, or has any unusual colour changes.

3. Blood Tests

May be used to detect:

• Mumps-specific IgM or IgG antibodies
• Elevated inflammatory markers

4. Ultrasound

Scrotal ultrasound is the most effective imaging tool. It helps:

• Confirm inflamed testicular tissue
• Rule out testicular torsion (a medical emergency)
• Assess blood flow

5. PCR Testing

Sometimes, they might run a PCR test on a sample of spit or pee to prove the mumps virus is definitely the culprit.

Treatment & Management

Rest and Activity Modification

Since no antiviral drug targets the mumps virus, mumps orchitis is treated mainly through supportive measures. When your pain, fever, or swelling is at its highest, the best thing you can do is rest. Moving too much can irritate the swollen testicle, making everything feel worse.

Scrotal Support and Cold Compresses

Support the scrotum right away to reduce pain. Wear tight, supportive underwear or a sling to limit movement. Apply a cold compress briefly to bring down swelling and ease discomfort.

Pain and Fever Management

Certain medicines that possess analgesic and antipyretic capabilities for managing pain, inflammation, and fever may be prescribed. This dual capability helps ensure patient comfort and supports a quicker resolution of the illness.

Hydration and General Care

Make hydration your priority! It's especially crucial while fighting a fever. Be sure to drink plenty of water or electrolyte solutions; this small effort effectively helps your body regulate its temperature and powers you toward a quicker overall recovery.

When Antibiotics or Hospital Care Are Needed

Because mumps orchitis is viral, antibiotics are not routinely used unless a secondary bacterial infection is suspected. Hospitalisation may be necessary in rare cases involving severe bilateral orchitis, uncontrolled pain, or dehydration. Patients should avoid strenuous exercise, heavy lifting, and sexual activity until symptoms resolve.

Potential Complications

Mumps orchitis can sometimes cause additional problems, although many people recover without lasting effects.

Testicular Atrophy

One of the most reported issues is that about 30%–50% of cases with one affected testicle may develop shrinkage.

Reduced Fertility

Problems are more likely if both testicles are inflamed. Sperm levels and quality might fall for a while, sometimes longer.

Subfertility

Some individuals stay fertile but may not regain completely normal sperm health.

Chronic Scrotal Pain

Lingering discomfort can remain for some.

Hormonal Changes

Rarely, severe damage reduces testosterone, causing tiredness, lower sex drive, and weakened muscles.

Rare Problems

Such as abscess formation, bacterial infection, or extremely rare complete infertility.

Prevention

MMR Vaccination

The MMR vaccine is the primary defence against mumps. Two doses are recommended for the best protection. It significantly cuts the risk of mumps orchitis and simultaneously guards against measles and rubella.

Avoiding Contact With Infected Individuals

Most important in schools, hostels, and other high-exposure settings.

Good Hygiene Practices

Practising routine handwashing, avoiding shared personal items, and following proper coughing etiquette reduces viral spread.

Early Isolation

Anyone infected should isolate for at least 5 days after parotid swelling begins.

Conclusion

Although mumps orchitis can be painful and worrying, especially for males after puberty, most people recover completely with proper rest and care. Still, it’s important to be aware of the possible long-term risks, such as testicular atrophy or reduced fertility, mainly when both testicles are affected. Early evaluation and supportive treatment make a big difference. Thanks to the MMR vaccine, cases have dropped sharply, though occasional outbreaks still appear where vaccination rates are low.