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PubMed1980

Testalgia associated with rubella infection.

Investigation of an outbreak of rubella on a college campus provided an opportunity to study the occurrence of orchitis, or testalgia, in male adolescents and young adults. Of 68 subjects with rubellla infection, five reported pain without swelling in one or both testicles lasting up to three days. Two of them had laboratory-confirmed rubella infection. Since the majority of all currently reported cases of rubella in the United States occur in persons 15 years of age and older, an increased awareness of rubella as a possible cause of testicular pain, and perhaps of orchitis, in postpubertal boys and men result in further characterization of this symptom.

Adult↗
PubMed2005

Urologic diseases in america project: trends in resource use for urinary tract infections in men.

PURPOSE: Various types of urinary tract infection (UTI) occur in men. In this study we examined health care use trends, including epidemiological and economic factors, for UTI in men in the United States. MATERIALS AND METHODS: The analytical methods used to generate these results have been described previously. RESULTS: Approximately 20% of all UTIs occur in men. Between 1988 and 1994 the overall lifetime prevalence of UTI was estimated to be 13,689/100,000 men. Orchitis rates, particularly in older men, are generally higher than those of cystitis or pyelonephritis. Approximately 10% of all inpatient care of men with UTI is for orchitis (12 to 14/100,000 population). Rates of outpatient hospital and physician office care for male UTI have increased in the last decade. Rates for emergency room care for UTI in elderly men (85 to 94 years old) were almost twice those in men younger than 85 years. The adjusted mean health care expenditure for privately insured men with UTI was 5,544 dollars in 1999 compared to 2,715 dollars for men without UTI. Total annual health care expenditures for men and women with UTI were 5,544 dollars and 5,407 dollars, respectively. Mean time lost from work was slightly higher for men. Based on composite data overall medical expenditures for men with UTI in the United States were estimated to be approximately 1.028 billion dollars in 2000. CONCLUSIONS: Health care use and economic data on UTIs in men revealed a number of intriguing trends. These results raise various important questions for future research.

Absenteeism↗
PubMed2005

Discordance between trends in chlamydia notifications and hospital admission rates for chlamydia related diseases in New South Wales, Australia.

BACKGROUND: In Australia, notification rates for chlamydia have increased fourfold since the early 1990s. An increasing incidence of genital Chlamydia trachomatis infection would be expected to lead to a rise in the incidence of chlamydia related diseases. OBJECTIVES: To determine trends in hospital admission rates for pelvic inflammatory disease (PID), ectopic pregnancy, and epididymo-orchitis in New South Wales. METHODS: Age specific admission rates from 1992 to 2001 were ascertained using inpatient data from all hospitals within the state. RESULTS: Among women aged 15-34 years, hospital admission rates for PID fell from 165 per 100,000 population in 1992 to 64 per 100,000 population in 2001 (p for trend<0.0001). 15% of PID cases in women aged 15-24 years were chronic, compared with 32% in those aged 25-34 years, and 46% in the 35-44 year age group. The incidence of ectopic pregnancy and admission rates for epididymo-orchitis remained constant. CONCLUSIONS: On a population level, trends in the incidence of chlamydia related diseases do not necessarily parallel those of reported chlamydia rates and ecological associations between the two need to be interpreted with caution.

Acute Disease↗
PubMed2005

Immune privilege and inflammation of the testis.

Immune cells are found in considerable numbers within the normal, unaffected testes of mammals, including humans. Located in the interstitial compartment, they are implicated in the mechanisms that make the testis an immunologically privileged site where germ cells are protected from autoimmune attack and foreign tissue grafts may survive for extended periods of time. With regard to normal development and function of the testis, both pro- and antiinflammatory cytokines have been shown to play an important regulatory role. The testicular environment, however, does not preclude immune activation resulting in inflammatory reactions and potential damage. In experimental animals, active immunization with testicular tissue or adoptive transfer of specific T lymphocytes causes autoimmune orchitis. In men, infection and inflammation of the reproductive tract including the testes are widely accepted as important etiological factors of infertility. Whereas symptomatic orchitis due to bacterial or viral infections is considered to be rare, a high prevalence of asymptomatic testicular inflammatory reactions could be demonstrated among infertile males. Despite the patchy distribution of the lesions, inflammation is associated with disruption of testicular function, i.e. spermatogenesis. The pattern of lymphocyte infiltration and concomitant damage of seminiferous tubules supports the concept that activation of autoreactive T cells is involved.

Animals↗
PubMedDate not supplied

Efficacy of ceftizoxime in the treatment of incubating syphilis in rabbits.

While ceftizoxime given as a single intramuscular shot cures uncomplicated gonorrhoea in almost every case, its efficacy against Treponema pallidum in cases of concomitant incubating syphilis is less clear. To analyse this question, the rabbit orchitis model was used. After initial experiments defining appropriate inocula and doses, ceftizoxime was compared to penicillin G with its well-known activity against the organism in vitro and in vivo. According to the final experiment, ceftizoxime applied in doses corresponding to the ones used in humans for uncomplicated gonorrhoea cures rabbit orchitis due to T. pallidum about as effectively as penicillin. Hence there seems to be no need to refrain from using the third-generation cephalosporin ceftizoxime to cure gonorrhoea for fear of masking concomitant syphilis.

Animals↗
PubMed1991

Mumps vaccination of young adults is unwarranted.

A clinical and epidemiological study of mumps was carried out over a 18-month period and included 104 soldiers (61% of the reported cases in the Israel Defence Forces). The average number of days off work was 12.9 +/- 9.2 days. The most common complication was orchitis (19/72 men; 26%), followed by 3 cases of pancreatitis (3%) and 2 cases of meningitis (2%). 13 men with orchitis were tested, and all had normal spermograms. No long term important sequelae were described. The transmission rate was low with no respondent reporting more than one secondary case among soldiers serving in the same unit. The socio-economic level of mumps patients was comparable to that of the general army population at the time of the study. Our data do not support a mass immunization program of the adult population.

Adolescent↗
PubMed2004

Xanthogranulomatous funiculitis and orchiepididymitis: report of 2 cases with immunohistochemical study and literature review.

Two patients with xanthogranulomatous inflammation are described, one with involvement of the spermatic cord and the other with 1 testicle and epididymis affected. To our knowledge, only 12 cases of xanthogranulomatous orchiepididymitis have been reported previously, one of which also presented a xanthogranulomatous funiculitis. Clinically, our patients presented with spermatic cord enlargement (case 1) and chronic orchitis that did not respond to treatment with antibiotics (case 2). Histopathologically, both cases showed extensive xanthogranulomatous inflammation with numerous foamy macrophages that were associated with colonies of microorganisms suggestive of actinomyces in case 1. Additionally, Escherichia coli was cultured from the surgical specimen of case 2. The possible underlying pathology may be diabetes in case 1 and phlebitis associated with chronic orchitis in case 2. Differential diagnoses with other lesions that are rich in macrophages, such as malakoplakia, and those testicular neoplasms without serologic tumor markers are discussed.

Abscess↗
PubMed1999

[Establishment of murine model of autoimmune male infertility].

BACKGROUND: Experimental autoimmune orchitis (EAO) has been studied as an animal model for human immunological male infertility. We have already reported the induction of contralateral EAO ("sympathetic orchitis") by unilateral testicular injury in mice. In this paper, we report the induction of autoimmune infertility in such mice as well as EAO. METHODS: Ten to 20 needle punctures were made to the unilateral testis of mice and it was crushed by a needle-holder. Such mice were mated in vivio with female mice. RESULTS: Fifty to 80% mice whose testis was injured unilaterally became infertile in 3 months. Delayed type hypersensitivity (DTH), one of the cell-mediated immunities, to autologous testicular cells (TC) as well as anti-TC antibodies, humoral immunity, were both detected in those mice. CONCLUSION: We have clearly shown that unilateral testicular injury could induce not only the contralateral EAO but also autoimmune infertility in mice. Our present injury model mimics clinical testicular trauma; therefore, this testicular injury model can be very useful in studying the immunological mechanism of EAO and of human immunological male infertility.

Animals↗
PubMed2002

[Progresses on macrophages of male reproductive tract].

The review summarized the recent progress on macrophages of male reproductive tract and the action of macrophages on male reproductive physiology and pathology. The close correlation and effect between testicular macrophages and Leydig cells, Sertoli cells, germ cells, hypothalamic-pituitary-gonadal axis were introduced, respectively. At the same time, it pointed out the changes of macrophages' morphology and function in immune orchitis, and their regulation on the development of orchitis. So the complex immune regulation network in testes and testicular macrophages playing an important role on spermatogenesis and the stableness of spermatogenetic microenvironment in testes were further illuminated, which can provide theoretical basis for clinic therapy.

Genitalia, Male↗
PubMed2003

Whipple's disease with destructive arthritis, abdominal lymphadenopathy, and central nervous system involvement.

We describe a patient with Whipple's disease who had an unusual erosive and destructive polyarthritis, massive abdominal lymphadenopathy, asymptomatic central nervous system involvement, and rare manifestations of orbital pseudotumor and orchitis with epididymitis. Taking oral therapy with trimethoprim-sulfamethoxazole he had recurrent flares of orbital pseudotumor, an episode of orchitis with epididymitis, and persistent polymerase chain reaction T. whipplei-positive cerebrospinal fluid. Resolution was achieved with a one month course of intravenous ceftriaxone and a 6 month course of azithromycin, and no relapse occurred during 24 months of followup.

Abdomen↗
PubMed2005

Acute scrotum -- etiology and management.

OBJECTIVE: Acute scrotal pain is a common urological emergency. Urgent exploration is the standard means of management, since no investigation can confidently exclude torsion of testis from the differential diagnosis. METHODS: A review of all boys presenting with acute scrotal pain who underwent emergency scrotal exploration between January 1983 and March 2003 was performed. RESULTS: 195 boys were included in this study. They were divided into 3 groups: group 1-73 with epididymo-orchitis, group 2-63 with torsion of testicular appendages and group 3- 57 with spermatic cord torsion. The patients in group 2 were older than group 1, also patients in group 1 were older than group 3. During neonatal period the most common pathology was spermatic cord torsion, whereas in prepubertal period torsion of appendages was more common. In all boys, mean duration of pain at presentation was 2.11 days. Epididymo-orchitis was diagnosed in 37% of patients, with torsion of the appendages being the next most common entity. Testicular torsion was diagnosed in 29% of patients. In the group with testicular torsion salvage rate of testis was 37% because of late admission. The perioperative morbidity and mortality was not seen in any of the groups. CONCLUSION: We believe that any boy with acute scrotal pain and any suspicion of testicular torsion in physical examination must be applied routine surgical exploration.

Acute Disease↗
PubMed2006

[Mumps--an underestimated disease].

UNLABELLED: In countries, where vaccination against mumps is not obligatory, epidemic increase in morbidity is observed every 4-5 years. In Poland vaccination had not been obligatory until 2004. Year 2004 was an epidemic year--135,178 cases were reported. In 2005 (up to 31.07.05) 64,062 cases were noted and many hospitalizations. The aim was analysis of clinical course of mumps in children hospitalized between 1.01.04 and 31.07.05. MATERIAL AND METHODS: 292 children in age from 11 months to 16 years, 90 (30,8%) girls and 202 (69,2%) boys. Diagnosis of mumps was based on typical clinical picture, history of exposure and amylase activity in serum and urine. 111/292 (38%) children were referred to the hospital with suspicion of meningitis: in 68/292 (23,3%) lymphocytic meningitis was diagnosed (49 boys and 19 girls) and in 43 meningeal signs were not observed. Orchitis was observed in 48/202 (23,76%) boys 12-16 years old, in 3 of them both testes were affected. In 3 boys meningitis and orchitis were diagnosed, in one of them with encephalitic symptoms. 73/292 (25%) children were admitted to the hospital because of emesis and dehydration. 43/292 were hospitalized with suspicion of meningitis. 15 children were admitted because of high fever with poor response for antipyretics. In two children unilateral deafness was observed. In two children edema of subcutaneous tissue of upper chest. In remaining cases mumps was diagnosed in children with hematologic and oncologic diseases, kidney failure, congenital defects. CONCLUSIONS: Complications of mumps and need for hospitalization in children with mumps still are problems of public health. The only method of prophylaxis is accurate vaccination pragramme.

Adolescent↗
PubMed2006

[Clinical and laboratory features of mumps in hospitalized children in 2003-2004 epidemics].

OBJECTIVES: The frequency and duration of hospitalization as well as symptoms and chosen laboratory tests in children with mumps hospitalized during 2003-2004 epidemics. METHODS: The inpatients records of children with mumps hospitalized from January 2003 to September 2004 at the Clinic of Pediatric Infectious Diseases in Bialystok were reviewed. RESULTS: At this time, the percentage of hospitalizations due to mumps increased from 1.6% up 34.3% in December 2003. The main cause of hospitalizations was mumps meningitis (81.4%). Children with mumps orchitis (3.4%), pancreatitis (1.9%) and mixed symptomatology i.e. meningitis with pancreatitis (2.3%) or meningitis with orchitis (1.1%) were also hospitalized. Children with pancreatitis needed the most longer time of hospitalization (16 days). The analysis of the laboratory tests revealed that serum lipase has the most diagnostic value for mumps pancreatitis and lymphocytic pleocytosis for meningitis. CONCLUSION: Mumps-associated morbidity could be limited if susceptible children population

Adolescent↗
PubMedDate not supplied

[The clinico-statistical characteristics of the testicular generative function in male subfertility following mumps].

The paper emphasized the role of mumps complicated by orchitis in the etiology of male subfertility with allowances for a possible development of testicular degeneration in the course of epidemic parotiditis alone, i.e. without clinically evident orchitis. To distinguish the impact of mumps sustained in childhood on the infertility development clinical and laboratory investigations would be advisable in the majority of subfertile males. The results of clinical and statistical study of 865 infertile males aged between 20 and 36 yrs whose marital life varied from 8 mos to 12 yrs were reported. Anamnestic evidence of epidemic parotiditis sustained at the age of 5-13 yrs was found in 174 examinees (20.1 per cent). Spermographic data on subfertile males with a history of mumps were exposed to statistical computation and correlated with the data on 200 subfertile males who avoided the disease and the data on 22 healthy fertile males. The authors noted significantly low (p less than 0.05) contents of ejaculate spermatozoa in subfertile males with a history of mumps and a significantly low number of morphologically normal spermatozoa (p less than 0.001) in comparison to those values in subfertile males without a history of epidemic parotiditis.

Adult↗
PubMedDate not supplied

[Choice of the treatment method in patients with acute inflammatory diseases of the scrotal organs].

The results of treatment for acute scrotal inflammations are reported. Conventional methods of conservative treatment are of little effect, while the duration of hospital stay is 24 days, and 25% of the patients are eventually readmitted to hospital for various complications. The choice of treatment strategy is made with reference to the clinical severity of acute epididymo-orchitis (mild, moderate and severe forms). Ninety-nine patients with mild and moderate acute epididymo-orchitis received combined conservative treatment. In the past two years, combined treatment has made use of a helium-neon optic quantum-mechanical oscillator, OKG-LG-12, producing beams with a wavelength of 632.8 nM and an output power of 18-20 mV. No side effects were identified during or after the laser treatment. Patients with severe conditions are subject to surgical treatment. Early surgical intervention includes the opening of testicular membranes, inspection of the epididymis and drainage. Postoperative patients were treated with broad-spectrum antibiotics and 3 or 4 sessions of laser therapy. The use of combined conservative treatment, incorporating laser therapy, for mild and moderate conditions, and surgical treatment for severe ones has shortened hospital stay two-fold, while the results have been good.

Acute Disease↗
PubMedDate not supplied

Antibodies against spermatozoids. Studies in homosexuals, AIDS and infertile men.

The presence of antibodies against spermatozoids was evaluated in one person with AIDS and six homosexuals (HS). Indirect immunofluorescence was utilized along with immunoenzymatic trial with peroxidase (ELISA) in order to detect antibodies class IgG towards spermatozoids and their membrane proteins. Optic densities of the following groups of patients were compared: 1) One patient with AIDS. 2) Six homosexuals (HS). 3) Three HS with cells OKT8 greater than 30%. 4) Three HS with cells OKT8 less than 30%. 5) Three men with auto-antibodies against spermatozoids + infertility. 6) Two men without auto-antibodies against spermatozoids + infertility. 7) Five women, spouses of the infertile men. 8) Five multiparous with more than 3 pregnancies. 9) One man with orchitis. 10) Ten fertile and healthy (C.G.) heterosexual persons. The patient with AIDS and the one with orchitis had the highest optic densities (OD), (groups 1 and 9). Groups 8 and 10 had the lowest, non-significant values. Groups 2, 5 and 7 ranked second in place in reference to O.D. Groups 3, 4 and 6 ranked third in O.D. values. Groups 8 and 10 differed significantly at P less than 0.005 compared with the others. The presence of antibodies against spermatozoids was considered as an important factor associated with AIDS and previous states of the AIDS detected by OKT8 greater than 30% of lymphocytes. The IIF and ELISA were able to detect antigenic system in spermatozoids with allelic form, which may be similar to the mice locus t, or a new tissue specific system.

Acquired Immunodeficiency Syndrome↗
PubMed1986

[Realtime sonography of intrascrotal space-occupying lesions].

In 848 examinations of the testes in 317 patients, including 253 follow-up and/or multiple follow-up examinations and 36 unilateral testicle examinations (e.g., orchidectomy, aplasia or nondescent) it was shown that sonography is a diagnostic method which is on the one hand capable of clearly differentiating cystic from solid space-occupying processes, and on the other hand also offers certain possibilities for evaluating the status of solid findings. Histologic identification of malignant tumors was only achieved with teratomas. The differential diagnostic problem was in differentiating scrotal tumors from focal orchitis, chronic epididymitis, testicular torsion and contusion, and in differentiation between paratesticular neoplasms and epididymitides. The testicular findings included testicular neoplasms, cicatrization and cysts of the tunic, sequelae of trauma, orchitis, cryptorchism, hypoplasia, aplasia, and testicular cysts. Paratesticular findings included hydroceles, spermatoceles, varicoceles, paratesticular neoplasms, epididymitides, paratesticular scars, and thickening of the testicular coat.

Diagnosis, Differential↗
PubMedDate not supplied

Autoimmunity to sperm.

1. Sperm-specific antigens behave immunologically more like foreign than self antigens. 2. Consequences of autoimmune response to testicular and/or sperm antigens can result in allergic orchitis, postvasoligation orchitis, and infertility. In these conditions, multiple pathogenetic mechanisms, including immune complexes and T-cell-mediated immune reaction, have been shown to be important. 3. Normally, factors that circumvent sperm autoimmune disease are likely to be multiple. Besides the mechanism of sperm-antigen sequestration, other controlling mechanisms also should be considered.

Animals↗