Patient's question:
Three years ago, my testicles were compressed, which caused acute orchitis. After treatment, it was found that one testicle was of normal size, while the one that was affected is now only one-tenth of its original size. I want to consult if this can cause sexual dysfunction, such as erectile dysfunction? What is the likelihood of it leading to impotence?Doctor's answer:
Hello, based on your description, it cannot be ruled out that conditions such as orchitis and epididymitis may be present. These are often caused by bacterial infection of the testicles. The primary route of infection is retrograde infection, commonly occurring in patients with lower urinary tract infections, prostatitis, post-urethral surgery, or those with long-term indwelling catheters, leading to epididymitis and orchitis. It can also spread hematogenously to the testicles, causing isolated orchitis. The causative pathogens are often Escherichia coli, Proteus, Staphylococcus, Enterococcus, and Pseudomonas aeruginosa, among others.Clinical symptoms typically include unilateral pain radiating to the groin, accompanied by fever, chills, nausea, and vomiting. The scrotal skin may become red and swollen, with swelling and tenderness of the testicles and epididymis, which may also be accompanied by hydrocele. Treatment should be based on bacterial culture and susceptibility testing, with antibiotics being the primary choice. Additionally, bed rest and scrotal elevation should be recommended to alleviate symptoms. Sexual activity and physical exertion should be avoided. Early cold compresses can help prevent swelling, while later heat compresses may be used to accelerate inflammation resolution.