ISSN 2398-2977      

Testis: periorchitis

pequis
Contributor(s):

Allan Gunn

Graham Munroe


Introduction

  • Cause: uncommon condition of the stallion; inflammation of the vaginal tunics enclosing the testicle within the scrotum.
  • Signs: enlarged scrotum and/or colic.
  • Diagnosis: scrotal palpation, ultrasonography, centesis of peritoneal and vaginal tunic fluid.
  • Treatment: broad spectrum antibiotics, NSAIDs, and in some cases where appropriate, uni- or bilateral castration +/- closure of the external inguinal ring +/- scrotal ablation. Those associated with peritonitis include broad-spectrum antibiotics, peritoneal lavage and anti-endotoxic therapy.
  • Prognosis: guarded for saving the testicle(s) and fertility.

Pathogenesis

Etiology

  • Definition: inflammation of the vaginal tunics enclosing the testes within the scrotum. Possibly associated with an orchitis   Testis: orchitis - bacterial  .
  • May be septic:
    • Septic cases can be associated with trauma, wounds or penetrations. More rarely, from hematogenous spread or possibly accessory gland infection.
    • It has also been suggested that septic periorchitis (secondary form) can spread from a septic peritonitis   Abdomen: peritonitis  or vice versa.
  • Streptococcusspp   Streptococcus spp   andActinobacillusequuli  Actinobacillus equuli  have been isolated from cases of septic periorchitis.
  • Or non-septic, which may include inflammation due to the presence of nematodes.
  • In humans, meconium periorchitis is reported in neonates.

Predisposing factors

General
  • Intact males.

Specific

  • Wounds or trauma to the scrotum.
  • Peritonitis.
  • Orchitis.

Pathophysiology

  • Septic colonization of the peritoneal/vaginal tunic fluid by the offending bacterium leading to an inflammatory response.
  • Non-septic inflammatory response.
  • Swelling within the scrotum can lead to changes in pressure and temperature in the scrotum and testes with subsequent testicular degeneration and effects on fertility.

Timecourse

  • Variable, likely depending on presenting signs and detection by owners/carers.

Epidemiology

  • Uncommon.

Diagnosis

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Treatment

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Prevention

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Alanbuki A H, Bandi A & Blackford N (2013) Meconium periorchitis: A case report and literature review. Can Urol Assoc J (7-8), E495-E498 CUAJ.
  • Kinsley M A, Doran R E & Poulin Braim A E (2010) Unilateral periorchitis with a secondary peritonitis in a Standardbred stallion. Equine Vet Educ 22 (10), 489-492 VetMedResource.
  • Love C (2010) Periorchitis. Equine Vet Educ 22 (10), 493-494 VetMedResource.
  • Marino G et al (2009) Equine Testicular lesions related to invasion by nematodes. J Equine Vet Sci 29 (10), 728-733 VetMedResource.
  • Kasaback C M, Rashmir-Raven A M & Black S S (1999) Theriogenology question of the month. Septic orchitis-periorchitis and epididymitis. JAVMA 215 (6), 787-789 PubMed.
  • Belknap J, Arden W & Yamini B (1988) Septic periorchitis in a horse. JAVMA 192 (3), 363-364 PubMed.
  • Smith J A (1973) The occurrence of larvae of Strongylus edentatus in the testicle of Stallions. Vet Rec 93 (23), 604-606 PubMed.

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