Testicular atrophy after mumps orchitis: ultrasonographic findings

Abstract

Purpose: The purpose of this study was to describe the ultrasonographic findings of testicular atrophy after mumps orchitis. Methods: We retrospectively reviewed the case files of eight patients (14 to 24 years old; mean, 17 years) with mumps orchitis and testicular atrophy who were treated between January 2011 and September 2017. On gray-scale and color Doppler, the ultrasonographic features of volume, shape, echogenicity, and degree of blood flow in the testes were analyzed as part of both initial and follow-up ultrasonography. The duration between the initial diagnosis of mumps orchitis and the ultrasonographic diagnosis of testicular atrophy after mumps orchitis ranged from 25 to 230 days (mean, 95.9 days). Results: Of the eight patients with testicular atrophy after mumps orchitis, the testes were affected unilaterally in seven patients (6 right-sided and 1 left-sided) and bilaterally in one patient. The affected testes (n=9) were 23%-55% (mean, 44.7%) smaller in volume (mean, 6.3±2.0 mL) than the contralateral normal testes (n=7) (mean, 10.8±2.3 mL) on follow-up ultrasonography (P=0.001). The shape of the atrophic testes was oblong in seven cases and elliptical in two cases. The atrophic testes were either heterogeneously hypoechoic with multiple hyperechoic islands (n=7) or heterogeneously hyperechoic (n=2). On follow-up color Doppler ultrasonography, the degree of vascularity of the atrophic testis was either similar to (n=3) or lower than (n=6) that of the contralateral testis. Conclusion: On ultrasonography, atrophic testes after mumps orchitis tended to exhibit an oblong shape, heterogeneous low echogenicity with multiple hyperechoic islands, and decreased vascularity.

Current status of the COVID‐19 and male reproduction: A review of the literature

“…32 Mumps virus (MuV) has a high tropism for the testicles, and orchitis is a common complication. 33 Human immunodeficiency virus (HIV) infection also induces severe orchitis and results in male infertility. 34 HIV is detectable in semen shortly after infection and at all subsequent stages of the disease.…”

“…In fact, ZIKV was detected in the semen of symptomatic men 31 and was shown to be sexually transmitted 32 . Mumps virus (MuV) has a high tropism for the testicles, and orchitis is a common complication 33 . Human immunodeficiency virus (HIV) infection also induces severe orchitis and results in male infertility 34 .…”

“…However, the results are controversial. For example, some researchers have reported that SARS-CoV-2 was not detected in the male reproductive tract, [25][26][27][28][29][30][31][32][33][34] while others reported that SARS-CoV-2 RNA was found in the semen or testes of COVID-19 patients. 35,36 There are also unknown factors regarding COVID-19 and male reproduction.Orchitis and broad destruction of the testes were found in deceased COVID-19 patients, 35,37 while the pathological characteristics in survivors remain unknown.…”

Mumps Orchitis: Clinical Aspects and Mechanisms

“…Some cases also show increased luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels ( 46 ). The acute symptoms can resolve within two weeks; however, testicular atrophy can occur in half of the orchitis patients and is characterized by an oblong shape, low echogenicity, and decreased vascularity based on ultrasonographic findings ( 3 , 47 ). However, seminal abnormalities, including sperm count, motility and morphology, may sustain for years after recovery ( 37 ), suggesting the abnormal spermatogenesis can occur.…”

Serostatus of IgG antibody against mumps virus in adult population of Al Madinah Al Munawarah, Saudi Arabia

“…Unvaccinated postpubertal males who are diagnosed with mumps virus commonly present with complications such as mumps orchitis. [5][6][7] In general, natural viral infection provides lifetime protection against the virus for most individuals; however, repeated mumps attacks have been reported. 8 Immunity against mumps is associated with the presence of specific anti-mumps IgG antibodies in serum.…”