Change of the Testicular Volume after Mumps Orchitis

볼거리 고환염 치료 후 고환용적의 변화

Lee, Jae-Won;Lee, Tchun-Yong;Choi, Hong-Yong
이재원;이춘용;최홍용

  • Published : 20070500

Abstract

Mumps orchitis rarely occurs in prepubescent boys, but it is common in adolescents and adults. Approximately 30-40% of the affected testes are said to atrophy within several months as a complication, but any study on this is lacking. We studied the clinical outcomes and the ultrasonographic findings of mumps orchitis. Materials and Methods: We studied 15 patients who had been hospitalized and followed up for more than 3 months from July 2003 to June 2005. The average age of the patients was 16 years old. The patients' medical history, therapeutic measures and clinical outcomes were recorded, and scrotal color doppler ultrasonography was performed at the follow up sessions after the treatment. The criteria for testicular atrophy have been set according to the contralateral testicular volume reduction of 20% or 2ml. Results: During an average of 10 months of follow up period, 9 of 15 patients experienced atrophy and the contraction rate of the affected testes was about 39.8%. Two of 5 patients who under systemic interferon-α2b treatments experienced atrophy and their contraction rate was about 46.5%. On the ultrasonography, inhomogeneous and decreased echogenicity was noted in the atrophic testes and the blood flow comparably decreased. Conclusions: From the study, it has been confirmed that the interfereon-α2b treatment was not adequate to completely prevent the atrophy. Scrotal ultrasonography is a useful examination that is able to measure the correct testicular volume and judge testicular atrophy. As mumps orchitis seem to induce testicular atrophy, periodic check up may be required after the acute stage.

Keywords

References

  1. Yvonne M. Mumps. In: Richard EB, Robert MK, Hal BJ, editors. Nelson textbook of pediatrics. 17th ed. Philadelphia: Saunders; 2004;1035-6
  2. Hong CE. Pediatrics. 8th ed. Seoul: Daehan textbook Inc; 2004;468-9
  3. Choi YM, Kim CH, Seo JG, Son YM, Oh SH, Lee WJ, et al. Measle, mumps, rubella (MMR) vaccination: guide to vaccinations. 2nd ed. Seoul: Jungmoonsa Inc; 1992;48-54
  4. Korea Center for Disease Control & Prevention. 2004 Communicable diseases statistical yearbook. Seoul: Korea Center for Disease Control & Prevention; 2005;8
  5. Voughan VC. Epidemiology and public health. A text and reference book for physicians, medical students and health workers. London: Henry Kimpton; 1922;275-81
  6. Beard CM, Benson RC Jr, Kelalis PP, Elveback LR, Kurland LT. The incidence and outcome of mumps orchitis in Rochester, Minnesota, 1935 to 1974. Mayo Clin Proc 1977; 52:3-7
  7. Mark S, Jonathan PJ. Male infertility. In: Patrick CW, editor. Campbell's urology. 8th ed. Philadelphia: Saunders; 2002;1508
  8. Manson AL. Mumps orchitis. Urology 1990;36:355-8 https://doi.org/10.1016/0090-4295(90)80248-L
  9. Freeman BA. Mumps virus. In: Textbook of microbiology. 22th ed. Philadelphia: Saunders; 1985;794-6
  10. Baum SG, Litman N. Mumps virus. In: Mandell GL, Douglas RG, Bennett JE, editors. Principle and practice of infectious disease. 3rd ed. New York: Churchill Livingstone; 1990;1260-4
  11. Atkinson JE, Bass HN. Mumps orchitis in a three-year-old child. JAMA 1968;203:892 https://doi.org/10.1001/jama.203.10.892
  12. Bjorvatn B. Mumps virus recovered from testicles by fineneedle aspiration biopsy in cases of mumps orchitis. Scand J Infect Dis 1973;5:3-5
  13. Andrada JA, von der Walde F, Hoschoian JC, Comini E, Mancini E. Immunological studies in patients with mumps orchitis. Andrologia 1977;9:207-15 https://doi.org/10.1111/j.1439-0272.1977.tb01289.x
  14. Burhans RA. Treatment of orchitis of mumps. J Urol 1945; 54:547-8 https://doi.org/10.1016/S0022-5347(17)70111-5
  15. Nixon N, Lewis DB. Mumps orchitis: surgical treatment. J Urol 1946;56:554-60 https://doi.org/10.1016/S0022-5347(17)69843-4
  16. Mcares EM Jr. Nonspecific infections of the genitourinary tract. In: Tanagho EA, McAninch JW, editors. Smith's general urology. 14th ed. East Norwalk: Appleton & Lange; 1995; 237-8
  17. Adamopoulos DA, Lawrence DM, Vassilopoulos P, Contoyiannis PA, Swyer GI. Pituitary-testicular interrelationships in mumps orchitis and other viral infections. Br Med J 1978; 1:1177-80 https://doi.org/10.1136/bmj.1.6121.1177
  18. Casella R, Leibundgut B, Lehmann K, Gasser TC. Mumps orchitis: report of a mini-epidemic. J Urol 1997;158:2158-61 https://doi.org/10.1016/S0022-5347(01)68186-2
  19. Lepides J, Herwig KR, Anderson EC, Lovegrove RH, Correa RJ Jr, Sloan JB. Oxyphenbutazone therapy for mumps orchitis, acute epididymitis and osteitis pubis. J Urol 1967;98:528-30 https://doi.org/10.1016/S0022-5347(17)62928-8
  20. Erpenbach KH. Systemic treatment with Interferon-${\alpha}$2b: an effective method to prevent sterility after bilateral mumps orchitis. J Urol 1991;146:54-6 https://doi.org/10.1016/S0022-5347(17)37713-3
  21. Ruther U, Stilz S, Rohl E, Nunnensiek C, Rassweiler J, Dorr U, et al. Successful interferon-$\alpha$2 therapy for a patient with acute mumps orchitis. Eur Urol 1995;27:174-6 https://doi.org/10.1159/000475153
  22. Yi JT, Lee SD, Chung MK. 2 cases of mumps orchitis treated with systemic interferon-$\alpha$2b. Korean J Urol 1999;40:1385-8
  23. Ku JH, Kim YH, Jeon YS, Lee NK. The preventive effect of systemic treatment with interferon-$\alpha$2b for infertility from mumps orchitis. BJU Int 1999;84:839-42 https://doi.org/10.1046/j.1464-410x.1999.00273.x
  24. Yeniyol CO, Sorguc S, Minareci S, Ayder AR. Role of interferon-$\alpha$2b in prevention of testicular atrophy with unilateral mumps orchitis. Urology 2000;55:931-3 https://doi.org/10.1016/S0090-4295(00)00491-X
  25. Shulman A, Shohat B, Gillis D, Yavetz H, Homonnai ZT, Paz G. Mumps orchitis among soldiers: frequency, effect on sperm quality, and sperm antibodies. Fertil Steril 1992;57:1344-6 https://doi.org/10.1016/S0015-0282(16)55099-7
  26. Basekim CC, Kizilkaya E, Pekkafali Z, Baykal KV, Karsli AF. Mumps epididymo-orchitis: sonography and color Doppler sonographic findings. Abdom Imaging 2000;25:322-5. https://doi.org/10.1007/s002610000039
  27. Lee JW, Kim YT, Lee HM. Evaluation of the acute scrotum by color Doppler ultrasonography and radioisotope imaging in children. Korean J Urol 1996;37:671-6
  28. Carlsen E, Andersen AG, Buchreitz L, Jorgensen N, Magnus O, Matulevicuus V, et al. Inter-observer variation in the results of the clinical andrological examination including estimation of testicular size. Int J Androl 2000;23:248-53 https://doi.org/10.1046/j.1365-2605.2000.00240.x
  29. Chung KH, Choi H, Kim SW. Penile and testicular sizes of Korean children. Korean J Urol 1987;28:255-8
  30. Lee KW, Ku JH, Lee NK. Epidemiologic study about testicular volume performed in young men in Taejeon city and Chung-nam area. Korean J Urol 2003;44:49-53