Therapeutic Ultrasound Versus Levofloxacin in Lipopolysaccharide-Induced Orchitis: Comparative Effects on Testicular Inflammation and Tissue Recovery in Rats.

Background & Objective: Orchitis is a testicular inflammatory disorder that may impair spermatogenesis and compromise male fertility. Although fluoroquinolones are widely used in infectious orchitis and possess ancillary anti-inflammatory properties, concerns remain regarding their potential reproductive toxicity. Therapeutic ultrasound has emerged as a noninvasive modality with anti-inflammatory and tissue-modulating effects, but its role in testicular inflammation remains poorly characterized. Methods: This study evaluated the anti-inflammatory and tissue-protective effects of levofloxacin and therapeutic ultrasound in a rat model of lipopolysaccharide (LPS)-induced orchitis. Twenty-four adult male albino rats were allocated into four groups: control, untreated orchitis, levofloxacin-treated orchitis, and ultrasound-treated orchitis. Serum CRP, IL-1β, IL-6, TNF-α, IFN-γ, and IL-10 levels were measured. Testicular weight and histopathological alterations were also evaluated. Results: LPS-induced orchitis significantly increased testicular weight and proinflammatory markers while reducing IL-10 levels (P < 0.05), accompanied by marked histopathological damage. Both treatments significantly reduced IL-1β levels (P < 0.0001). Therapeutic ultrasound produced greater reductions in CRP (P < 0.01) and IFN-γ (P < 0.05) and significantly restored IL-10 levels compared with levofloxacin (P = 0.035). Levofloxacin significantly reduced testicular weight (P < 0.01), whereas ultrasound was associated with an improved histopathological appearance. Conclusion: Both interventions attenuated inflammatory alterations in the LPS-induced sterile orchitis model. Therapeutic ultrasound demonstrated more favorable cytokine modulation and histopathological findings than levofloxacin. However, the absence of a sham-ultrasound group and the lack of reproductive functional endpoints warrant cautious interpretation and further validation before clinical translation.