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Urology (Expert Forum)
Tender Testicle
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
Tender Testicle
by azone, Nov 14, 2003 12:00AM
I have been experiencing a swollen/tender feeling at the top of my left testicle and in my lower abdomen on and off for about 5 months. I am 35 yrs old.
In June I had prostatitis (diagnosed through a urine test and a prostate massage and subsequent fluid test). I also had symptoms of tenderness on the top of the left testicle (area of the epididymitis) and lower abdomin - doctor said this was epididymitis. I was given 30 days of Cipro. After 10 days symptoms of both the prostatitis and epididymitis were gone. I continued to take the medication. During the last 7 days of antibiotics the tenderness in my left testicle and lower abdomen returned.
I waited 3 weeks and went back to the doctor. Upon doing a self exam, my testicle felt normal except that it was tender near the top and the “tubes” on the left side felt more swollen than those on the right. I also felt something that seemed like a hard spot at the top of the left testicle. The doctor diagnosed my condition as epididymitis and gave me 10 days of Bactrim. He did a testicular exam and said the testicle was normal and the hard spot was a spermatocele and was not attached to my testicle.
During the 10 days I was on antibiotics I felt fine. During this time, I also went to a urologist as a recommended follow-up by my family doctor. The urologist did a testicular exam and said the testicle was normal, my urine sample was clear and he could not find the spermatocele. He said the tenderness should go away on its own. He also checked my prostate and said that was normal.
A day after finishing my 10 days of Bactrim, the tenderness returned. I waited two weeks then went back to my family doctor. He diagnosed my condition as recurring epididymitis and gave me 30 days of Bactrim with a 30 day refill. I also went back to the Urologist after about 15 days on antibiotics and he performed another testicular exam and found nothing wrong. The urologist wasn’t entirely convinced that I should be on antibiotics either. He did suggest that I take some Motrin. The tenderness went away while I was on antibiotics and I even had the refill prescription filled. After 33 days on Bactrim, the tenderness came back. I started to feel it while I was exercising on my treadmill. I took the antibiotics for about 5 more days then stopped. That was a week ago and I still have tenderness on top of my left testicle and in my lower abdomen (left side). I have no other symptoms – no burning during urination, no fever, no pain, ejaculation is normal. I have not had any injuries.
My questions are:
1) Can a urine test detect epididymitis?
2) Can I have testicular cancer without having a lump on my testicle?
3) I read somewhere that it could take several months for the swelling associated with epididymitis to go away, even though the infection is gone. Is this true?
4) Can exercising (even though not too strenuous) cause the tenderness?
5) Would a spermatocele cause a feeling of tenderness?
6) Any other tests I should have?
In June I had prostatitis (diagnosed through a urine test and a prostate massage and subsequent fluid test). I also had symptoms of tenderness on the top of the left testicle (area of the epididymitis) and lower abdomin - doctor said this was epididymitis. I was given 30 days of Cipro. After 10 days symptoms of both the prostatitis and epididymitis were gone. I continued to take the medication. During the last 7 days of antibiotics the tenderness in my left testicle and lower abdomen returned.
I waited 3 weeks and went back to the doctor. Upon doing a self exam, my testicle felt normal except that it was tender near the top and the “tubes” on the left side felt more swollen than those on the right. I also felt something that seemed like a hard spot at the top of the left testicle. The doctor diagnosed my condition as epididymitis and gave me 10 days of Bactrim. He did a testicular exam and said the testicle was normal and the hard spot was a spermatocele and was not attached to my testicle.
During the 10 days I was on antibiotics I felt fine. During this time, I also went to a urologist as a recommended follow-up by my family doctor. The urologist did a testicular exam and said the testicle was normal, my urine sample was clear and he could not find the spermatocele. He said the tenderness should go away on its own. He also checked my prostate and said that was normal.
A day after finishing my 10 days of Bactrim, the tenderness returned. I waited two weeks then went back to my family doctor. He diagnosed my condition as recurring epididymitis and gave me 30 days of Bactrim with a 30 day refill. I also went back to the Urologist after about 15 days on antibiotics and he performed another testicular exam and found nothing wrong. The urologist wasn’t entirely convinced that I should be on antibiotics either. He did suggest that I take some Motrin. The tenderness went away while I was on antibiotics and I even had the refill prescription filled. After 33 days on Bactrim, the tenderness came back. I started to feel it while I was exercising on my treadmill. I took the antibiotics for about 5 more days then stopped. That was a week ago and I still have tenderness on top of my left testicle and in my lower abdomen (left side). I have no other symptoms – no burning during urination, no fever, no pain, ejaculation is normal. I have not had any injuries.
My questions are:
1) Can a urine test detect epididymitis?
2) Can I have testicular cancer without having a lump on my testicle?
3) I read somewhere that it could take several months for the swelling associated with epididymitis to go away, even though the infection is gone. Is this true?
4) Can exercising (even though not too strenuous) cause the tenderness?
5) Would a spermatocele cause a feeling of tenderness?
6) Any other tests I should have?
Doctor's Answer
by Kevin Pho, MD, Nov 16, 2003 12:00AM
, Nov 16, 2003 12:00AM
To answer your questions:
1) A urine test may show white blood cells and bacteria in association with epididymitis. However, this doesn't happen in 100% percent of cases.
2) Typically, testicular cancer presents in a painless lump - but they may not be necessarily palpable in all cases. I would suggest a scrotal ultrasound if this is suspected.
3) It is certainly possible that it may take some months before the associated swelling completely heals from the epididymitis.
4) It is possible that exercising can exacerbate tenderness of scrotal conditions.
5) Most cases of spermatoceles are asymptommatic. However, if they enlarge, it can cause symptoms and tenderness.
6) If an ultrasound hasn't already been performed, this is what I would suggest to do next.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
1) A urine test may show white blood cells and bacteria in association with epididymitis. However, this doesn't happen in 100% percent of cases.
2) Typically, testicular cancer presents in a painless lump - but they may not be necessarily palpable in all cases. I would suggest a scrotal ultrasound if this is suspected.
3) It is certainly possible that it may take some months before the associated swelling completely heals from the epididymitis.
4) It is possible that exercising can exacerbate tenderness of scrotal conditions.
5) Most cases of spermatoceles are asymptommatic. However, if they enlarge, it can cause symptoms and tenderness.
6) If an ultrasound hasn't already been performed, this is what I would suggest to do next.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Member Comments
by dave_ross, Aug 22, 2008 10:33AM
A related discussion, Enlarged Prostrate - age 46- Cancer? was started.
