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Urology (Expert Forum)
Long term testicle pain
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.
Long term testicle pain
by Ome, Jun 15, 2005 12:00AM
I am 53 now. At age 14, my urine steam slowly diminished until there was complete blockage. I was catheterized which opened things back up but the urethra close again in about two weeks. I then had a systoscopy done and was diagnosed with a congenital urethral stricture, which my father also had. The stricture was close enough to the sphincter muscle that they decided not to open it surgically because the were afraid it might cause permanent incontinence. Instead they left in a catheter for about five days to stretch it out. That worked for a while longer but closed up again. I then started to have dialation treatments. Over the next eight years, I must have had over 50 treatments. Not only were they very painful, but the sounds would tear off large pieces of tissue and there would be much bleeding. For some reason, at age 22, my urethra finally stayed open and I have not had problems with urine flow since,(I even took a urine flow test to confirm this) although it may be a bit slow first thing in the morning.
Ever since this time I have had on and off problems with pain around my left testilcle. Even in the best of times it is very sensitive to touch. Once or twice a year, it will really flare up and cause much pain, which seems to be mostly around the spermatic cord, which is always larger than the one one the right side. Two things seem to set it off. One is an extended period of not drinking enough fluids, especially in the summer and the urine is dark. The other is ejaculation. This always seems to irritate it but too frequent sexual activity can set off a real attack of pain. My urologist always diagnoses this as Epeditimytis, sometimes with Prostatitis, and gives me a round of Doxycycline. Sometimes it clears up quickly but more often it lingers for weeks. Last time I had an ultrasound which showed nothing. PSA is normal and rectal exam is normal.
I am in the middle of one of these attacks now. I have been taking the Doxy, but having sex a couple of times over the weekend really set it off. This whole thing has affected my life daily for years. I suspect that my early problems were the cause of what I go through now. What is your opinion of what is causing my problems? Is there a course of action I can take for more permanent relief, or will I likely always have to live with this? Thanks.
Ever since this time I have had on and off problems with pain around my left testilcle. Even in the best of times it is very sensitive to touch. Once or twice a year, it will really flare up and cause much pain, which seems to be mostly around the spermatic cord, which is always larger than the one one the right side. Two things seem to set it off. One is an extended period of not drinking enough fluids, especially in the summer and the urine is dark. The other is ejaculation. This always seems to irritate it but too frequent sexual activity can set off a real attack of pain. My urologist always diagnoses this as Epeditimytis, sometimes with Prostatitis, and gives me a round of Doxycycline. Sometimes it clears up quickly but more often it lingers for weeks. Last time I had an ultrasound which showed nothing. PSA is normal and rectal exam is normal.
I am in the middle of one of these attacks now. I have been taking the Doxy, but having sex a couple of times over the weekend really set it off. This whole thing has affected my life daily for years. I suspect that my early problems were the cause of what I go through now. What is your opinion of what is causing my problems? Is there a course of action I can take for more permanent relief, or will I likely always have to live with this? Thanks.
Doctor's Answer
by Kevin Pho, MD, Jun 16, 2005 12:00AM
, Jun 16, 2005 12:00AM
With a normal ultrasound, it would make things like cancer, a cyst or varicocele/hydrocele less likely.
Prostatitis can certainly be considered - and this can be difficult to diagnose. Some cases of this may requires weeks to months of antibiotics. You may want to consider a transrectal ultrasound, which can image the prostate for any abscesses.
If the tests continue to be non-revealing, you can consider pain referred to the testicle from another source. A hernia or groin strain all can be considered.
These options can be discussed with your personal physician.
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.
Kevin, M.D.
Medical Weblog:
kevinmd_b
Prostatitis can certainly be considered - and this can be difficult to diagnose. Some cases of this may requires weeks to months of antibiotics. You may want to consider a transrectal ultrasound, which can image the prostate for any abscesses.
If the tests continue to be non-revealing, you can consider pain referred to the testicle from another source. A hernia or groin strain all can be considered.
These options can be discussed with your personal physician.
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.
Kevin, M.D.
Medical Weblog:
kevinmd_b
