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Urology (Expert Forum)
Can hydroceles/cysts cause testicular ache, radiating pain and discomfort?
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.
Can hydroceles/cysts cause testicular ache, radiating pain and discomfort?
by bmw1, Dec 29, 2005 12:00AM
Hello, I am male, 44 years old, about 15 pounds overweight, non-smoker, very light drinker. Normal descended testicles since birth.
In January 2005, I had slight testicle discomfort and noticed a small superior/posterior lump on my left testicle. I mentioned it to my PCP during my annual physical, and went for a scrotal ultrasound the next day, in late January 2005. Also had PSA test in my physical - result 0.4 (had sex that morning AND a digital rectal exam too.) Not sure why PCP ordered PSA test, since I am under 50 and low-risk, but anyway...
Radiologists report:
"Non painful mass in scrotum. Bilateral small hydroceles are noted. There are several cysts bilaterally in the head of the epididymis which is most likely what the patient is feeling. No masses are noted within the scrotum or testicles. There is bilateral cystic dilatation of a mild degree of the rete testis - a benign finding. The largest one measures 1.3 cm on the right and 1.7 cm on the left."
My PCP received the results and did not comment about further evaluations.
Later, in July 2005, I came down with all the symptoms of a chronic UTI and was diagnosed as such by my PCP. Blood and urine work showed extensive e.coli infection and was put on short course Cipro. Went to urologist who suspected prostatitis, extended Cipro treatment for a month, and everything resolved.
About a week ago (late December 2005), I noticed transient fleeting pain down my leg which seemed to radiate from my left testicle while lying on my bed. Since then my left testicle has ached on and off, and sometimes radiates down my groin/left leg, and sometimes up a few inches toward my lower abdomen. It is not constant.
Questions:
1) Would a varicocele be seen on the ultrasound if present?
2) Are the conditions noted by the radiologist common in a man of my age? (In researching the jargon, it seems like the bilateral cystic dilatation occurs in men over 55 years old.)
3) Can the conditions noted by the radiologist correlate to any malignancies (urological, renal, testicular)?
4) Could there be a relationship between current symptoms and the recurrent prostatitis? (I have no other UTI symptoms)
5) Could the conditions noted by the radiologist have 'flared up', causing my discomfort? (i.e., cysts enlarging, more hydroceles...)
6) Would it be wise to visit my urologist AGAIN for yet another ultrasound, or could I just ride this out and see if it gets better, or at least doesn't get any worse? (It's certainly not debilitating, just occassionaly uncomfortable.)
7) How is e.coli prostatitis/UTI contracted? I have been in a monogamous relationship since 1990. (One thought is that we have infants and I had been chronically sleep deprived for 18 months at the time of diagnosis - i.e., 4-5 hours of sleep a night for 18 months). Could such little sleep severely weaken my immune system leading to such infection?
Thank you in advance for your assistance.
In January 2005, I had slight testicle discomfort and noticed a small superior/posterior lump on my left testicle. I mentioned it to my PCP during my annual physical, and went for a scrotal ultrasound the next day, in late January 2005. Also had PSA test in my physical - result 0.4 (had sex that morning AND a digital rectal exam too.) Not sure why PCP ordered PSA test, since I am under 50 and low-risk, but anyway...
Radiologists report:
"Non painful mass in scrotum. Bilateral small hydroceles are noted. There are several cysts bilaterally in the head of the epididymis which is most likely what the patient is feeling. No masses are noted within the scrotum or testicles. There is bilateral cystic dilatation of a mild degree of the rete testis - a benign finding. The largest one measures 1.3 cm on the right and 1.7 cm on the left."
My PCP received the results and did not comment about further evaluations.
Later, in July 2005, I came down with all the symptoms of a chronic UTI and was diagnosed as such by my PCP. Blood and urine work showed extensive e.coli infection and was put on short course Cipro. Went to urologist who suspected prostatitis, extended Cipro treatment for a month, and everything resolved.
About a week ago (late December 2005), I noticed transient fleeting pain down my leg which seemed to radiate from my left testicle while lying on my bed. Since then my left testicle has ached on and off, and sometimes radiates down my groin/left leg, and sometimes up a few inches toward my lower abdomen. It is not constant.
Questions:
1) Would a varicocele be seen on the ultrasound if present?
2) Are the conditions noted by the radiologist common in a man of my age? (In researching the jargon, it seems like the bilateral cystic dilatation occurs in men over 55 years old.)
3) Can the conditions noted by the radiologist correlate to any malignancies (urological, renal, testicular)?
4) Could there be a relationship between current symptoms and the recurrent prostatitis? (I have no other UTI symptoms)
5) Could the conditions noted by the radiologist have 'flared up', causing my discomfort? (i.e., cysts enlarging, more hydroceles...)
6) Would it be wise to visit my urologist AGAIN for yet another ultrasound, or could I just ride this out and see if it gets better, or at least doesn't get any worse? (It's certainly not debilitating, just occassionaly uncomfortable.)
7) How is e.coli prostatitis/UTI contracted? I have been in a monogamous relationship since 1990. (One thought is that we have infants and I had been chronically sleep deprived for 18 months at the time of diagnosis - i.e., 4-5 hours of sleep a night for 18 months). Could such little sleep severely weaken my immune system leading to such infection?
Thank you in advance for your assistance.
Doctor's Answer
by Kevin Pho, MD, Jan 02, 2006 12:00AM
, Jan 02, 2006 12:00AM
To answer your questions:
1) Yes, a varicocele would be seen on an ultrasound.
2) Hydroceles are not uncommon in a man your age.
3) A scrotal ultrasound would evaluate for testicular cancer as well. If negative, then it is unlikely that this is present. If there is concern about bladder cancer or renal cancer - a cystoscopy or CT scan can be considered.
4) It is possible that prostatitis can be related to your symptoms.
5) Any change in the conditions can be evaluated by a repeat ultrasound to see if there is any change.
6) If the symptoms continue or worsen, seeing your urologist isn't a bad idea.
7) Prostatitis is contracted by bacteria ascending up the urethra in most cases. A weakened immune system can contribute to the condition.
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.
kevinmd_b
1) Yes, a varicocele would be seen on an ultrasound.
2) Hydroceles are not uncommon in a man your age.
3) A scrotal ultrasound would evaluate for testicular cancer as well. If negative, then it is unlikely that this is present. If there is concern about bladder cancer or renal cancer - a cystoscopy or CT scan can be considered.
4) It is possible that prostatitis can be related to your symptoms.
5) Any change in the conditions can be evaluated by a repeat ultrasound to see if there is any change.
6) If the symptoms continue or worsen, seeing your urologist isn't a bad idea.
7) Prostatitis is contracted by bacteria ascending up the urethra in most cases. A weakened immune system can contribute to the condition.
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.
kevinmd_b
Member Comments (1)
by bmw1, Dec 29, 2005 12:00AM
To: Urology - General
0
