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Urology (Expert Forum)
Testicle cancer VS. Epididimytis
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.
Testicle cancer VS. Epididimytis
by DeeDee1, Dec 14, 1999 12:00AM
My 43 year old boyfriend has been having problems with testicle pain for over a year off and on. Last Christmas he started having severe shooting pains in right testicle which also ran up to his abdomen, as well as lower back pain. No painful urination but very painful ejaculation and excruciating pain if testicle is touched. This initial flareup lasted for about 10 days and the took the antibiotic almost a week to make him feel better. A couple weeks after he finished his antibiotic, it came back and started hurting again. His Dr diagnosed him with epididimytis and was eventually put on long term (3 months) antibiotics, which kept him feeling good. Each time he finishes an antibiotic, the pain comes back. About 5 months ago when he had a very painful flareup, his Dr detected a lump on his right testicle. They did an ultrasound and some other tests as well as a psa test which came back normal, except to show the lump. They werent too concerned about the lump and said it would go away. Since this lump was found, the flareups come more and more often. As soon as he finishes an antibiotic, the pain and symptoms come back, and the lump is still there. He is very healthy in all other aspects and is athletic and in great shape. He never takes medicine, but is taking the antibiotics and now 2 darvocet every 4 hours for pain, so that shows how much he is hurting. His father had prostate cancer and colon cancer, so we are pretty concerned. He went back to Dr yesterday who said its epididimytis and to tough it out with the pills. He is very frustrated and is worried about cancer. Does this sound like epididimytis to you? What do you make of a lump being present with the other symptoms? I know you can only give general answers, I'm just wondering what this sounds like to you, and if you have any suggestions. Also, is there anything besides narcotics that can help with the pain. Your time and answers are greatly appreciated. Thank you
DD
Doctor's Answer
by HFHS M.D.-BL, Dec 14, 1999 12:00AM
Dear DD,
Your husband’s pain and frustration is shared by many men that are afflicted with chronic epididymitis (an inflammation of the epididymis and often the testicle.) Epididymitis is not always accompanied by a urinary tract infection, but it can sometimes require months of antibiotics and anti-inflammatory drugs to control the pain. It is difficult to give advice without actually seeing the ultrasound myself. However, it is common to see hypoechoic areas on the testicle adjacent to the inflamed epididymis on an ultrasound exam. In some patients with presumed epididymitis who fail to respond to antibiotics, a scrotal or testicular abscess may be seen on ultrasound.
Unfortunately, due to their similar presentation such as scrotal swelling and sensation of fullness, testicular cancer is often first diagnosed as epididymitis. Close follow-up is critical, and any mass that is still present after a prolonged course of antibiotics should raise suspicion. Very sensitive serum markers such as human chorionic gonadotropin (HCG) and alpha-fetoprotein (AFP) are used to help detect testicular cancer. Despite all of our recent technical advances, the treatment of an often baffling disease like epididymitis still requires a great deal of clinical judgment, and I seriously doubt that your physician would be offended if you chose to pursue a second opinion elsewhere.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-BL
Your husband’s pain and frustration is shared by many men that are afflicted with chronic epididymitis (an inflammation of the epididymis and often the testicle.) Epididymitis is not always accompanied by a urinary tract infection, but it can sometimes require months of antibiotics and anti-inflammatory drugs to control the pain. It is difficult to give advice without actually seeing the ultrasound myself. However, it is common to see hypoechoic areas on the testicle adjacent to the inflamed epididymis on an ultrasound exam. In some patients with presumed epididymitis who fail to respond to antibiotics, a scrotal or testicular abscess may be seen on ultrasound.
Unfortunately, due to their similar presentation such as scrotal swelling and sensation of fullness, testicular cancer is often first diagnosed as epididymitis. Close follow-up is critical, and any mass that is still present after a prolonged course of antibiotics should raise suspicion. Very sensitive serum markers such as human chorionic gonadotropin (HCG) and alpha-fetoprotein (AFP) are used to help detect testicular cancer. Despite all of our recent technical advances, the treatment of an often baffling disease like epididymitis still requires a great deal of clinical judgment, and I seriously doubt that your physician would be offended if you chose to pursue a second opinion elsewhere.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-BL
Member Comments (19)
by idh, Dec 27, 1999 12:00AM
To: Testicular Cancer
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by Doug Bank, Dec 27, 1999 12:00AM
To: Testicular Cancer
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by eddie.walters, Jan 12, 2000 12:00AM
To: Testicular Cancer
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by rbk, Feb 02, 2000 12:00AM
To: Testicular Cancer
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by dave, Feb 05, 2000 12:00AM
To: Testicular Cancer
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by Irene Torres, Feb 06, 2000 12:00AM
To: Testicular Cancer
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by JIM A S. CALIFORNIA, Feb 09, 2000 12:00AM
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by al, Feb 23, 2000 12:00AM
To: Testicular Cancer
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by Millie Littleford, Feb 28, 2000 12:00AM
To: Testicular Cancer
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by Fredrick Davies, Mar 13, 2000 12:00AM
To: Testicular Cancer
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by warren, Mar 16, 2000 12:00AM
To: Testicular Cancer
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by Rob, Apr 08, 2000 12:00AM
To: Testicular Cancer
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by Ryan, Apr 18, 2000 12:00AM
To: Testicular Cancer
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by Bill Stevens, Apr 22, 2000 12:00AM
To: Testicular Cancer
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by debbie, May 04, 2000 12:00AM
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by Joe, May 25, 2000 12:00AM
To: Testicular Cancer
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by Nick Bouthillette, Jun 22, 2000 12:00AM
To: Testicular Cancer
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by joel