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5 Dr. visits no end in site
I am (well was) a sexually active 26 year old male. Last July I woke up in the middle of the night with pain in my right testicle. Went back to bed and woke up feeling fine and didn't think much of it. Over the next week or two I had some pain at night in my lower right groin region. I still did not think too much of it as over the past few years I would occasionally have some very very mild pain in the lower right groin area. After a couple weeks of nightly groin pain, I woke up one morning and the right testicle was hurting quite bad. This time it did not go away. I went to a doctor and was referred to a Urologist.
1st visit – urine was "clear" with no visible/palpable swelling. I was instructed to wear a jock-strap and take advil.
2nd vist - Pain had not subsided. I was given Doxycycline for 10 days + Mobic assuming Chlamydia.
3rd visit - Z-Pak and scrotal ultrasound. Ultrasound said I had a thickening in the tail of the right epididymis indicating the onset of epididymitis.
4th visit – Another Z-Pak.
5th visit - Pain has now also developed permanently in my lower right groin. I can feel soreness in the tubes/veins on the right side just as they leave my groin. Urine was still clear and returned from the lab as sterile after all visits. Was given Cipro. 7 days 500mg once a day.
After two days of Cipro for the first time in 4 months it felt as if the vulcan grip on my right testicle had finally been released. That was 2 days ago. No further improvement since then and pain is now starting to worsen.
Could it be Gonorrhea (never any discharge and sterile urine on 5 different lab urinalyses)? Would a cephalosporin be worth a shot?
Also, do you have a suggestion as to the type of doctor or clinic I should go visit as I think this is a bacterial STD because of the initial success of the Cipro treatment? Do you agree? Urologist does not.
What should my next steps be? How do find the right doc/clinic? I would love to get rid of this hell!
1st visit – urine was "clear" with no visible/palpable swelling. I was instructed to wear a jock-strap and take advil.
2nd vist - Pain had not subsided. I was given Doxycycline for 10 days + Mobic assuming Chlamydia.
3rd visit - Z-Pak and scrotal ultrasound. Ultrasound said I had a thickening in the tail of the right epididymis indicating the onset of epididymitis.
4th visit – Another Z-Pak.
5th visit - Pain has now also developed permanently in my lower right groin. I can feel soreness in the tubes/veins on the right side just as they leave my groin. Urine was still clear and returned from the lab as sterile after all visits. Was given Cipro. 7 days 500mg once a day.
After two days of Cipro for the first time in 4 months it felt as if the vulcan grip on my right testicle had finally been released. That was 2 days ago. No further improvement since then and pain is now starting to worsen.
Could it be Gonorrhea (never any discharge and sterile urine on 5 different lab urinalyses)? Would a cephalosporin be worth a shot?
Also, do you have a suggestion as to the type of doctor or clinic I should go visit as I think this is a bacterial STD because of the initial success of the Cipro treatment? Do you agree? Urologist does not.
What should my next steps be? How do find the right doc/clinic? I would love to get rid of this hell!
Thanks for the quick response. Amazing actually...
I wanted to use this forum as a reality check on my treatment. Also, even though my urologist is highly regarded by my doctor and seems to be highly competent, he is not the best communicator.
I became anxious after reading about the CDC recommendation in 2007 that a third generation cephalosporin is the only recommend treatment for gonorrhea in California and that I had not been treated with that class of antibiotic. Sometimes the worst part about these medical issues are not physical pain, but the emotional stress and anxiety.
It sounds like the proper steps are being taken. Also it is good know that I don't have to be on the run from romance in fear of spreading some horrible disease.
For $15 you guys provide an amazing service! Keep it up.
I wanted to use this forum as a reality check on my treatment. Also, even though my urologist is highly regarded by my doctor and seems to be highly competent, he is not the best communicator.
I became anxious after reading about the CDC recommendation in 2007 that a third generation cephalosporin is the only recommend treatment for gonorrhea in California and that I had not been treated with that class of antibiotic. Sometimes the worst part about these medical issues are not physical pain, but the emotional stress and anxiety.
It sounds like the proper steps are being taken. Also it is good know that I don't have to be on the run from romance in fear of spreading some horrible disease.
For $15 you guys provide an amazing service! Keep it up.
MEDICAL PROFESSIONAL
Reacting first to the title you chose for your question: If 5 visits to qualifed health care professionals have not come up with clear solutions to your medical problem -- whatever it turns out to be when I read the question -- it is very unlikely that a distant online forum, no matter how expert, can solve the problem.
Now I have read the question. Unfortunately, my gut reaction is confirmed.
"I woke up in the middle of the night with pain in my right testicle": An STD is a possible cause of such a symptoms, but not the most likely explanation.
2nd visit: "Doxycycline for 10 days + Mobic assuming Chlamydia": Was a test for chlamydia not done? What were your risk factors for STD? New sex partner recently? Multiple partners?
3rd visit: "thickening in the tail of the right epididymis indicating the onset of epididymitis": Epididymitis due to chlamydia or gonorrhea (the only STD causes of epididymitis) was pretty much impossible at this point, since you had already received doxycycline -- which would have cured chlamydia for sure and usually gonorrhea as well.
4th visit: Continuing symptoms despite azithromycin (Z-pak) was further evidence that an STD was not the problem.
5th visit: Continuing pain despite yet another course of azithromycin: Still stronger evidence against STD.
Subsequent improvement (but then not so much) on ciprofloxacin: There is no STD that responds to cipro but not azithro and doxy. Theoretically gonorrhea could do that, but there are many other reasons to be confident gonorrhea was not the problem. My guess is that no infection of any kind is the problem here. However, your urologist may be correct, that you had a non-STD infection with an organism of the type that commonly causes urinary tract infections, like E. coli and others.
My advice is to continue to work with the urologist about this. It is clear that no STD explains this problem.
Good luck. I wish you well --- HHH, MD
Now I have read the question. Unfortunately, my gut reaction is confirmed.
"I woke up in the middle of the night with pain in my right testicle": An STD is a possible cause of such a symptoms, but not the most likely explanation.
2nd visit: "Doxycycline for 10 days + Mobic assuming Chlamydia": Was a test for chlamydia not done? What were your risk factors for STD? New sex partner recently? Multiple partners?
3rd visit: "thickening in the tail of the right epididymis indicating the onset of epididymitis": Epididymitis due to chlamydia or gonorrhea (the only STD causes of epididymitis) was pretty much impossible at this point, since you had already received doxycycline -- which would have cured chlamydia for sure and usually gonorrhea as well.
4th visit: Continuing symptoms despite azithromycin (Z-pak) was further evidence that an STD was not the problem.
5th visit: Continuing pain despite yet another course of azithromycin: Still stronger evidence against STD.
Subsequent improvement (but then not so much) on ciprofloxacin: There is no STD that responds to cipro but not azithro and doxy. Theoretically gonorrhea could do that, but there are many other reasons to be confident gonorrhea was not the problem. My guess is that no infection of any kind is the problem here. However, your urologist may be correct, that you had a non-STD infection with an organism of the type that commonly causes urinary tract infections, like E. coli and others.
My advice is to continue to work with the urologist about this. It is clear that no STD explains this problem.
Good luck. I wish you well --- HHH, MD
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
