Epididymitis and orgasm

Hello Dr.
Thirteen days ago (I'll reference as Day 1) I woke up with pain and swelling in my left testicle. Nothing unusual had been noticed the previous night. Thought it might possibly be associated with an erection that had not ended in a release. Masturbated and, in a short time, uncontrollably ejaculated blood and semen. This was without orgasm. Also, my urine had some blood. Researched on the internet, About six hours later went to the ER. Was given an ultrasound and gave a urine sample. Utrasound checked out OK, Unspecified Epididymitis was diagnosed (lab takes 6 days) and was given 1 gram of Zithromax (pill) and 1 gram Rocephin (injection). Was also given a prescription for Bactrim DS tablets (Sulfamethoxazole-TMP DS was substituted by pharmacist). Started these pills on Day 2. My problem is that I have not had an orgasm since this started, though I do ejaculate without any pain. On Day 3, I felt better and masturbated and ejaculated with a little blood in semen) After this episode no more blood was visible in semen or urine. Day 5 masturbated, ejaculated with slightly more control. Days 5 to 11 had very slow improvement to pain/swelling. Days 12 and 13 I felt 80% of normal. Masturbated, felt some more control, but no orgasm & ejaculation time was short. Will this improve? Can't see my internal medicine Dr. for another 18 days (Day 31). Also ER said they would call me if I needed a new prescription based on the lab report. They haven't called and I am getting better, except for the orgasm problem. Thanks in advance.

[Edward W Hook, MD]

Welcome to the Forum. Several comments before we get you your primary question:

1. The antibiotics you took are highly effective for STD and for the urinary tract bacteria which can cause urinary tract infections and complicating epididymitis.  
2.  The blood in your ejaculate is a process called hematospermia which is a descriptive term.  When this occurs, it is often transient and when that is the case, there is usually no detectable cause.  It tends to go away without complication or problem.  I would not worry about it unless it recurs.

As far as the orgasm issue, as distinct from ejaculation, this is unusual and there is little explanation for it from an STD perspective.  My advice would be to try the urology Forum on this site.  Sorry I can't clarify things more- hope this helps.  EWH

[yikes00]

Forgot to mention that the affected testis has a lump on the bottom. From what i read this can be expected with epididymitis. Like I mentioned, the ultrasound did not show anything that would have changed the diagnosis. Could this affect orgasm? I'll try the urology forum if you don't have any other info. Thanks again.

[Edward W Hook, MD]

The lump could be normal and in fact, with a normal ultrasound, almost certainly is.  Let us know what the urologist says.  EWH