Gonorrhea then epididymitis - now abdominal / back pain

[jatlg]

Hi - I posted a question the other day related to this, but wanted some follow up regarding symptoms I am experiencing now.  Long story short, got gonorrhea in Thailand, was treated with Rocephin and 5 days of cefixime 400 mg 2x a day (I believe doctor didnt speak great english) symptoms cleared within a week.  About 10 days later testicles started to swell and was diagnosed with epididymitis.  

Went to urologist and was given 10 days of doxy 2x a day.  Still had minor swelling, so Dr gave me 1 more week 2x a day.  I was fine until I rowed for exercise and then my testicles swelled again.  Dr gave me Cipro 2x a day for 2 weeks.  I experienced off and on swelling thereafter for 1 week which has since subsided.

I finished the cipro 4 days ago, but am now experiencing 2 issues:

1) Dull lower back pain in the kidney region, slight lower abdominal pain and side pain, which seems to get a little worse if I flex my stomach. I have no discharge, pain when urinating, etc.  My legs and knees were sore as well, but this has recently subsided.

2) Whenever I ejaculate (or just prior to it) I notice that what I assume to be part of my epididymis at the bottom of both testicles tense up and feel firm. This lasts for 30 secs - 2 mins or so and then goes away.  It is a bit uncomfortable.  I honestly can't remember if this is normal or not, but I don't seem to remember it happening before.  

So:

1. I have read cipro can cause back pain.  Is this something I should be worried about since it is in the kidney region?  Will it subside on its own? And if so, how long would you expect it to last? I have not exercised much since getting sick and am usually very active, so I also wonder if this could be part of the pain issue.

2.  What is going on with my epididymis?  Is this a potential issue from scarring?  Or is this another example of something that will subside on its own?  It has been 6 weeks since I contracted gonorrhea and about a month since epididymitis symptoms started.  

[H. Hunter Handsfield, M.D.]

Trich is not a likely explanaiont for any of this.  Infection in men is generally asymptomatic.

I see no risk in waiting another few days to see the urologist.

That should end this thread. Whatever is going on is not an STD, even if it started with gonorrhea -- and STDs are the only topic for this forum.  Good luck.

[jatlg]

He never explicitly said it was in my head, but he did not seem concerned and seemed to insinuate it without saying it.  

Do you think I could have trichomoniasis?  I am still having back pain and abdominal pain today (of course now that I am out of town for work again).  I thought it was decreasing over the weekend, but it is definitely still bothering me and does seem to be originating from the prostate.  I still have some pain during ejaculation and noticed a tingling feeling in the urethra that started at some point today.  

Is it likely that I could have developed prostatitis associated with gonorrhea after being on antibiotics for about 5 weeks (cipro/doxy?)  

Could prostatitis/epididymitis develop as a result of trichomoniasis? I was never tested for trichomoniasis, but was tested for everything else (i.e. never given urethral swab - just had urine analyzed).  

I plan on going to the urologist again on Friday - do you think it is OK for me to wait that long?  

[H. Hunter Handsfield, M.D.]

Certainly many if not all your symptoms are consistent with anxiety focused on the genital area.  If that is your urologist's considered opinion, I suggest you give it credence.  Probably he has a lot of experience with patients with similar problems.

[jatlg]

Thanks - Good to know in the future.  

I ask online because my doctor has always been/seemed very busy and not concerned about my symptoms (not uncaring per se, just didn't think they were an issue).  To me, they obviously seem like an issue as they impact my day-to-day and this is something I have never dealt with before so it is a bit unnerving.  I am a logical, reasonable (usually) working professional, and I don't think these symptoms are in my head.  The last time I saw him I felt as if he speculated that they were.  

Have not talked to my doctor about these specifically since my last visit, but figured I would follow up online in the interim just to make sure I don't need to go see him earlier that scheduled (have an appointment for follow up in 2 weeks).

[H. Hunter Handsfield, M.D.]

This question could (and should) have been posted as a follow-up comment in your other thread.  Please ask it there for Dr. Hook's reply.  I predict that he will agree that none of your symptoms suggests continuing epididymitis or any other problem, just the nonspecific symptoms that can go along with any illness.  If you sprain an ankle, it can continue to hurt long after all signs are it has healed; the epididymis is no different.  It doesn't necessarily mean any long term problem.  Equally important, my advice -- and I'm sure Dr. Hook will agree with this as well -- is that your urologist is the person to whom you should be asking these questions.  He or she probably has a lot more experience treating epididymitis than we do, and a distant online opinion is almost always inferior to that of the doctor in charge.

My only other advice is that when you speak with your urologist about all this, ask whether s/he thinks there might be a prostate gland problem.  Your symptoms sound more like that than they do continuing epididymitis.

Regards--  HHH, MD