Underlying Infection?

[going crazyyy]

Hi Doc,

i have been experiencing pain and discomfort in my left testicle and lower abdomen for over a year now.  My testicles have recently become very warm and my sac tends to sweat a lot.  Discomfort gets worse the longer I remain seated.  My urine also tend's to "dribble" after I urinate.  This results in wet underwear and a foul odour from my mid region.      

Have been tested for Chlamydia, syphilis, gonorrhea and HIV...all negative.  Also had an ultrasound done which revealed a very small Varicocele around the left testicle.  Doctor assured me this was nothing to worry about and the pain/discomfort i've been feeling is due to Chronic Epididymitis.  

I suspect the epididymitis is the result of an infection I had which was not caught in time (Chlamydia).  I also suffered a very minor cut on one of my testicles as a result of shaving.  I've wondered if this, and not Chlamydia, could have possibly led to an infection?

My question to you is regarding any possible underlying infection I might have based on the above.  As noted above, the basic std tests came back negative as did a CBC test and urine analysis.  Can you suggest or recommend any other tests I should consider?  My fear is that there might be an underlying infection or, even worse, something that can be passed on to my partners (have not engaged in intercourse since).  Also, regarding the epididmitis, is there anything I can do or take to help with it?    

      

[H. Hunter Handsfield, M.D.]

I did not say your symptoms are not "real".  Anxiety can cause symptoms that are just as real, with physiologic (not mental) origins, as a broken leg can cause.  With the male chronic pelvic pain syndrome, the pain probably originates in the pelvic musculature.  

You have my only recommendations.  Did you do the online reading I suggested?  There is no test for any STD (or any other infection) that I can think of.  Your symptoms do not suggest epididymitis.  Some urologists would consider an ultrasound of your prostate, as part of the workup for CPPS, but I have no experience with that.  In any case, there is no realistic chance you have anything that will ever harm you or a sex partner.  If I were in your situation, knowing what I know, I would probably cease seeking health care about it -- but even if I did, I certainly would not hesitate to have sex with my wife.

[going crazyyy]

Thank you for the response.

With all due respect, my "heightened level of anxiety" is not due to HIV fears.  The symptoms I feel are real (i.e. discomfort, tenderness, overly warm testicles).  Irrespective of the tests I had performed, I wanted to know if you could recommend any other ones?  Given the time frame, would an infection still be detected based on the above?  My biggest fear is that I have "something" and pass it on to my partner

What about an ultrasound?  Would that show Epididymitis?  Is there a formal test for epididymitis?  

Thanks again.  

[H. Hunter Handsfield, M.D.]

No STD is a likely cause of "pain and discomfort in my left testicle and lower abdomen for over a year now".  Ditto for the other symptoms you describe.  Your STD tests have been negative and a doctor has reassured you -- which is pretty much always more reliable than any speculation a distant online expert could make.  I'm not convinced you have "chronic epididymitis" either, but in any case no STD -- and that's as far as this forum goes.  In response to your specific question, I have no advice for additional testing.  Instead, you should rely on your own doctor's advice; or if not certain of his expertise, ask for referral for another opinion, perhaps from a urologist.

You have been asked many questions on several community forums, especially the HIV community forum, for almost 2 years.  The general tone suggests a rather heightened level of anxiety -- and certainly all the symptoms you describe here are classical for genitally focused anxiety.  You may have the chronic pelvic pain syndrome, which used to be considered a form of prostatitis but is probably usually (always?) anxiety-related.  You might google that phrase, then start your reading with the excellent Wikipedia article, which will be near the top of the google hit list.  If or when you see your doctor or a urologist about your symptoms, you might ask him or her about possible psychological origins of most of your problems in this area.

Best wishes--  HHH, MD