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Urology (Expert Forum)
Chronic Epididymitis
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
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.
Chronic Epididymitis
by tony100, Jan 19, 2005 12:00AM
I am 52 years old, uncircumsised and with some little genital warts that I had all my life.
14 months ago I begun to have some disconfort that went from some peeling on the head of the penis (diagnosed and treated as yeast infection), that later turn into urethritis were I got my first round of CIPRO.
6 months ago the disconfort increased and I had severe pain (a 9 out of 10 in the pain scale) in the left testicle. This was diagnose as epididymitis by several urologist (3 at least) and initially treated with antibiotics Cipro (first, 4 weeks), Cipro (again 4 weeks), Bactrim (6 weeks), Cipro XR (6 weeks) and lately Dyoxicyclin (2 weeks).... After the initial treatment the pain went down (in two weeks) from 9 (out of 10 in the apin scale) to severity 2 or 3, and has remain that way since.
What I feel is a little bit of pain is in both sides of the penis (on the body not on the penis itself), and mainly, burn/pain on the back of the left testicle.
One Dr. recomended to treat the varicocele first... which I did three weeks ago (on the left side), and indeed, the pain in the left side of the penis has gone... all the other pain remains i.e. right side of the penis and on the back of the left testicle.
So....
1. What next?
2. I will like to get a hold of an specialist in this matter and not a generic urologist (I have used google with no success) (Georgia or New Jersey area much better)
3. One urologist suggested that I should have the epipidymis removed... I wonder how will be my life after that and what are the implications and success rate
After all
14 months ago I begun to have some disconfort that went from some peeling on the head of the penis (diagnosed and treated as yeast infection), that later turn into urethritis were I got my first round of CIPRO.
6 months ago the disconfort increased and I had severe pain (a 9 out of 10 in the pain scale) in the left testicle. This was diagnose as epididymitis by several urologist (3 at least) and initially treated with antibiotics Cipro (first, 4 weeks), Cipro (again 4 weeks), Bactrim (6 weeks), Cipro XR (6 weeks) and lately Dyoxicyclin (2 weeks).... After the initial treatment the pain went down (in two weeks) from 9 (out of 10 in the apin scale) to severity 2 or 3, and has remain that way since.
What I feel is a little bit of pain is in both sides of the penis (on the body not on the penis itself), and mainly, burn/pain on the back of the left testicle.
One Dr. recomended to treat the varicocele first... which I did three weeks ago (on the left side), and indeed, the pain in the left side of the penis has gone... all the other pain remains i.e. right side of the penis and on the back of the left testicle.
So....
1. What next?
2. I will like to get a hold of an specialist in this matter and not a generic urologist (I have used google with no success) (Georgia or New Jersey area much better)
3. One urologist suggested that I should have the epipidymis removed... I wonder how will be my life after that and what are the implications and success rate
After all
Doctor's Answer
by Kevin Pho, MD, Jan 20, 2005 12:00AM
, Jan 20, 2005 12:00AM
To answer your questions:
1) I would ensure that any bacteria that grew from the culture are resistant to the antibiotics you have obtained. There are some cases that require an extended period of antibiotics, and this should be discussed (i.e. several months of therapy). You may also want to consider imaging to ensure an abscess isn't present.
2) You may want to inquire about an infectious disease specialist if multiple urologic referrals aren't getting you anywhere.
3) I am not a urologist, so I cannot comment on success rates for surgery for epididymitis. That being said, I am not familiar with this approach, and this can be discussed with another urological opinion - preferably at a major academic medical center.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
1) I would ensure that any bacteria that grew from the culture are resistant to the antibiotics you have obtained. There are some cases that require an extended period of antibiotics, and this should be discussed (i.e. several months of therapy). You may also want to consider imaging to ensure an abscess isn't present.
2) You may want to inquire about an infectious disease specialist if multiple urologic referrals aren't getting you anywhere.
3) I am not a urologist, so I cannot comment on success rates for surgery for epididymitis. That being said, I am not familiar with this approach, and this can be discussed with another urological opinion - preferably at a major academic medical center.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
Member Comments
by tony100, Jan 26, 2005 12:00AM
To: Urology - General
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