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Urology (Expert Forum)
Epididymitis and don't know what to do next
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.
Epididymitis and don't know what to do next
by Northernspy, Sep 26, 2004 12:00AM
Short history:
I've had symptoms since February 2004, which now (September 2004) are mostly left-sided epididymitis and to some extent prostatitis. At their worst (May 2004) my symptoms were disabling -- pain made worse by sitting, sit-bone and tail-bone pain, feverishness, back-pain.
Now after nearly 3 months of antibiotics (quinolones, except for 3 months of Septra) my prostate is much better (so says a urologist after a DRE), but the epididymitis is worse (I still apply ice to my testicles several times a week). I can't take Cipro any more because of joint pains (ankles mostly, but also knees, hips, fingers, everywhere).
My urologist believes I do not have pelvic muscle disorder (he checked). Since Cipro is out of the question (he would have had me continue) now, he does not have any new suggestions. HALP!
What I have NOT had (no one suggested them):
- EPS
- transrectal ultrasound
- semen culture
What I HAVE had:
- PSA (low -- 0.6)
- testicular sonogram (cysts that are "not vascular")
- other tests all negative (spinal x-ray, pelvic MRI, stomach sonogram)
What to do? Who to see (I live in New York City)? What is my prognosis?
I am currently (starting this week) taking Zithromax on the theory that epididymitis is usually caused by chlamydia, for which Zithromax is (I believe) the drug of choice. For awhile recently I had pain in my right eye and sensitivity to light, which in my amateur desperation guess could be chalmydial induced Reiter's.
mucho thanks in advance....
- Carlos
***@****
PS my "quality of life" in the NIH scale is "24". This is a major life problem, and I am not making progress.
I've had symptoms since February 2004, which now (September 2004) are mostly left-sided epididymitis and to some extent prostatitis. At their worst (May 2004) my symptoms were disabling -- pain made worse by sitting, sit-bone and tail-bone pain, feverishness, back-pain.
Now after nearly 3 months of antibiotics (quinolones, except for 3 months of Septra) my prostate is much better (so says a urologist after a DRE), but the epididymitis is worse (I still apply ice to my testicles several times a week). I can't take Cipro any more because of joint pains (ankles mostly, but also knees, hips, fingers, everywhere).
My urologist believes I do not have pelvic muscle disorder (he checked). Since Cipro is out of the question (he would have had me continue) now, he does not have any new suggestions. HALP!
What I have NOT had (no one suggested them):
- EPS
- transrectal ultrasound
- semen culture
What I HAVE had:
- PSA (low -- 0.6)
- testicular sonogram (cysts that are "not vascular")
- other tests all negative (spinal x-ray, pelvic MRI, stomach sonogram)
What to do? Who to see (I live in New York City)? What is my prognosis?
I am currently (starting this week) taking Zithromax on the theory that epididymitis is usually caused by chlamydia, for which Zithromax is (I believe) the drug of choice. For awhile recently I had pain in my right eye and sensitivity to light, which in my amateur desperation guess could be chalmydial induced Reiter's.
mucho thanks in advance....
- Carlos
***@****
PS my "quality of life" in the NIH scale is "24". This is a major life problem, and I am not making progress.
Doctor's Answer
by Kevin Pho, MD, Sep 30, 2004 12:00AM
, Sep 30, 2004 12:00AM
I would consider another urology opinion. A culture of prostatic fluid (obtained during prostatic massage) can be discussed to ensure that the bacteria is sensitive to the antibiotics you are taking. You may also want to consider the imaging tests mentioned - specifically the transrectal ultrasound - to ensure there is no prostatic abscess. If present, antibiotics will not be effective in these cases.
If there are evidence of cysts on the testicular ultrasound, then you may want to ensure they are not causing your symptoms. If they are, removing them may be a consideration.
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
If there are evidence of cysts on the testicular ultrasound, then you may want to ensure they are not causing your symptoms. If they are, removing them may be a consideration.
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 (2)
by ozzy983, Sep 26, 2004 12:00AM
To: Prostate
0
by samuri, Nov 02, 2004 12:00AM
To: Prostate
0
