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Urology (Expert Forum)
Epididymitis (chronic) Treatment options
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 (chronic) Treatment options
by mctc7777, Nov 06, 2004 12:00AM
I have two lumps in or around the epididymis on the right side. The first is on the top portion where epididymis connects to the testicle. At times it is mushy, but when i pre and post ejaculate, it gets very hard. The second lump is again, in or around the epididymis, but at the base. The consistency of this one is firm at all times. When I gently apply pressure to this one, I can feel pain shoot up through the right side of my stomach, into what appears to be the area of the abodomen. (just under the ribs.) What appears to be my spermatic cord on the right side is swollen at all times, and I have a heaviness in the right groin, and an ocassional burning sensation in that area.
I had a R inguinal hernia repair and R hydrocele repair 15 years ago. For the current issue, I went to two urologists. The first said he would remove the R epididymis. The second prescribed 30 day cycle Cipro and Celebrex to no avail. Two ultrasounds, 6 months apart showed small varicoceles. The urologist determined I have chronic epididymitus and indicates surgery to remove the epididymis is the only option. I have to take 600-1000mg of motrin at night to sleep due to the discomfort.
I am in my 30s, plan on having more kids and enjoy the sensation of ejaculating during sex.
1) Any thoughts on the diagnosis?
2) Could there be a blockage of an epididymal duct, or scar tissue from my hernia repairt that is causing this?
3) If I do the the epididymis removed, what can I expect of my sex life, and any other issues should I be aware of?
Thank you.
Doctor's Answer
by Kevin Pho, MD, Nov 08, 2004 12:00AM
, Nov 08, 2004 12:00AM
To answer your questions:
1) Tough to comment on the diagnosis without examining you. Ultrasounds are pretty good tests to help with the diagnosis. Epididymitis, epididymal cysts and varicoceles are all possibilities at this time. Having a third opinion at a major academic medical center wouldn't hurt.
2) It is possible that scar tissue from the pervious scrotal surgery may be playing a part in your symptoms.
3) I am not a urologist, so I don't have much experience with epididymectomies. My understanding is that there is a possibility of sexual dysfunction after the procedure, however this is not common. Infection and bleeding are the other complications to be aware of for the procedure.
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) Tough to comment on the diagnosis without examining you. Ultrasounds are pretty good tests to help with the diagnosis. Epididymitis, epididymal cysts and varicoceles are all possibilities at this time. Having a third opinion at a major academic medical center wouldn't hurt.
2) It is possible that scar tissue from the pervious scrotal surgery may be playing a part in your symptoms.
3) I am not a urologist, so I don't have much experience with epididymectomies. My understanding is that there is a possibility of sexual dysfunction after the procedure, however this is not common. Infection and bleeding are the other complications to be aware of for the procedure.
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
