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Urology (Expert Forum)
Infected vasectomy 10 yrs ago / infected epididymis now
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.
Infected vasectomy 10 yrs ago / infected epididymis now
by Indiana9, May 18, 2003 12:00AM
A vasectomy 14 years ago by a surgeon famous for successful reversals. Tested sterile 1 month later. Five months later I impregnated my wife for third child (yes mine). Wife then had tubes tied during c-section so I did not pursue re-doing my vasectomy. Ten years ago I felt pain and marble-sized lump between my body and left testicle. The surgeon suggested it was too big for an antibiotic treatment and I underwent next-day surgery. It was an infected suiture from the vasectomy. Non-cancerous, he said he cut(that side), cleaned and scrapped everything very well. He felt it was an uncommon thing to happen but not extraordinary. Since that surgery I have often felt a very slight dull ache in that location after physical exertion or sex. Last month both my wife and I felt we had bladder infectins and drank cranberry juice until we both felt better. Last week after a two day automobile trip I felt intense pain on my left testicle and in the above noted area. A TSE revealed a hardened and enlarged epididymis. Family Doctor response: infected epididymis, rare but often heals itself, prescribed DOXYCYCL HYC 100mg 2x day - 10 days.
After five days, a TSE shows the swelling and hardness of the epididymis is mostly gone but the pain is still very much present, especially between the testicle and my body.
42 years old, 22 year monogamous marriage, 3 healthly children (19,16,13), no known stds ever, no health problems except as noted above
Two part question: 1. is the Med/dose being used a passive or aggressive amount?, 2. does my history of occasionally rare but occurring problems with the same area warrant a "big picture review?"
After five days, a TSE shows the swelling and hardness of the epididymis is mostly gone but the pain is still very much present, especially between the testicle and my body.
42 years old, 22 year monogamous marriage, 3 healthly children (19,16,13), no known stds ever, no health problems except as noted above
Two part question: 1. is the Med/dose being used a passive or aggressive amount?, 2. does my history of occasionally rare but occurring problems with the same area warrant a "big picture review?"
Doctor's Answer
by Kevin Pho, MD, May 19, 2003 12:00AM
, May 19, 2003 12:00AM
Hello - thanks for asking your question.
If you are continue to have difficulty after a course of antibiotics and a testicular self-exam continue to show a hardened and enlarged epididymis, it is time to obtain imaging studies. A scrotal ultrasound should be considered to make sure that it isn't anything more - i.e. a mass or tumor, or other further complications from your previous surgery.
If the case is indeed epididymitis, you may need more antibiotics than doxycycline alone. Normally, Rocephin (an intramuscular antibiotic) is given in conjunction with doxycycline. Alternatively, Cipro as a single antibiotic should coner this as well. I would consider appropriate urine cultures and cultures for STDs such as Chlamydia or gonorrhea.
As for the "big picture review", I would re-evaluate that if you continue to have symptoms despite more aggressive antibiotics and a negative ultrasound.
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.
Thanks,
Kevin, M.D.
If you are continue to have difficulty after a course of antibiotics and a testicular self-exam continue to show a hardened and enlarged epididymis, it is time to obtain imaging studies. A scrotal ultrasound should be considered to make sure that it isn't anything more - i.e. a mass or tumor, or other further complications from your previous surgery.
If the case is indeed epididymitis, you may need more antibiotics than doxycycline alone. Normally, Rocephin (an intramuscular antibiotic) is given in conjunction with doxycycline. Alternatively, Cipro as a single antibiotic should coner this as well. I would consider appropriate urine cultures and cultures for STDs such as Chlamydia or gonorrhea.
As for the "big picture review", I would re-evaluate that if you continue to have symptoms despite more aggressive antibiotics and a negative ultrasound.
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.
Thanks,
Kevin, M.D.
