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Urology (Expert Forum)
Lump and Inital Diagnosis - Please Respond!
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.
Lump and Inital Diagnosis - Please Respond!
by Woried__0__0, Apr 08, 1999 12:00AM
Posted By HFHS M.D.-BE on April 14, 1999 at 10:29:41
Topic Area: Testicular Cancer
Any doctor's analysis would be welcome...in brief, here's my
story:
I'm 30 years old. I was born with two undescended testicles,
corrected at age 3. Knowing the increased risk of testicular
cancer, I've been pretty careful about checking myself (or so
I thought).
Woke up with sensitivity last Friday, and found a painful lump
(behind and underneath the right testicle). I've had a lingering
sinus infection for almost six weeks - treated with a course of
Amoxicillan which I just wrapped up when I found the lump.
I did the HMO runaround with my GP, who ordered up uranalysis and
a chest x-ray and got me a referral (and said she had no idea
what she was feeling down there - not encouraging). Haven't
heard anything bad back from her yet, which is probably good.
Finally got in to see the urologist; he said he was "99% sure"
the lump was an infection (from feeling), but he scheduled an
ultrasound to make sure. Haven't had the ultrasound yet. He
started me on a course of CIPRO and told me to get lots of bed
rest. He also said the Amoxicillan wouldn't have done much for
the testicular infection.
The lump is now less painful, but I don't think it's gotten any
smaller. (I've only been on the CIPRO for a day and a half.)
Lots of foot-dragging on the ultrasound scheduling, which is
bad (stressing me out). My cough (from the sinus infection) is
clearing up, though. :)
Question: can a urologist tell with reasonable certainty from
a manual "feel-up" test that a lump is probably an infection,
or was this guy just feeding me a line to make me feel better?
Since it may be a week before I get results from the as-yet
not done ultrasound, I don't want to go through another week of
sleepless panic.
Also, I've read about epidydimitis, which sounds promising, but
I don't have any fever, or urinary tract infections - just this
nagging six-week cough. Can other infections cause
lumps/swellings?
Please be straight with me...I'm trusting my urologist, but I
want to cover all avenues. I'm supposed to be moving, so I'm
putting down huge deposits on apartments and things...i.e.,
doing stuff that's not smart if I have to stick around here for
cancer treatments and not work for a couple of months.
Do doctors ever use phrases like "99% sure" when they don't mean
it?
- Dave
Topic Area: Testicular Cancer
Any doctor's analysis would be welcome...in brief, here's my
story:
I'm 30 years old. I was born with two undescended testicles,
corrected at age 3. Knowing the increased risk of testicular
cancer, I've been pretty careful about checking myself (or so
I thought).
Woke up with sensitivity last Friday, and found a painful lump
(behind and underneath the right testicle). I've had a lingering
sinus infection for almost six weeks - treated with a course of
Amoxicillan which I just wrapped up when I found the lump.
I did the HMO runaround with my GP, who ordered up uranalysis and
a chest x-ray and got me a referral (and said she had no idea
what she was feeling down there - not encouraging). Haven't
heard anything bad back from her yet, which is probably good.
Finally got in to see the urologist; he said he was "99% sure"
the lump was an infection (from feeling), but he scheduled an
ultrasound to make sure. Haven't had the ultrasound yet. He
started me on a course of CIPRO and told me to get lots of bed
rest. He also said the Amoxicillan wouldn't have done much for
the testicular infection.
The lump is now less painful, but I don't think it's gotten any
smaller. (I've only been on the CIPRO for a day and a half.)
Lots of foot-dragging on the ultrasound scheduling, which is
bad (stressing me out). My cough (from the sinus infection) is
clearing up, though. :)
Question: can a urologist tell with reasonable certainty from
a manual "feel-up" test that a lump is probably an infection,
or was this guy just feeding me a line to make me feel better?
Since it may be a week before I get results from the as-yet
not done ultrasound, I don't want to go through another week of
sleepless panic.
Also, I've read about epidydimitis, which sounds promising, but
I don't have any fever, or urinary tract infections - just this
nagging six-week cough. Can other infections cause
lumps/swellings?
Please be straight with me...I'm trusting my urologist, but I
want to cover all avenues. I'm supposed to be moving, so I'm
putting down huge deposits on apartments and things...i.e.,
doing stuff that's not smart if I have to stick around here for
cancer treatments and not work for a couple of months.
Do doctors ever use phrases like "99% sure" when they don't mean
it?
- Dave
Doctor's Answer
by HFHS M.D.-BE, Apr 08, 1999 12:00AM
_
======================================
Dear Dave,
By now you must have had your ultrasound study done, which should help your urologist determine the nature of the testicular "lump" you found. It is possible to make a relatively certain determination about the nature of a lesion ("lump") by doing a physical exam. However, the ultrasound is an added diagnostic tool. You have had improvement of symptoms in just a couple days of taking the Cipro; this is encouraging, and suggestive of a possible infectious process. You asked about epididymitis. Not all men with epididymitis also have fever or UTI. Any time a man finds a lump of any size on his testicle, he should be evaluated by a physician. Peak incidence of testicular cancer is between the ages of 20 and 40. The usual presentation of a testicular tumor is a painless swelling or a nodule (small hard bump). This may be noted incidentally by the patient or by a sexual partner, as well as during testicular examination. You have done the right thing by seeing your urologist right away. Whatever the source of your lump, your urologist is the appropriate physician to carry out the treatment plan for you.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-BE
*keyword: testicular mass
