Member Comments are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum. ALWAYS check with your personal physician before taking any action regarding your health! MedHelp International and our partners, sponsors and affiliates have no obligation to monitor any comments posted on this site, or the content and/or accuracy of such exchanges. MedHelp International does not endorse the views of any user.
Urology (Expert Forum)
Prostatitis versus Testicular Cancer: What tests should my doctor be running?
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.
Prostatitis versus Testicular Cancer: What tests should my doctor be running?
by intrepidhiker, Jul 17, 2006 12:00AM
Symptoms & symptoms: Approximately three years ago, symptoms initially occurred with intermittant stabbing pain in prostrate region. Symptoms resolved after a couple of days. Later started to develop low back pain when engaged in a lot of sexual activity. Also experienced reduced urinary stream and output.
Placed on Cipro for 14 days with relief of symptoms. Symptoms returned several days after completion of antibiotics. Placed on cipro again for 1 month. Symptoms initially resolved, but then returned while still on antibiotics.
I was unable to follow up with a doctor routinely due to my insurance and job circumstances.
About 1.5 years ago, the low back pain got steadily worse. "aching" in character followed by difficulty in urinating, then brief "burning" sensation followed by back pain relief. Small hard lump palpated on both sides of back. Painful ejaculation with reduced libido, impotence, and reduced amount of ejaculate. Reduced urinary stream. Possible soft lump in left part of the scrotum above the testicle. Possible breast swelling (although I have had that for about ten years (about an A-cup size) I thought it due to just genetics and working out).
I recently tried sulfa & cipro together with relief of symptoms for 5 days, then symptoms returned. Symptoms also seem to temporarily resolve with use of high dose anti-inflammatories.
CBC, Chem 7 and BPH levels normal.
Prostrate "normal" sized per urologist
Urine Analysis normal, although I have seen "tranlucent floaties" in it when I
experience the burning urination.
Abd/pelvis CT w/o contrast showed "possible punctate stone", but otherwise
normal.
I tried an over the counter urine pregnancy test to check for HCG and it was negative.
The backpain and impotence has severely altered my life. The pain has stopped me from exercising regularly and I've given up bicycling and many other activities. The impotence has cost me four potential relationships at this point.
I'm 36 years old, 6'2", 195 pounds. Formerly in excellent shape (I backpacked 192 miles last summer). I am still experiencing insurance difficulties and my doctor seem to want slowly treat these complaints with many office visits spaced 1 or 2 months apart. Do the symptoms more closely resemble prostatitis or testicular cancer? What tests should I expect my doctor to run? My next appointment is in 8 days.
Completely aside: I have insurance, it's just that they are fighting me on every charge.
Placed on Cipro for 14 days with relief of symptoms. Symptoms returned several days after completion of antibiotics. Placed on cipro again for 1 month. Symptoms initially resolved, but then returned while still on antibiotics.
I was unable to follow up with a doctor routinely due to my insurance and job circumstances.
About 1.5 years ago, the low back pain got steadily worse. "aching" in character followed by difficulty in urinating, then brief "burning" sensation followed by back pain relief. Small hard lump palpated on both sides of back. Painful ejaculation with reduced libido, impotence, and reduced amount of ejaculate. Reduced urinary stream. Possible soft lump in left part of the scrotum above the testicle. Possible breast swelling (although I have had that for about ten years (about an A-cup size) I thought it due to just genetics and working out).
I recently tried sulfa & cipro together with relief of symptoms for 5 days, then symptoms returned. Symptoms also seem to temporarily resolve with use of high dose anti-inflammatories.
CBC, Chem 7 and BPH levels normal.
Prostrate "normal" sized per urologist
Urine Analysis normal, although I have seen "tranlucent floaties" in it when I
experience the burning urination.
Abd/pelvis CT w/o contrast showed "possible punctate stone", but otherwise
normal.
I tried an over the counter urine pregnancy test to check for HCG and it was negative.
The backpain and impotence has severely altered my life. The pain has stopped me from exercising regularly and I've given up bicycling and many other activities. The impotence has cost me four potential relationships at this point.
I'm 36 years old, 6'2", 195 pounds. Formerly in excellent shape (I backpacked 192 miles last summer). I am still experiencing insurance difficulties and my doctor seem to want slowly treat these complaints with many office visits spaced 1 or 2 months apart. Do the symptoms more closely resemble prostatitis or testicular cancer? What tests should I expect my doctor to run? My next appointment is in 8 days.
Completely aside: I have insurance, it's just that they are fighting me on every charge.
Doctor's Answer
by Kevin Pho, MD, Jul 18, 2006 12:00AM
, Jul 18, 2006 12:00AM
Prostatitis has been appropriately evaluated with the urine tests as well as the digital exam. A transrectal ultrasound as well as sending any prostatic fluid off for analysis and culture would complete the prostate workup.
If there is concern about testicular cancer, a scrotal ultrasound can be considered. If negative, this would be an unlikely possibility.
Other considerations would include an ultrasound to evaluate vascular flow to the penis (which can lead to impotence) as well as a cystoscopy to look for anatomical strictures.
These options can be discussed with your urologist.
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.
kevinmd_
If there is concern about testicular cancer, a scrotal ultrasound can be considered. If negative, this would be an unlikely possibility.
Other considerations would include an ultrasound to evaluate vascular flow to the penis (which can lead to impotence) as well as a cystoscopy to look for anatomical strictures.
These options can be discussed with your urologist.
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.
kevinmd_
