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Urology (Expert Forum)
Re: Testicle Pain
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.
Re: Testicle Pain
by HFHS M.D.-MS, Jan 01, 1995 12:00AM
Posted By HFHS M.D.-MS on July 11, 1998 at 14:42:53:
In Reply to: Testicle Pain posted by Jim Haydel on July 02, 1998 at 17:10:28:
I have recently started to experience some pain in both of my testicles. It started about 4 days ago (Sunday afternoon), and has gradually gotten worse. I went to the hospital the other day to get checked out, because there was a chance that whatever was going on had something to do with an STD. The nurse looked me over and did some tests, and assured me that I didn't have anything like herpes, but that I might have something like chlamydia, syphilis, or ghonorrea (although I didn't have any sores, discharge, etc). I did have pretty bad itching, just kind of all around my crotch, but she said that was probably just a yeast infection and told me to get some lotrimin, which is working (slowly). She gave me a shot and 7 days worth of doxycycline. Her diagnosis was urethritis, but she gave the shot because "it would kill off anything else that might be there". I've only been on the doxycycline (which she also prescribed) two days now, but it seems like my pain has gotten worse. It seems like the pain is even spreading a little into my stomach (although this is a little hard to determine, because I get bad gas aches when I drink caffeine, and its been a caffeine kind of week). This *HURTS*, I have to spread my legs when I'm sitting, and I have to walk bo-legged. The only time it doesn't hurt is when I first wake up in the morning. If doxycycline was going to help in this matter, then wouldn't I already feel a little better? Any suggestions/comments?
Any help is greatly appreciated.
Dear Jim
Thanks for your questions.
Bilateral testicular pain due to a localized process is rare and usually caused by referred pain(Pain generated from somewhere else in the body like the abdomen). You are also have abdominal complaints they maybe more related than you think. I would avoid caffeine because it confuses the clinical picture. Varicoceles are usually not acute in onset, do not present with this severity, and not usually bilateral. An acute painful bilateral varicocele is a sign of possible inferior vena caval ( the largest body vessel in the abdomen) blockage.
Epididymitis usually does not present with bilateral pain without gross swelling of the epididymis. If you have had a vasectomy or your urinalysis / urine culture was negative, the chances of bacterial epididymitis is extremely low. Mumps orchitis is a possibility however again usually not bilateral and usually affect post pubertal adolescent males. You would also have swollen parotid glands on the side of your face and neck.
The key to your diagnosis lies in a good physical exam. Test maybe needed to support or disprove clinical suspicions. A thorough physical exam of the testicles, penis, rectum, abdomen and lymphatic symptom is needed for the diagnosis. A xcrotal ultrasound may also be warranted.
More individualized care is available at the Henry Ford Hospital and its urban campuses by calling (1 800 653 6568). We can also arrange local accommodations through this number if this is your need. Please bring any physicians notes and lab test results that you may be able to obtain. These will help us greatly.
This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.
Sincerely;
HFHS-M.D. MS
* Keyword: bilateral testicular pain, atypical testicular pain
In Reply to: Testicle Pain posted by Jim Haydel on July 02, 1998 at 17:10:28:
I have recently started to experience some pain in both of my testicles. It started about 4 days ago (Sunday afternoon), and has gradually gotten worse. I went to the hospital the other day to get checked out, because there was a chance that whatever was going on had something to do with an STD. The nurse looked me over and did some tests, and assured me that I didn't have anything like herpes, but that I might have something like chlamydia, syphilis, or ghonorrea (although I didn't have any sores, discharge, etc). I did have pretty bad itching, just kind of all around my crotch, but she said that was probably just a yeast infection and told me to get some lotrimin, which is working (slowly). She gave me a shot and 7 days worth of doxycycline. Her diagnosis was urethritis, but she gave the shot because "it would kill off anything else that might be there". I've only been on the doxycycline (which she also prescribed) two days now, but it seems like my pain has gotten worse. It seems like the pain is even spreading a little into my stomach (although this is a little hard to determine, because I get bad gas aches when I drink caffeine, and its been a caffeine kind of week). This *HURTS*, I have to spread my legs when I'm sitting, and I have to walk bo-legged. The only time it doesn't hurt is when I first wake up in the morning. If doxycycline was going to help in this matter, then wouldn't I already feel a little better? Any suggestions/comments?
Any help is greatly appreciated.
Dear Jim
Thanks for your questions.
Bilateral testicular pain due to a localized process is rare and usually caused by referred pain(Pain generated from somewhere else in the body like the abdomen). You are also have abdominal complaints they maybe more related than you think. I would avoid caffeine because it confuses the clinical picture. Varicoceles are usually not acute in onset, do not present with this severity, and not usually bilateral. An acute painful bilateral varicocele is a sign of possible inferior vena caval ( the largest body vessel in the abdomen) blockage.
Epididymitis usually does not present with bilateral pain without gross swelling of the epididymis. If you have had a vasectomy or your urinalysis / urine culture was negative, the chances of bacterial epididymitis is extremely low. Mumps orchitis is a possibility however again usually not bilateral and usually affect post pubertal adolescent males. You would also have swollen parotid glands on the side of your face and neck.
The key to your diagnosis lies in a good physical exam. Test maybe needed to support or disprove clinical suspicions. A thorough physical exam of the testicles, penis, rectum, abdomen and lymphatic symptom is needed for the diagnosis. A xcrotal ultrasound may also be warranted.
More individualized care is available at the Henry Ford Hospital and its urban campuses by calling (1 800 653 6568). We can also arrange local accommodations through this number if this is your need. Please bring any physicians notes and lab test results that you may be able to obtain. These will help us greatly.
This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.
Sincerely;
HFHS-M.D. MS
* Keyword: bilateral testicular pain, atypical testicular pain
