Re: all sorts of problems...

Posted By HFHS M.D.-MS on February 06, 1998 at 17:03:17:

In Reply to: all sorts of problems... posted by Jeremy on February 05, 1998 at 13:26:04:








I am a 23 year old male and for around 6 years I have experienced painful urination, lower back pain and a delayed urine stream. Plus a small pimple like bump was located on my right teste when i was 7 years old.  I was told that it was normal and wouldnt cause any problems down the line.  Well...that is still present also.  That has never caused any pain up until just recently.  About 3 months ago i was rushed to the hospital with terrible lower ab pains (about 3 inches above the apendix-level with my navel).  Doctors were testing for hernias and kidney stones and infections but could not find anything other than a minor case of epiditamitis (sp.)  The teste pain has left but there is still a tremendous amount of tendernous in my abdominal area.  To even ad more problems to the list...a week ago i notices that directly under my glans (glands) was a large swollen area (about 1/10 of the entire shaft).  It is present in both flacid and erect stages but the pain and swelling is increased in the erect stage. Next to that is a small bump under the skin.  It is consistant and does not move.  It is very hard and feels almost like there is a rock under there.  Plus with the swelling came EXTREME lower left back pain. These are all symptoms of prostititis, UTI, and a few other STD's but upon dozens of exams and ultrasounds and several different medications (cipro, sulfamex, floxin...)no doctor could identify the problem and the symptoms are still present to this day.  I know that this is nothing like im continually being told.  
Have you heard of anything resembling this wide range of symptoms?
Thank you and I look forward to you response.
Jeremy







        


Dear Jeremy;
Thanks for your question.
I think your symptoms may not all related to each other. It is difficult to say without knowing all the results of your tests. Whenever a multitude of symptoms are experienced, it is very important that diagnostic and treatment strategies are very organized.  You can help your doctors by offering a complete and accurate history of your symptoms.  It is helpful to have various tests coordinated by one practioner.  Sometimes a diagnosis is delayed until the disease process has developed tell-tale signs. The following discussion may or may not directly address your various symptoms:    
Prostatitis is typically a dull ache that is in the distribution of say boxer shorts.  It is seldom been associated with higher extreme pains you describe.  Did the ER order a IVP, IntraVenous Pyelogram or abdominal CT (computed tomography) or just an Ultrasound to see if you had a kidney stone? The ultrasound can miss some stones especially if you were passing a stone  which was not blocking the flow of urine at that moment.  It is difficult to be sure but your  episode of intense abdominal and back pain is similar to  renal colic or passing a kidney stone. If your urine analysis showed  red and few white blood cells in your urine but no or few bacteria, then a stone is more of a possibility.
Did the ER order an ultrasound of the scrotum looking at the blood flow to the testicle? This may have been done if there was suspicion of the testicle twisting on its blood supply.  This can have associated abdominal pain with nausea and vomiting.  This condition is called Testicular Torsion (TT) and is usually seen in post pubertal boys and young men.  The testicle could have untwisted during the work-up with swelling of the testicle.  TT occurs because of a developmental defect of the testicular cord attachments.
Testicular torsion, is a medical emergency and you have four hours to untwist the testicle else irreversible damage begins.  This can happen repeatedly unless surgery is done to both side to tack down the testicle to the scrotal wall  so it can not twist.            
You state you have been on several antibiotics, were you taking an antibiotic when you noted the swelling of the penis and bump?   If so, this could be what is called a Fixed Drug Eruption which is self limiting and is cured by stopping the medication which caused it.   If you can narrow it down to one medication remember not to take it in the future else you will get a similar bump and swelling.
As for the bump/ pimple of the scrotum associated with your testicle when you were 7.  It is hard to tell over the internet but maybe a sebaceous cyst.  In laymans terms, a blackhead of the scrotum.  If this is truly a sebaceous cyst, the clinical course is benign and rarely grows larger or becomes infected.

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. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653 6568).
Hope all these things are settling  down and things are back to normal.
Sincerely;
HFHS-M.D. MS
*Keyword;  Testicular torsion, Fixed drug eruption, sebaceous cyst of the scrotum