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Urology (Expert Forum)
Repeat Episode of Testicular and Back Pain
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.
Repeat Episode of Testicular and Back Pain
by tuner, Nov 02, 2004 12:00AM
In late September I started getting this small pain in the groin - seemed to be in testicular area, but there didn't seem to be any swelling. It was just a vague pain in the area. Shortly afterwards I started feeling generally run-down, spaced-out (even very dizzy) and the pain started getting worse. Two other symptoms were that my skin got very bad, and I developed a lower back pain.
This is actually a repeat of an episode I had earlier this year in the spring. Exactly the same symptoms, and it lasted for two months. Each time (both earlier this year and now), I did go to the doctor and had blood drawn, and he checked me out. The doctor couldn't find anything unusual either time. I tried a short course of Cipro in the spring and it didn't help.
As the first episode did correspond with the beginning of a sexual relationship with my girlfriend, I was thinking it might be STD-related. However, at the time both she and I were screened and negative for gonhorrea, chlamydia, syphilis and HIV. Just to be sure, I was screened and negative for the same again recently. When the spring episode ended, the only symptom that persisted was a tenderness under my arms. Again, no swelling. And that is still going on now.
This time my skin was very bad, and I was even suspecting genital herpes. I had two furuncles on my buttocks, a red patch of skin (no sensation, just red) at the top of the "crease" where the leg meets the abdomen, and pink, itchy, irritated skin on scrotum. But I went to the dermatologist and he said none of that was indicative of herpes. He gave me some cortizone cream that cleared up the red patch, and the skin has largely gotten better.
This time my doctor, on a hunch that it could be chronic protatitis, has me on a 14-day course of 750mg of levaquin. I'm about 9 days into it and I don't really feel any better.
So, I really don't know what's going on here - I've been dealing with this for over a month now. My groin and lower back hurt all the time, especially when sitting down. I have this permanent fog in my head and at times I'm alarmingly unsteady, and it's affecting my work and social life. I just have no energy and feel drained all the time, and have difficulty sleeping. When it happened the first time and went away, I closed the book on it. But now that it has come back it has me very concerned.
I am in very good health - eat well and run between 15-30 miles a week (when not feeling like this). Any help or advice is appreciated.
This is actually a repeat of an episode I had earlier this year in the spring. Exactly the same symptoms, and it lasted for two months. Each time (both earlier this year and now), I did go to the doctor and had blood drawn, and he checked me out. The doctor couldn't find anything unusual either time. I tried a short course of Cipro in the spring and it didn't help.
As the first episode did correspond with the beginning of a sexual relationship with my girlfriend, I was thinking it might be STD-related. However, at the time both she and I were screened and negative for gonhorrea, chlamydia, syphilis and HIV. Just to be sure, I was screened and negative for the same again recently. When the spring episode ended, the only symptom that persisted was a tenderness under my arms. Again, no swelling. And that is still going on now.
This time my skin was very bad, and I was even suspecting genital herpes. I had two furuncles on my buttocks, a red patch of skin (no sensation, just red) at the top of the "crease" where the leg meets the abdomen, and pink, itchy, irritated skin on scrotum. But I went to the dermatologist and he said none of that was indicative of herpes. He gave me some cortizone cream that cleared up the red patch, and the skin has largely gotten better.
This time my doctor, on a hunch that it could be chronic protatitis, has me on a 14-day course of 750mg of levaquin. I'm about 9 days into it and I don't really feel any better.
So, I really don't know what's going on here - I've been dealing with this for over a month now. My groin and lower back hurt all the time, especially when sitting down. I have this permanent fog in my head and at times I'm alarmingly unsteady, and it's affecting my work and social life. I just have no energy and feel drained all the time, and have difficulty sleeping. When it happened the first time and went away, I closed the book on it. But now that it has come back it has me very concerned.
I am in very good health - eat well and run between 15-30 miles a week (when not feeling like this). Any help or advice is appreciated.
Doctor's Answer
by Kevin Pho, MD, Nov 03, 2004 12:00AM
, Nov 03, 2004 12:00AM
The prostate would still be suspicious, and there are some cases of prostatitis that are difficult to treat. Extended (i.e. several months) courses of antibiotics are required in some cases.
I would consider obtaining some prostatic fluid and sending it out for culture and analysis. This can be done after a digital rectal exam.
Another consideration would be a prostatitc abscess - where antibiotics aren't much help. A transrectal ultrasound can be considered to evaluate this.
These options can be discussed via a urology referral.
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.
Medical Weblog:
kevinmd_b
I would consider obtaining some prostatic fluid and sending it out for culture and analysis. This can be done after a digital rectal exam.
Another consideration would be a prostatitc abscess - where antibiotics aren't much help. A transrectal ultrasound can be considered to evaluate this.
These options can be discussed via a urology referral.
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.
Medical Weblog:
kevinmd_b
