Scared and Confused

[worriedalot]

Hi Doctor:

I am only 21 yrs old. About 3 months ago, I started having very bad pain in my right testicle, within a week, it started radiating or also occuring in my left testicle, after a visit w/ my doc., he said he though i had epidiymitis and gave me a 10 days worth of dyoxacycline, I did not ejaculate while taking it, but felt pain go away, after 14 days, I ejaculated and almost nothing came out.  After a few more attempts, I got back to near normal amounts coming out.

Throughout the past 3 months I have continued to have pain in the tesicles and radiating groin pain (mainly right side, sometimes left)  There seem to be 2 or 3 prominant blue vessels sticking out of my right testicle and one on the bottom of my left.  I do not have the bag of worms feeling, but I do have alot of pain. I am at most pain when my testes are droppy and hot, like after work or a jog.  I must say my right testicle does not feel like it is in the right spot, it feels a bit higher and doesn't sit in the same relaxed position that my left testicle sits at.

I have lost about all of my libido and even sometimes have trouble iwth erections.  When I ejaculate lately, it feels like someone is kicking me in the testes as they rise up to my body very fast (no blood though).  My urine flow seems a little weaker,, maybe just a little less force but I do not have frequent urination or dribbling.  Lately there is also no force when I ejaculate.

I have been on Propecia for about 2 years and have not been taking it regaularly over the past few months, as I thought my problems could be related to the sexual side effects.  Furthermore, the only sexual encounter I had was about 15 months ago ( got oral from a very questionable lady, all tests came out clean). I embrassingly probed myself in the rear earlier this yaer after reading that it would heighten sexual pleasure.  I am not gay and it was surely not very pleasuarble.  I just do not if that incident played a role in anything either.  The only things I found were prostatis and variococele.

Could there be a problem with my prostate or can a varicocle cause this or perhaps epidymitis?  I am sorry for the long question but I just don't know what to do.

[Kevin Pho, MD]

All of the considerations you mentioned are possibilities.  I would definitely get the prostate checked by your physician as well as a scrotal ultrasound to evaluate for any infection, masses or varicocele.  

Also with the prostate, you may want a more thorough evaluation for prostatitis - including sending out the prostatic fluid for analysis and culture.  

Regarding the radiating groin pain, this can be evaluated for a hernia - either with imaging studies (i.e. ultrasound or CT scan) or with a physician exam.

I would also have the testosterone level checked - since a low level can lead to erectile dysfunction.

These options can be discussed with your personal physician.

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

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