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Urology (Expert Forum)
Stones Wreaking Havoc?
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.
Stones Wreaking Havoc?
by TroubledWife, Feb 18, 2005 12:00AM
Hello. Thanks for all of the great information you offer in this forum. My husband is 43 years old and is sexually active. About 1.5 months ago, he had some tingling and slight
burning sensation upon urination. A couple of weeks later, he developed a fever of up to 104 degrees, violent shaking and the chills, and nausea/vomiting. The following day, he felt much better, but still not quite up-to-par. On the second morning after his sick episode, he discovered dark reddish brown gravel in his urine. There were about 15 pieces, and some the size of a pencil tip or smaller. He went to a general practitioner, and the doctor did a urinalysis which resulted in a diagnosis of UTI. My husband took a round of Bactrum and another medicine that made his urine bright, and he did feel much better. Two weeks later, he had pinkish/red colored semen in the evening. The following morning, prior to going to the doctor, he checked his semen again, and it was still the same. The doctor did a blood test (including a PSA test), urinalysis, and a rectal
examination. He told my husband that his prostate was “full.” He said that my husband still may have an infection of some sort, and he prescribed him 10 days of Cipro (1,000 mg). After his round of Cipro, his semen was back to normal, and he went in for the follow-up and blood test results this past Tuesday. His PSA was 3.98 (which he wonders if his ejaculating within 2 hours of the test would have affected this reading). My husband
also showed the doctor a lump in his left testicle that he has had for some years now. The doctor did some feeling around on the testicle and then pushed around up inside to check
for hernias. He said there were none; however, he touched an extremely sensitive spot, which he told my husband was his “ring.” The doctor scheduled my husband for a testicular sonogram next Wednesday. The following day, my husband could hardly walk. Yesterday and today, he is a bit better, but he has extreme discomfort in his left testicle and a line that travels up to the spot that the doctor touched on (in his lower groin). I have 3 questions:
1. Overall, what would you make of my husband's symptoms,
and do you think they may all be related?
2. Do those I described sound like kidney stones (I’ve
also heard of prostatic stones), and could the stones
have caused all of these symptoms by strictures;
perhaps he still has some stones?
3. Could the exam on Tuesday be the cause of his
testicular and groin pain, and if so, is there
anything he can take for the pain (he’s been trying -- rather unsuccessfully -- ibuprofen).
I’m sorry this is so lengthy, but I wanted to relay as much information as I can to you regarding my husband’s situation. I appreciate your time!
C.Neal
burning sensation upon urination. A couple of weeks later, he developed a fever of up to 104 degrees, violent shaking and the chills, and nausea/vomiting. The following day, he felt much better, but still not quite up-to-par. On the second morning after his sick episode, he discovered dark reddish brown gravel in his urine. There were about 15 pieces, and some the size of a pencil tip or smaller. He went to a general practitioner, and the doctor did a urinalysis which resulted in a diagnosis of UTI. My husband took a round of Bactrum and another medicine that made his urine bright, and he did feel much better. Two weeks later, he had pinkish/red colored semen in the evening. The following morning, prior to going to the doctor, he checked his semen again, and it was still the same. The doctor did a blood test (including a PSA test), urinalysis, and a rectal
examination. He told my husband that his prostate was “full.” He said that my husband still may have an infection of some sort, and he prescribed him 10 days of Cipro (1,000 mg). After his round of Cipro, his semen was back to normal, and he went in for the follow-up and blood test results this past Tuesday. His PSA was 3.98 (which he wonders if his ejaculating within 2 hours of the test would have affected this reading). My husband
also showed the doctor a lump in his left testicle that he has had for some years now. The doctor did some feeling around on the testicle and then pushed around up inside to check
for hernias. He said there were none; however, he touched an extremely sensitive spot, which he told my husband was his “ring.” The doctor scheduled my husband for a testicular sonogram next Wednesday. The following day, my husband could hardly walk. Yesterday and today, he is a bit better, but he has extreme discomfort in his left testicle and a line that travels up to the spot that the doctor touched on (in his lower groin). I have 3 questions:
1. Overall, what would you make of my husband's symptoms,
and do you think they may all be related?
2. Do those I described sound like kidney stones (I’ve
also heard of prostatic stones), and could the stones
have caused all of these symptoms by strictures;
perhaps he still has some stones?
3. Could the exam on Tuesday be the cause of his
testicular and groin pain, and if so, is there
anything he can take for the pain (he’s been trying -- rather unsuccessfully -- ibuprofen).
I’m sorry this is so lengthy, but I wanted to relay as much information as I can to you regarding my husband’s situation. I appreciate your time!
C.Neal
Doctor's Answer
by Kevin Pho, MD, Feb 21, 2005 12:00AM
, Feb 21, 2005 12:00AM
To answer your questions:
1) Tough to say whether they are related without examination. I would agree with the scrotal ultrasound to evaluate the testicular lump. If negative, I would further evaluate for prostatitis - a transrectal ultrasound can be considered to image this organ.
2) Kidney stones are certainly possible. However, there seems to be an infection present as well with the fever. Although stones can lead to infection, you want to investigate the prostate and scrotum to evaluate for prostatitis and epididymitis respectively.
3) It is possible, but unlikely, that the exam may have led to the pain. I cannot recommend any treatment without examination - so you may want to bring this up 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
1) Tough to say whether they are related without examination. I would agree with the scrotal ultrasound to evaluate the testicular lump. If negative, I would further evaluate for prostatitis - a transrectal ultrasound can be considered to image this organ.
2) Kidney stones are certainly possible. However, there seems to be an infection present as well with the fever. Although stones can lead to infection, you want to investigate the prostate and scrotum to evaluate for prostatitis and epididymitis respectively.
3) It is possible, but unlikely, that the exam may have led to the pain. I cannot recommend any treatment without examination - so you may want to bring this up 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
