I am a 23 yo M w/ no significant past medical history. For the past 7 months I have been experiencing bilateral testicular pain only upon palpation of my testicles on a certain area next to the epididymis bilaterally. At the same time I wake up in the middle of the night 3-4 times to urinate. I went to a urologist who said I have an inf inflamed testicular cyst on the right side and possibly a case of low grade epididymitis bilaterally. He also said most likely have overactive bladder. Started me on Levaquin 500mg PO QD x 7 days and Vesicare 10mg PO QD.The cyst went down but the pain around the epdidymis persisted w/ no change. After 4 weeks of Vesicare I still have no change in my nocturia. I had an ultrasound of my bladder, testicles, kidneys all normal. I then had a cystoscopy done which showed no abnormalities besides a tight sphincter. My urologist told me to continue the Vesicare which I have been doing. At my latest follow up I had a trace of a urinary infection which he said was most likely from the cystoscopy prescribed me Cipro 500 mg PO BID x 10 days. I am to return for another follow up in 2 weeks. However I still pain in my testicles, radiating to my inguinal area and lower abdomen. I also still wake up in the middle of the night 3-4 times to urinate. This is driving me crazy. I am a medical student about to start residency and I cant take it anymore. I have no pain w/ ejaculation. I have no erectile dysfunction. I have no pain with urination. I only use the bathroom 2-3 times during the day. My CBC w/ diff was normal. I had complete metabolic panel done it was normal. HBa1C 4.5. Thyroid tests all normal. Full STD panel including HIV negative. Complete hepatic panel negative
The urologist I used to work for would probably do an IVP next, I think. CT scans supposedly make it obsolete, but CT scans deliver quite a bit more radiation. He used IVPs to identify stones, mostly. Not all stones show on plain x-rays, but an IVP shows blockage even if the stone doesn't show up on the film.
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