Testicular ache

-40 year old male with constant left testicle ache
-Diagnosed in January with Prostatitis and secondary infection epididymitis. Shot of Torolac(?) and doxyclcine as well as urised, dolobid and flomax
-Negative results on PSA and ultasuond

-Felt better until a month ago...now have a recurrent ache.

-Urologist now has had me on 30 days of CIPRO, urised, flomax and dolobid
-Three days ago gave a shot of Kenalog
-No relief to date; the doctor also suggested surgical options

My question at this point is twofold:

1)Is there anything more effective we should be trying to combat the discomfort...it feels fine in the morning but hurts quite a bit after sitting a while

2)I guess the doc is treating chronic prostatitis...what are the next steps...I'm off to see him again in two weeks

[Kevin Pho, MD]

Hello - thanks for asking your question.

Chronic prostatitis is difficult to treat.  Make sure that prostatic massage with culture of prostatic secretions were performed to make sure an bug is sensitive to the antibiotics you are taking.

Transurethral microwave thermotherapy is a treatment that may improve comfort and this can be discussed with your urologist.

Sometimes prostatitis is associated with bladder neck spasm.  Urodynamic studies can be performed to see if medications (i.e. terazosin, diazepam) can help for bladder spasm or any pelvic floor dysfunction.

If the antibiotics are not helpful, an ultrasound can be performed to make sure an abscess is not present.  

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.

Thanks,
Kevin, M.D.