Urinary Urgency/Thickened Scrotum

Hi,

About three months ago, I started getting urinary urgency. I feel the need to urinate - but I don't actually need to go. I have been treated for UTI and NSU. I've been checked for any sexual disease and I've been cleared on all fronts inc HIV/AIDS. I've been on three different antibiotics, but it hasn't cleared up.

I had an ultrasound on my bladder and it is emptying properly. My kidneys were also examined and appear to be fine.

Now, I also seem to have a thickened scrotum. No pain whatsoever and my testicles don't appear to be enlarged. I certainly seem to 'notice' my testicles/scrotum more. No trouble urinating or getting/sustaining an erection - if anything, my libido seems to have increased!

No blood in the urine or semen. Sometimes, a slight discomfort and I mean, very slight in the meatus on urination or ejaculation.

I am pre-diabetic.

Any ideas? My concern is that it may be bladder/testicular cancer.

[Stephen Liroff, MD]

Frequency and urgency to urinate can be caused by problems both inside and outside of the bladder. Urine infections are the most common causes and can be ruled out by a urine culture (more accurate than a urinalysis).  Bladder tumors, as you mentioned , and stones in the ureter can  also be a cause, and are usually (but not always) associated with some blood in the urine. Failure to empty your bladder as well as the presence of urethral/prostatic obstruction is another reason  Neurologic problems and pelvic masses/inflammation need to be considerations and lastly emotional issues. If things are stable then you might consider waiting and seeing if things are getting worse before going further. In part, consider how severe the symptoms are and if they are getting worse. If you have not seen a urologist yet, then you need to do so. If you have, then you need to push for  a more extensive evaluation. I would suggest a cystoscopy and a CT Urogram .
I do not see the scrotal thickening as figuring into this.
S.A.Liroff, M.D.