pain in testies

Iam a 50 year old white male.I have had some discomfort in both tecticles for some 10 years now.I have been to the urologolist and they say it is a low grade infection and usually prescribe trimetropin.This usually makes the symthoms go away.I just got back from a 500 mile trip and it really hit fast and hard.Severe  pain in both testicles and lower back pain.Riding in an automobile for long periods always has seemed to irritate this condition.The first time this ever happened was ten years ago and it happened after a trip.Same as this time except this time is a lot more intense and the antibiotics are not working nearly as fast as in the past.Wondering what this could be?

[Kevin Pho, MD]

Prostate infections are the first thing that comes to mind.  These infections can present with testicular pain and back pain.  They can be very difficult to treat.  I would suggest a digital rectal exam to evaluate the prostate and obtaining prostatic secretions to send off for culture and analysis.  Tests for gonorrhea and chlamydia should be done as well as a urinalysis.  There are some cases of prostatitis that require 4-12 weeks of antibiotics.  If the trimethoprim isn't working, another antibiotic should be considered.

If the diagnosis is still unclear, imaging studies can be obtained.  This would include a transrectal ultrasound to evaluate the prostate and a scrotal ultrasound to evaluate for any scrotal infections.  

If the symptoms persist, you may want to consider a second urological opinion.  

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.

[Nick280]

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