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pain

for about a month now i have had periodic pain in my testicles and sometimes pain in my groin.  i also sometimes have scrotal discomfort and pain at the tip of my penis and lately after i masturbate i have bad penis pain for a couple of minutes.  also everyonce in a while i have some pain below my scrotum do you think this is testicular cancer and if not what could it be?
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Avatar_dr_f_tn
Hi,

The symptoms you have described could be attributed to prostatitis or epididymoorchitis.

If you have prostatitis, you will need to be treated with a course of antibiotics that the infective organism is sensitive to. This can be determined by urinalysis and/or semen analysis and culture sensitivity.
A digital rectal examination of the prostate may be carried out to check for prostate enlargement and this may be followed up by a prostate ultrasound.

Epididymitis will be checked for during physical examination and may be diagnosed on urinalysis.
The possibility of STDs will also need to be ruled out.

You will need to consult a urologist for further investigations and management.

In the interim,
you will need to keep fluid intake over 2000 ml per day;
avoid prostate irritants, such as caffeine, alcohol, citrus fruits, and spicy foods;
and practice safe sex.

Do keep us posted on your doubts and progress.
Regards
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Avatar_n_tn
So you dont think that testicular cancer is the cause of this?
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Avatar_dr_f_tn
Hi,

The symptoms you have discussed point to other causes, not to testicular cancer per se.
Testicular cancer would usually present with a hard painless lump arising from the testes, pain in semen, weight loss, and a host of other symptoms.

A urologist examining you for prostate-related problems or inflammation of the epididymis or testes would also rule out possibility of cancer of the testes.

Regards
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Avatar_n_tn
i made an appointment with the urologist and i noticed a new symptom i think that my testicles are a little more sensitive to being touched and moved around.  Does this fit in with prostatitis or epididymitis or is this a symptom of something else?
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Avatar_dr_f_tn
Hi,

The sensitivity of the testes could also be due to an inflammation of the prostate or bilateral epididymitis.

The nerve supply of the prostate gland is by the same nerve complex that also supplies part of the penis, scrotum, and inguinal region.
Any pain in the prostate can be felt with referred pain in these related structures.

Epididymitis or epididymo-orchitis presents on one side of the scrotum usually and commonly does not affect both testes at the same time.
The exception is when the orchitis is caused by viral agents.

You will need to discuss all your symptoms with the urologist including the general or systemic symptoms even if they seem unrelated to the problem. This will aid diagnosis.

Regards
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Avatar_n_tn
Sorry to bother you again but i was wondering if you could give me all of the symptoms of testicular cancer.  Thank you
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Avatar_dr_f_tn
Hi,

"Symptoms may include one or more of the following:

    * a lump in one testis or a hardening of one of the testicles
    * The testicle should normally feel smooth to the touch. Ridges may be felt because of enlarged blood vessels or tumor growth. Additionally the entire testicle may feel hard and bumpy to the touch.
    * Abnormal sensitivity (either numbness or pain)
    * loss of sexual activity
    * sexual withdrawal
    * build-up of fluid in the scrotum
    * a dull ache in the lower abdomen or groin
    * an increase, or significant decrease, in the size of one testis
    * blood in semen
    * General weak and tired feeling
    * The testicle with a tumor may be severely enlarged, as much as 3 times the original size. Simultaneously the other testicle may be shrunken in size, due to the tumor taking up the majority of the blood supply to the scrotum.

The nature of any palpated lump in the scrotum is evaluated by scrotal ultrasound, which can determine exact location, size, and some characteristics of the lump, such as cystic vs solid, uniform vs heterogeneous, sharply circumscribed or poorly defined. The extent of the disease is evaluated by CT scans, which are used to locate metastases. Blood tests are also used to identify and measure tumor markers that are specific to testicular cancer. AFP alpha1 feto protein, Beta-HCG, and LDH are the typical markers used to identify testicular cancer. The diagnosis is made by performing an orchiectomy, surgical excision of the entire testis along with attached structures epididymis and spermatic cord; the resected specimen is evaluated by a pathologist. A biopsy should not be performed, as it raises the risk of migrating cancer cells into the scrotum. The reason why inguinal orchiectomy is the preferred method is that the lymphatic system of the scrotum links to the lower extremities and that of the testicle links to the retroperitoneum. A transscrotal biopsy or orchiectomy will potentially leave cancer cells in the scrotum and create two vectors for cancer spread, while in an inguinal orchiectomy only the retroperitoneal route exists"
http://en.wikipedia.org/wiki/Testicular_cancer#Signs_and_symptoms

Regards
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