testicular discomfort/testicular retraction. No answers yet.

[tbiti]

I'm 28 yr, medical resident in fact (oncology) & haven't found a solution to my problem. Please help!

Ever since adolescence I've had some discomfort (not really pain; almost like a tingling) in both testicals leading to them feeling often partly retracted & with slight touch they retract completely into the inguinal canal. I've been to GP with not much help- told to try different underwear (i haven't been great at seeking help either).

I find the discomfort is more secondary to the testical(s) being always retracted since the odd times that they relax, there is minimal discomfort. (warm baths can make them relax completely but often short lived when i'm out of the bath)

The impact on my life has been huge as it's often difficult to concentrate with the constant retraction & my sex life is non-existent as with a little stimulation to the testicles they retract & the discomfort is too much to get aroused. (i can get erections though if i concentrate & only stimulate the penis)

No previous STD or uro infxn, never sexual active (because of this), no child illness/uro prob, N erection, N ejaculation, no d/c or blood. Otherwise healthy, no meds.

The plot thickens: In the last year, I've noticed the left side became much better (sometimes completely relaxed- not sure what caused it) but the right still retracted & with some discomfort. I never really examined my testicles much before (probably because they were so retracted) but now I can- on one occasion I felt what i thought was a mass on the right side; had an urgent uro appnt & US. At time of exam- no mass present, US completely normal (no mass, no hydro/spermat/varico-coele, no epydidymitis, no infxn). Of course they thought i was crazy (being oncology resident) & thought i "felt" my epydidymis & related the discomfort to general "inflammation" seen in reproductive years & told to learn to live with it.

I've noticed this "mass" a few times after- it's transient, ~0.5cm, infer/anter pole of testicle, seems to resolve with squeezing. When resolved, i think i feel a "membrane" fold inferiorly i don't feel compare to left side. I wonder what this is & if it's related to my discomfort/retraction.

Then recently, as i was comparing to the left, i squeezed the L epydidymis & then thought i felt a transient "bulge" in same place as left (smaller though) & now this discomfort/retraction is back on the left & i'm back to square one!! (now both testes discomfort/retraction). "bulge" has not recurred on L side.

I'm due for a f/u with uro but i want answers & i'm afraid the uro might not take my complicated story seriously with my previous "scare" & normal U/S. What might this be considering my completely normal exam (by uro & another GP) AND U/S? Can i do anything to help symptoms? I've tried nsaids with no relief.

Please help!! i know i'm not crazy!

[Kevin Pho, MD]

Difficult to say without examination.

I would assume that the common causes, like prostatitis or epididymitis, have already been ruled out.  The ultrasound certainly would be helpful in that respect.

Another option would be to consider further imaging of the scrotum - such as an MRI - to further elucidate the testicular mass.

If the urological evaluation continues to be negative, despite multiple evaluation, it may be worth exploring a referral to a neurologist to workup any nerve disorder that can be leading the symptoms.  

Consideration to physiatry or pain management can also be considered if the tests remain non-revealing.

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.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[robmc]

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