Chronic pain in Testicals

[zuma1]

About 8 weeks ago received oral from female friend with my underware on for a few moments and stopped the situation before it got out of hand. No ejaculation. No partners before that except for g/f of 15 years. Three days later, started  to not feel very well, real tired and one incident of burning after urination. Soon after developed low grade testicle pain on and off for a few weeks, sometimes with nauseau. No visable swelling in testicles. No redness at end of penis.Just a general discomfort feeling in my testicles, like being kicked in them. I have been struggleing with weight gain at the same time and jeans were aggravating the situation. The pain went away on Jan 01, but returned yesterday, still no burning or discharge. Pants tend to aggravate situation so been wereing lots of sweet pants.



I had this same situation about 5 years ago after no sexual exposure and DOC gave me rectal exam, everything ok there, checked for hernia, ok there to, and perscribed cipro and said it may be some type of bacterial infection. Went away slowly for a few more weeks after cipro was taken. I am trying to self diagnose, so I do not have to go through a list of exhaustive test of process of elimination and extensive cost in doing so and trying to zero in on what it may be.



If this is STD related or just a coincidence, which STD do you suspect? Will it clear up on its own since its been 8 weeks? or do I need treatment? If so What Kind?



I am very frightened of a swab, will I need one or will a urine test to? Digiatl rectal exams  also send steel chills down my spine and another reason I have been avoiding the Doc.



Any thoughts what this might be DOC? I am worried only about Gon, NGU and Clamidia. Not concerned about HIV, Hep B or Herps.  or Should I be?



I spoke to my friend whom I have know for five years(she is widow)and she insisted that she has not been with anyone in over four years.



I really need some direction here DOC, my primary DOC is very cold and unfriendly, and feel I cannot go to him other then normal health issues.



Thanks so much for your help!

[H. Hunter Handsfield, M.D.]

First off, just responding to the title you chose for your question, no STD causes testicular pain unless there is epididymitis, with marked swelling and tenderness to touch.  Just general aching pain isn't a symptom of any STD.  Further, the STD risk is minimal from receiving oral sex, and those that sometimes are acquired that way, like gonorrhea and herpes, usually cause overt, recognizable symptoms (dishcarge, painful urination, and/or obvious sores on the penis.  Chlamydia isn't an issue (rarely if ever acquired by oral exposure).  Finally, you describe a partner at zero risk.



Putting it all together, there simply is nothing here to even hint that you might have an STD.  As to the actual cause of your symptoms, they are typical for the sort of thing seen in people who are anxious over their sexual risks.  But if you want the reassurance of testing and aren't keen on seeing your own doc, you could visit your local health department STD clinic for confidential, expert care.  Don't worry about the swab:  since your last evaluation 5 years ago, almost all clinics have gone over to urine testing of men.  We never use swabs anymore in my clinic in men without visible urethral discharge.  And digital rectal exams aren't normal in STD checkups.



I hope this helps.  Best wishes--  HHH, MD

[zuma1]

Yes it helps very much. I have to admit, I am very anxiuos over this brief exposure. The pain is real. If it is not an STD, something else is going on down there. I brought up the digital rectal exam because doctors like to rule everything out. So It looks like I am going to get the "old bend over" as part of my exam when I visit him if this dull ache does not go away soon.



Thanks for your advice DOC, you really provide a great service.

[H. Hunter Handsfield, M.D.]

I didn't think to say it, but a prostate problem is a possible explanation for such symptoms, so a digital exam might be in store.  I don't have much sympathy for your hesitation about it--not because I'm a hard-hearted doc, but because of my own experiences as a patient.  Suffice to say I am well experienced with the receiving end "the old bend over" and a lot more.  It never seemed a big deal to me.



But don't undersell the effect of anxiety.  It doesn't matter how "real" your discomfort is; the sort of discomfort you describe could well have a primarily emotional origin.



HHH, MD