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Urology (Expert Forum)
Persistent Epididymitis
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
Persistent Epididymitis
by kfb5926, Oct 12, 2007 05:25PM
I'm a 35-year-old male and married.
I've had an epididymitis for about 8 months now. It causes ED and pain/swelling in testicles. Early on Levaquin 500 mg treated it effectively, but anytime I tried to lower the dosage to 250, the pain and ED returned. I've been taking Ibuprofen and Alleve for the inflammation.
Since late August though, the problems have come back and the Levaquin no longer seems to be helping. Pain is actually fairly mild, but no erections. My urologist tells me to keep taking them, that this will usually clear up. I'm taking warm baths nightly and my wife (who's about 3 months pregnant) has been supportive.
We did an ultrasound and found nothing. My testosterone levels are actually high (like 580). My doctor thinks the pain and inflammation are causing the ED.
Are there alternatives to Levaquin? I'm terribly stressed and worried. If you were me, would you seek out other doctors.
I've had an epididymitis for about 8 months now. It causes ED and pain/swelling in testicles. Early on Levaquin 500 mg treated it effectively, but anytime I tried to lower the dosage to 250, the pain and ED returned. I've been taking Ibuprofen and Alleve for the inflammation.
Since late August though, the problems have come back and the Levaquin no longer seems to be helping. Pain is actually fairly mild, but no erections. My urologist tells me to keep taking them, that this will usually clear up. I'm taking warm baths nightly and my wife (who's about 3 months pregnant) has been supportive.
We did an ultrasound and found nothing. My testosterone levels are actually high (like 580). My doctor thinks the pain and inflammation are causing the ED.
Are there alternatives to Levaquin? I'm terribly stressed and worried. If you were me, would you seek out other doctors.
Doctor's Answer
by Kevin Pho, MD, Oct 13, 2007 09:43AM
, Oct 13, 2007 09:43AM
I agree with the workup thus far, as well as the antibiotic choice. The ultrasound would rule out prostatic abscesses, which can lead to your symptoms.
A prostatic massage can be considered to send off any fluid for culture and analysis.
There may be a possibility that the bacteria may be resistant to the Levaquin - so it's important that culture and sensitivity needs to be done.
A cystoscopy can also be considered to further image and evaluate the lower GU tract.
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.
www.kevinmd.com
A prostatic massage can be considered to send off any fluid for culture and analysis.
There may be a possibility that the bacteria may be resistant to the Levaquin - so it's important that culture and sensitivity needs to be done.
A cystoscopy can also be considered to further image and evaluate the lower GU tract.
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.
www.kevinmd.com
Do you occasionally see epididymitis that take this long to treat? Do they typically clear up?