Infection or not, acute or not, the pain in my scrotum is only stoppable with opioids. Surgery is not an option due to cardiac problems. What is left?

[quintby]

I was first diagnosed with prostatitis  at 30 & the 6 weeks it took to recover (with Septra DS) nearly forced me out of law school. At 40 I began a string of 'prostatitis' episodes which occurred closer & closer together while lasting longer each time. My urologist for 8 years prescribed antibiotics only after digital-rectal exam confirmed my complaints and stopped my antibiotics as soon as DRE found a normal prostate despite my continuing intense pain. I was  prescribed only Mobic & other prescription NSAIDs for pain. Consults w/ urologists at a major teaching hospital were not taken seriously considering I literally could not sit w/o hugely aggravating pain & could not work even part time. At age 53 following 6 months of horrendous pain my wife called an ambulance. In 3 minutes the ED doctor had a clinical diagnosis for me which was confirmed by color Doppler ultrasound imaging: advanced bilateral orchitis/ epididymitis. Given hydrocodone for 1st time I was incredulous at the relief it brought, but the infection only came under control after 10 days of outpatient IV antibiotic therapy of cetriaxone, 1 gram daily. But this has stopped acute symptoms:  fever, malaise, etc. but NOT the pain which strikes like a thunderclap as soon as I get up (I am fortunate that pain subsides during sleep). I have since sought help at the Epidiymitis Center at the UW med school in Seattle (I live in central California) but neither Botox injections or alpha blockers has shown much and I cannot afford regular plane trips. My condition is tolerable w/Norco x3 but I live in fear that down the line this will not continue to control. What suggestions for pain relief ( injections, surgery etc) do you think hold the best odds for longterm relief w/o opioids?  

[quintby]

I thank you for your sympathy but I know that I directed this towards an expert - at least that's what Medhelp indicated, and I was careful as I've been burned previously. Can you tell me just how I can assure that the expert whose picture I am looking at when I hit send will be the recipient?

Thanks, and sorry if I sound a bit testy.

[Tuckamore]

Hello Quintby,

Welcome to the Pain Management Community. Please be aware that there are no physicians on this site. While some of us have a medical background none of us are experts, we are chronic pain patients.

You've asked a good question. I know that advanced bilateral orchitis/ epididymitis can be very painful and even more difficult to treat and manage. You might want to consider a consult to a PMP. I do not know their criteria for taking patients with your diagnosis but it bears some investigation. They are the experts inmost states for managing chronic pain...which is what this condition may very well produce.

If you have a PCP he should be able to direct you to a good PM Clinic.

If you have not posted this in MedHelp's Urology community I encourage you to do so. We also have a Men's health Community that I would post this in also. I am sure they will have more knowledge regarding treatments and expected outcomes. If you need assistance in locating these communities please let me know.

I am so sorry that this took so long to be diagnosed. Unfortunately early DX and treatment can be a real key in the successful treatment of this condition which apparently your physicians did not provide you. My heart goes out to you.

I wish you the very best and hope that you will find better remedies. Please let us know how your well your pain is controlled.

Take Care,
~Tuck