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Epididymitis? Cause?
Brief History:
33 male in a long term, monogamous relationship with a woman
August 24th - Very drunkenly had intercourse with a sex worker. Vaguely remember using a condom
August 26th - Started having mild discomfort in my penis, not just after urinating, but kind of an achiness
August 27th - Went to GP and told him what was going on. He told me that I probably had nothing to worry about, but gave me 5 days of Doxycycline just in case and said that if symptoms persisted, to get std tested
August 29th - Still worrying, I went and got STD tested anyways (G&C NAAT urine). All tests came back negative.
September 9th - Had a friend prescribe me another week of doxycycline because I was still worried about the whole thing
September 16th - Near the end of my second round of doxy, I started feeling a bit of mild achiness/pain in my testicles
September 23rd - Went to urologist and was examined by the PA. Told me that there was a little fullness in the right testicle and diagnosed me with epipididymitis. Prostate was normal. She gave me 2 weeks of ciproflaxin.
October 7th - Went back for follow up with PA. She didnt physically examine me, only asked if pain/swelling had gone down, and I told her that there was still some residual pain/achiness. She said that sometimes infections are hard to reach & gave me another 2 weeks of cipro. She also told me to make sure that I had testicular support and rest. Said they not make a follow up appointment unless I called and said something was wrong. She said at that point they would want to schedule an ultrasound
October 10th - Went back and had another gonnorhea/chlamydia test performed, still came back negative.
Today, October 14th - Still mild achiness in my right testicle,and only have 1 week left of the cipro
33 male in a long term, monogamous relationship with a woman
August 24th - Very drunkenly had intercourse with a sex worker. Vaguely remember using a condom
August 26th - Started having mild discomfort in my penis, not just after urinating, but kind of an achiness
August 27th - Went to GP and told him what was going on. He told me that I probably had nothing to worry about, but gave me 5 days of Doxycycline just in case and said that if symptoms persisted, to get std tested
August 29th - Still worrying, I went and got STD tested anyways (G&C NAAT urine). All tests came back negative.
September 9th - Had a friend prescribe me another week of doxycycline because I was still worried about the whole thing
September 16th - Near the end of my second round of doxy, I started feeling a bit of mild achiness/pain in my testicles
September 23rd - Went to urologist and was examined by the PA. Told me that there was a little fullness in the right testicle and diagnosed me with epipididymitis. Prostate was normal. She gave me 2 weeks of ciproflaxin.
October 7th - Went back for follow up with PA. She didnt physically examine me, only asked if pain/swelling had gone down, and I told her that there was still some residual pain/achiness. She said that sometimes infections are hard to reach & gave me another 2 weeks of cipro. She also told me to make sure that I had testicular support and rest. Said they not make a follow up appointment unless I called and said something was wrong. She said at that point they would want to schedule an ultrasound
October 10th - Went back and had another gonnorhea/chlamydia test performed, still came back negative.
Today, October 14th - Still mild achiness in my right testicle,and only have 1 week left of the cipro
MEDICAL PROFESSIONAL
2.5 days is enough time for reliable G and C testing by NAAT. Your negative result was valid.
Thanks for your kind comments about the forum. We're glad to be of help.
Thanks for your kind comments about the forum. We're glad to be of help.
Thank you doctor.. I really appreciate your response, and it seems that guilt and anxiety have probably caused most if not all of what I've been feeling. I had one other question for you on this matter. I did have one other std test that I didnt mention before I started the first round of doxy from my GP. I tested negative for G+C (NAAT) on that one as well, but it was only 2.5 days post encounter. Would that have been too early to detect either? Because as you said, the subsequent tests all came after I had started treatment.
Finally, I have to say that what you do on these forums is a great thing. Searching any type of symptoms on the internet produces so much anxiety and after reading for a while you are sure that you have something. You help people to alleviate those fears with an objective diagnosis, and I thank you for that.
Finally, I have to say that what you do on these forums is a great thing. Searching any type of symptoms on the internet produces so much anxiety and after reading for a while you are sure that you have something. You help people to alleviate those fears with an objective diagnosis, and I thank you for that.
MEDICAL PROFESSIONAL
As noted above, if your testicular pain has anything to do with the sexual encounter, I would suspect a psychological origin -- i.e. genitally focused anxiety. You virtually admit to that diagnosis on your own. Personally, I see no need for an ultrasound -- but as noted above, you should discuss next steps with the urologist.
MEDICAL PROFESSIONAL
Welcome to the forum. Thanks for your question.
The opinion of a urologist has after direct examination has to be respected. On the other hand, your symptoms are not at all typical -- most epididymitis cause much more dramatic symptoms than you describe, the amount of swelling is dramatic (almost always on only one side), and tenderness on touch is extreme. I have to suspect your urologist considered epididymitis a possibility but not confirmed -- perhaps influenced by your desire for a definitive diagnosis. In any case, it's virtually impossible to have sexually acquired epididymitis after doxycycline, especially given the amount of it that you took. The failure of your symptoms to improve promptly and completely after still more doxy, and then with ciprofloxacin, almost certainly does not mean you have an infection resistant to those drugs. The true interpretation is that you never had a bacterial infection to start with.
There are several other reasons I am confident you do not have sexually acquired epididymitis from the encounter described: condom use makes it pretty much impossible; and you had no symptoms of urethritis (penile discharge, painful urination) which usually are present with sexually acquired epididymitis. To me, your symptoms are typical for genitally focused anxiety and I'm inclined to doubt you have (or had) any infection of any kind from the sexual encounter described.
It was a mistake for the first doctor to treat you with doxy before testing you. Even if you had started out with gonorrhea or chlamydia, that treatment would have cleared it up. Your subsequent negative tests are 100% proof you were not infected at the time you were tested. There are no tests to tell if you might have been infected before you were treated, but I strongly doubt you were. In any case, there is no point in any further STD testing.
Of course you should discuss these thoughts with your urologist or the PA; they have exmained you and I have not. But I very much doubt you have (or ever had) any STD. If you have not resumed unprotected sex with your regular partner, you should do so now. There is no realistic chance you could transmit anything to her.
Best regards-- HHH, MD
The opinion of a urologist has after direct examination has to be respected. On the other hand, your symptoms are not at all typical -- most epididymitis cause much more dramatic symptoms than you describe, the amount of swelling is dramatic (almost always on only one side), and tenderness on touch is extreme. I have to suspect your urologist considered epididymitis a possibility but not confirmed -- perhaps influenced by your desire for a definitive diagnosis. In any case, it's virtually impossible to have sexually acquired epididymitis after doxycycline, especially given the amount of it that you took. The failure of your symptoms to improve promptly and completely after still more doxy, and then with ciprofloxacin, almost certainly does not mean you have an infection resistant to those drugs. The true interpretation is that you never had a bacterial infection to start with.
There are several other reasons I am confident you do not have sexually acquired epididymitis from the encounter described: condom use makes it pretty much impossible; and you had no symptoms of urethritis (penile discharge, painful urination) which usually are present with sexually acquired epididymitis. To me, your symptoms are typical for genitally focused anxiety and I'm inclined to doubt you have (or had) any infection of any kind from the sexual encounter described.
It was a mistake for the first doctor to treat you with doxy before testing you. Even if you had started out with gonorrhea or chlamydia, that treatment would have cleared it up. Your subsequent negative tests are 100% proof you were not infected at the time you were tested. There are no tests to tell if you might have been infected before you were treated, but I strongly doubt you were. In any case, there is no point in any further STD testing.
Of course you should discuss these thoughts with your urologist or the PA; they have exmained you and I have not. But I very much doubt you have (or ever had) any STD. If you have not resumed unprotected sex with your regular partner, you should do so now. There is no realistic chance you could transmit anything to her.
Best regards-- HHH, MD
I am worried that something has been missed, or at least about what caused the epididymitis to begin with. Looking on the web points to gonnorhea/chlamydia being the main reasons. I never had any discharge, and had 2 negative std tests since the encounter. Could the testicluar pain be coincidental or is it likely caused from encounter? Also, I'm not 100% sure if I ever had epididymitis to begin with. I know that I have a lot of anxiety about this, and have read that stressing about it can actually cause/worsen any potential symptoms. Should I schedule an ultrasound just to be safe, or is it a waste at this point?
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Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
