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Avatar universal

Maybe a swollen testicle or epidimitis?

I am married.  I have unprotected sex with my wife all the time. I had a vasectomy 5 years ago. Since then I will occasionally develop pain in my testicles. I thought I had a hernia and have been to the emergency room, pcp, and a urologist.  All over the course of the last 5 years. Never found a problem.. My urologist thought perhaps that I had nerve damage, but that was about all.

3 weeks ago I started to get the pain again. This time however my testicles seemed to swell.  It really only seems to be the right one, or the right side. It was real bad for about 3 days, then tapered off and kinda comes and goes. I started searching for causes of testicle pain, and of course have found probably to much information. I have since started panicking to the point of not eating.  I read that chlamydia and ghonerea can cause this so I have been taking some expired amoxicillin and cephalexin to see if that helped it. I can't really tell if it did, and I have been self medicating myself for 2 weeks.  The last 2 days the pain seemed to disappear, but last night my testicles were hanging very, very low. I definitely noticed a difference.  I believe I felt a lump on top of my testicle, or a tube like bump. I have no discharge that I can see, and really no pain when urinating. Unfortunately I have been so nervouse and hypersensitive that its ometimes is hard to tell if I have a symptom. This morning, my scrotum is pretty tight to my body. This is how its been most of the last 3 weeks.

My wife hasn't complained of any symptoms as far as I know. I am thinking about going to the ER today.  I
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239123 tn?1267647614
MEDICAL PROFESSIONAL
I also scanned your follow-up message and understand an emergency room doc diagnosed epididymitis.  It is true that "lots of things" can cause it. You say nothing about your sexual lifestyle, but sort of imply you are mongamous with your wife and she is unlikely to have other partners, in which case the STD risks obviously are low.  In younger men (e.g, under 30-35) and others at risk for STD, chlamydia and gonorrhea are by far the most common.  In older men or men who have had recent urological instrumentation (e.g., catheter insertion, surgery) and men who have insertive anal sex, non-STD bacteria (e.g., the infamous E. coli) are most common.  Some cases aren't infectious.  For example, the cardiac drug amiodarone can cause a toxic reaction with epididymitis, and other drugs may as well.  And although I have not heard of vasectomy or other procedures on the scrotum/testes predisposing to epididymitis years afterward, it would not surprise me if this happens from time to time.  And it's also true that there are cases whose cause simply can't be determined.

You should have been tested for gonorrhea and chlamydia; I hope the ER doc did this--as well as a urine culture for common non-STD bacteria.  He also should have taken a sexual history.  But if you are currently monogamous with your wife, and are confident in her fidility, then that overrides the STD risk and you'll need to look to other causes.  Also, most cases caused by gonorrhea or chlamydia also have evidence of urethritis, ie discharge, uncomfortable urination, etc; without those, the likelihood of STD is lower.

Take the antibiotics as directed, await test results, and perhaps follow up with a urologist.  And of course if this does turn out to be STD, your wife will need to be tested and treated.

Good luck--  HHH, MD
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Avatar universal
Sorry for posting again, not trying to rush your post.  Just wanted to add something else..

Weight loss, and loss of appetite.  I have probably lost 5-10 pounds the last 3 weeks.  May be attributed to the anxiety, but thought it was important to note.
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Avatar universal
Something else I wanted to point out.. About two weeks ago I noticed a sore spot on near my tonsils.. Also, my eyes are red and irritated.  The spot seems to be gone but I still do have a little bit of a sore throat.  Maybe unrelated, but wanted to add.
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Avatar universal
Earlier today I definitely felt my right epididymis swollen.. Now its not so swollen, and the left one appears to be quite swollen and hurts a bit.. WHat in the world!
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Avatar universal
Ok. I went to the ER.  They took urine and did an ultasound. The doctor said it appears to be Epidimytis. He also said I have an small epididymal cyst on both testicles.  He told me Epidimytis can be caused by lots of different things. Oddly, never mentioned STD.  He is treating me with doxycycline and naproxen.  He told me the swelling wasn't too bad.

Should I be concerned with having sex with my wife. And as a precaution, or pain prevention, should I abstain anyways?  Should I worry about these cysts?
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