Right Testicle Pain

[kraymerica]

Dear Dr.

I am a 40 year old male that has had right testicle pain since October 2008.
The pain is constant usually about a 3-3.5 on pain scale. Starts as low pain in morning and gradually gets worse during day.
My family GP conducted several physical exams and put me on antibiotics.
I have had a case of epididymitis 6 years ago.
After my initial 2 week anti-biotic course I had an Ultrasound done (nothing abnormal).
GP put me on a further course of anti's for a month.
Later referred me to a general surgeon. (I looked for a second opinion).
Found new GP who sent me for a CT of lower lumber section as I developed sciatic type pain down right leg.
CT showed minimal bulge between L4-L5. I consulted a Ortho surgeon who thought it as insignificant (normal for my age and job - I work as theatre OR technician).
New GP referred to Urologist who put me on 2 week course of very strong antibiotics (special registered script) and anti inflammatory tablets.
After 3 days pain was gone. It came back before I finished course.
I'm due back to Urologist in 2 weeks and according to him I'm up for a cystoscopy (don't know if this will help as I don't have urinary symptoms).
Pain is often a burning sensation up the right side of groin to top of pubic area on the inside of leg.

Where to next?

[kraymerica]

Thanks for reply, good to know someone is out there.

I've had an ultrasound of testis, no abnormalities - therefore I assume its not cancer, varicocele or spermatocele.

I don't think its Tinea cruris as the burning sensation is not on the skin but internal. Gets worse as day progresses. No rash visible.

I've had a D-dimer test when I developed right leg pain (sciatic type pain) it came back negative - I assume this rules out DVT?

I haven't has a culture sensitivity test for both semen and urine. I will get this done.

What are your thoughts on the urologist wanting to do a cystoscopy? I haven't had any urinary symptoms.

thanks.

[Dr. Kokil Mathur]

Hi
Thanks for writing to the forum!
Pain in testicle could be due to infection, like prostatitis, epididymitis or orchitis. Get a culture sensitivity test for both semen and urine done. Only orchitis will present with some redness and swelling in the testicular area. Also it could be due to referred pain of kidney stones. An ultrasound of the lower abdomen will be able to rule out kidney stones 9has been done in your case). It could be due to cancer of testis. It could be due to varicocele or spermatocele. An ultrasound of the testicles will diagnose cancer, varicocele and spermatocele (has this been done?).
Alternatively it could be Tinea cruris which is again a type of fungal infection and can cause burning sensation in the groin area. Deep vein thrombosis of the veins of the area should also be looked into.

Hope this helps. It is difficult to comment beyond this at this stage. Consult your urologist with these possibilities. Please let me know if there is any thing else and do keep me posted. Take care!