I have chronic testicular pain. How can I get it treated?

Question

Hi doctor,

I am a 25-year-old male, and I have had a consistent dull ache in my testicles (most of the time, the left side and less of the right side) for two months. From time to time, it causes stomach aches, which I know is due to the spermatic cord going up into the abdomen.

I have also had infertility issues, and I am hopeful that this is related. I have been to two urologists since my symptoms started. The first urologist felt around and did a sonogram to rule out testicular cancer and check for epididymitis and varicocele.

According to that doctor, the ultrasound showed bilateral epididymitis and maybe some trace varicocele (he did not think that varicocele was significant enough to cause issues). He also ruled out testicular cancer due to not feeling any lumps and not seeing any on a sonogram. He prescribed me an antibiotic for 10 days to help get rid of the infection in the epididymis.

My symptoms did not subside with the 10-day antibiotic (which raised some questions for me). I was referred to a second urologist, who is also a male infertility specialist, to get the ball rolling on what is causing low sperm numbers.

This urologist prescribed me a new antibiotic that I have now been taking for almost three weeks, along with 500 mg Aleve, to take twice a day with the antibiotic. He also agreed that there was epididymitis, but wanted to order a second sonogram to make sure nothing else was going on.

My symptoms have still not gotten any better. This doctor also did a sonogram, blood work, urine testing, and two semen analyses. I will be going back for a follow-up appointment within the next week, but I am concerned that I have been taking an antibiotic for about a month, and the symptoms caused by what they claim is epididymitis have not improved.

I appreciate your help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

Please be relaxed, and do not worry.

The testicular pain you are suffering from is referred to as testicular orchialgia. First of all, I would like to say both of your urologists treated you correctly. If there is a doubt about epididymitis, it should be treated. Now, your symptoms are not getting improved, which means it may not be epididymitis.

So, most of the time, as in your case, the cause of orchialgia cannot be found. I suggest you take painkillers and wear a scrotal support for some time. Do physiotherapy or yoga for orchialgia (can be seen on the internet) and avoid any pressure on the testis. If everything fails, then you may require testicular denervation for pain (the last option).

Regarding low sperm count, it may be an incidental finding and will require a repeat semen test to confirm it.

I hope this helps.

Please revert in case of further queries.

Thank you.