My scrotal area is a little painful especially if I do not wear underwear. The pain is felt specifically on the vein surrounding the testicle. I believe that is the epididymis. Can you please advise if I have to go to the hospital or if I can get prescription medicine.
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Epididymoorchitis is a painful condition and not really mild pain. It is associated with inflammation and swelling to variable size and might be associated with hydrocele collection of water around the testis. Other related condition with mild pain is varicocele which is dilated veins around your testis but varicocele usually do not have white cells in urine. The problem can be combined as well.
For diagnosis history and examination are really important. Did this pain started suddenly or gradually? Was it severe then reduced to mild? Did this problem happened before, do you have any urinary complaints or difficulties passing urine? Did you have a urine culture done? Are you sexually active? Any blood in urine or ejaculation?
On further investigations, you will need ultrasound scrotum it can diagnose epididymoorchitis or varicocele and hydrocele with good accuracy. In addition, send me the urine report if you have otherwise you need urine analysis and culture. If you have urethral discharge or you are sexually active then I need to do more tests for that.
Please get back to me with answers and ultrasound then I can advise for further investigations and management plans.
Thank you doctor,
The pain started gradually. I think it has started a few months ago but the pain is tolerable to almost none. I just felt more discomfort probably in the last two to three weeks radiating from the scrotum and it can be felt in the urinary bladder area or lower back. I pass urine normally and no pain. But I think there is a little discharge because when urine splatters over the toilet, there is something yellowish when it gets dried. I will try to get my urine test.
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If there is discharge from urethra you need to do a swab for culture and gonococcal, chlamydia. If you are sexually active with unprotected intercourse you need to add blood tests of Hepatitis B, C, syphilis, and HIV.
Investigations for sexually transmitted infections need to be done for both partners. Please get back with results for me to decide on the treatment.
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