Is new pain normal after I had my testicular cancer surgery?

Question

Hello doctor,

I am a 44-year-old male. Last month, I was diagnosed with stage 1 seminoma in the right testicle and had a Rio surgery four weeks ago today. I am beginning adjuvant treatment in the next few weeks.

Last week, I experienced symptoms on the left side, and I am curious about what it may be. It can only be described as mild sensitivity in the testicle and scrotum, with occasional jarring ache that can radiate to the flank, hip, and sometimes down the hamstring.

I experienced this in the past, about a year before the seminoma diagnosis on the right side, and it lasted about four to six weeks before subsiding. In the discovery of seminoma, all imaging (US and CT, all done in the last four weeks) showed that the left one is clean.

Likewise, my urologist did a physical exam of the remaining testicle just three weeks ago. Also noteworthy, these new symptoms began a day or two after my partner and I had sex for the first time post-surgery. I am not worried about something nefarious and have full confidence in my surveillance team. But my next appointment is not until next month, and I am hyper-aware, given the recent diagnosis.

Any thoughts on what could be causing these symptoms?
Can this be mild epididymitis?

Please help.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and can understand your concern.

Stage 1 seminoma has a good prognosis, and the cure rate is almost 100 % after adjuvant therapy. I do not think this pain is related to cancer or recurrence, as cancers are painless. It might be vague pain as it radiates to many places, and if it is mild, I suggest you leave it alone.

If this pain is moderate to severe or associated with scrotal swelling, you need to get a scrotal ultrasound. The cause of scrotal pain is idiopathic (unknown cause). Mild pain comes and goes; mild epididymo orchitis inflammation causes pain, but is associated with swelling and increased size. Torsion is severe pain due to a testicular twist.

In your case, I think it is idiopathic and does not need intervention.

I hope this helps.

Please revert in case of any doubts.

Thank you.