The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I am having testicular pain after unprotected intercourse, and my doctor has suspected STD after a scrotal scan. The pain lasted for a month, and the severity decreased after taking several antibiotics. The pain had almost subsided but started again when I masturbated two days back. Now, my doctor has prescribed another antibiotic. However, the severity of the pain and discomfort in my abdominal and testicular region has not reduced.
Kindly help.
Hello,
Welcome to icliniq.com.
I understand your concern and will surely help you out. You have chronic prostatitis, and the treatment is by alpha-blockers and antibiotics together for four weeks. I suggest you give a sample of semen for culture in the laboratory before you start antibiotics. I suggest you take tablet Ciprofloxacin 500 mg twice daily, and tablet Tamsulosin 0.4 mg once daily before bed for 28 days. Consult a specialist doctor, talk to him or her, and start the treatment with their consent. Please follow up after a month for further treatment, and if you get culture result after a few days, do share it with me.
Kindly revert in case of further questions.
Kind regards.
Patient's Query
Hello doctor,
Thank you for the response.
I am sharing the scrotal scan reports.
Kindly review.
Hello,
Welcome back to icliniq.com.
I have reviewed the reports (attachment removed to protect the patient's identity). There is mild hydrocele on the left testicle that can be treated with the same antibiotic. Therefore, there is no need for surgery.
Patient's Query
Hello doctor,
I am having more pain and a burning sensation on the left part of my waist and pelvic area. I have mild pain on my right side, which usually does not stay long. Also, there is no burning sensation on my right side.
Hello,
Welcome back to icliniq.com.
The symptoms point towards prostatitis. The inflammation and swelling will resolve with medications, and you will start feeling better within three days.
I hope this helps.
Thank you.
Patient's Query
Hello doctor,
It has been 17 days since I have been taking tablets of Ciprofloxacin and Tamsulosin. My testicle pain has reduced a lot. But I still feel a dull pain sometimes when I use my hand to touch it, especially the left one. However, there is no pain when I do not touch it. Currently, I have dull pain around my waist. The pain is there even when I wake up, urinate, and lie down again. The first symptom I noted before testicular pain was muscle pain near the end of my right scapula. I have to bend my back and release it when such pain occurs. The muscle pain in my back reduced when I started taking antibiotics for testicle pain.
Hello,
Welcome back to icliniq.com.
I am happy to hear that you got improved with time. The prostate responds slowly and will need a full month of treatment. If after one month you still feel some pain, then we need to give you an anti-inflammatory medication for another month (anti inflammatory is not antibiotic). For now, please continue with the medicines suggested as we look for a complete recovery in one month.
Kind regards.
Patient's Query
Hello doctor,
Thank you for the response.
I have completed the course of tablet Tamsulosin 0.4 mg and tablet Ciprofloxacin 500 mg for 28 days. The pain in my testicle has reduced but not completely. I feel very little pain when I touch my testicle and sometimes, no pain at all. I also have pain in my waist, mostly on the left side, that starts when I have testicle pain.
Hello,
Welcome back to icliniq.com.
I am happy that you improved with medications. The recovery can take longer time than medications. We try to limit usage of medications according to guidelines so symptoms can get better with time. I think your prostate got better now and pain in lower back radiating to testis can be due to colic which is ureteric stone or back pain as they both share the same nerves. For proper diagnosis it is better to have ultrasound KUB (kidney, ureter, bladder) and to see an orthopedic surgeon if there is no ureteric stone or hydronephrosis for the back pain. Multidisciplinary team management is indicated for this sort of issue. To explain clearly, now we have completed treatment for prostate so we want to rule out ureteric colic and back pain which share the same symptoms. After proper diagnosis can go with further treatment. Please keep me updated and I will advise further.
Kind regards.
Patient's Query
Hello doctor,
I am sharing the ultrasound KUB report.
Hi,
Welcome back to icliniq.com.
I have reviewed the report (attachment removed to protect the patient's identity). Bilateral hydronephrosis means both the kidneys are dilated and the kidney function might be compromised. So we need to check serum creatinine to see kidney functions, urine for culture, and MCUG(micturating cystourethrogram) scan to look for reflux. If we detect reflux, we need urodynamic studies to look for bladder pressure. Please update me about your progress. I recommend you visit a urologist in your area as your condition should be worked up well and intervention is required. If you have any questions please let me know. Kind regards.
Patient's Query
Hello doctor,
My testicle pain has not completely stopped up till now. I am still feeling little pain when I try to touch my testis. I have very little discomfort sometimes while sitting down. Kindly help.
Hello,
Welcome back to icliniq.com.
This mild pain can be due to varicocele which is dilated veins on the testis. An ultrasound scan of the scrotum can tell whether there are any abnormalities with the testis and the varicocele grade, then a treatment decision can be made. So I suggest you get a urine analysis test and a scrotum ultrasound, then I will choose the best treatment option for you. If you have any questions, please let me know.
Thank you.
Patient's Query
Hello doctor,
I am attaching the test results, scrotum ultrasound, and urine analysis test. Kindly suggest.
Hello,
Welcome back to icliniq.com.
I have seen the attached reports (attachment removed to protect the patient's identity). Your urine test is fine, but you have varicocele causing pain in the testis. The treatment of varicocele is microscopic ligation. It is a small surgery where we ligate the veins around the testicle. I hope you will be alright. If you have any more queries, please ask me.
Thank you.
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