Dr. Madhav Tiwari
General Surgery
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 a 30-year-old male. Ten weeks ago, my sperm showed no liquefication, low mobility, and a high count of leukocytes. Eight weeks ago, I experienced severe sudden pain on the right side of the scrotum, specifically on the epididymis. I do not have a bacterial infection in the urine, and the ultrasound was normal. I underwent surgery to exclude testicular torsion, but it was not testicular torsion, so I was given antibiotics for 18 days. After three weeks of being forced to bed by the pain, the discomfort reduced, and I could go back to my normal life, still with some manageable distress in the right testicle. Now, eight weeks after the surgery and four weeks from the end of acute pain, I was still experiencing discomfort and went to the urologist, who performed another ultrasound. He identified a scrotal mass, which was spheroid and 1 cm in diameter. The mass was absent in the various ultrasounds I had eight weeks ago. Tomorrow I will have a blood check for cancer markers. What can I expect? What does it mean for me if the result comes back positive? Is surgical removal the most likely outcome? What will be the next step if the result comes back negative? Kindly suggest.
Hello,
Welcome to icliniq.com.
It seems highly unlikely that a testicular tumor would have been missed on various ultrasounds before your surgery. Where did the doctor say the lesion was? Was it within the testis or outside? More likely, it could be an infection, infarct, torsion, or infection of the appendix, testis, epididymal cyst, or abscess. Kindly share the ultrasound report and images for a more detailed analysis. You must get the tumor markers tested. If the markers are positive, you will have to get an orchidectomy and imaging for further evaluation. If the test reports are normal, you will need regular follow-ups. I suggest you do not worry and get the tests done one by one.
Thank you.
Patient's Query
Hello doctor,
On the day of the surgery, the ultrasound looked nominal. Six days after the surgery, another urologist reported my testis to be swollen. I was already taking antibiotics at that point. Today, a different urologist took the ultrasound, and I am attaching the reports for your reference. Kindly suggest.
Hello,
Welcome back to icliniq.com.
I have seen the ultrasound reports you have attached (attachment removed to protect the patient's identity). So the lesson is definitely within the testis. I suggest you get the tumor markers checked and then proceed accordingly.
Thank you.
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General Surgery
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