Q. I have on and off mild testicular pain for the past four weeks. Kindly help.

Answered by
Dr. Samer Samer Juma Ali Altawil
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Feb 03, 2021

Hello doctor,

I have had testicular pain for the last four weeks on and off on both testicles at different times. It started about weeks ago when I developed inflamed and tender lymph nodes in my groin and an inflamed penis, so I went to my GP and was prescribed Flucloxacillin 500 mg for what was thought to be balanitis. After a few days, my symptoms completely cleared up, but a day or afterward, I noticed a dull pain in my testicles, which was made worse by exercise or wearing tight pants. So, I went back to my GP, who proscribed me Ciprofloxacin 500 mg. This did not help, so I went to the hospital where I had numerous tests such as a full STI check, which came back clear urine test which showed no infection, and an ultrasound on my kidneys and testicles, which was also clear. Please help.



Welcome to

This testicular pain is not caused by infection; therefore it is not responding to antibiotics. As you said, testicular ultrasound is normal. Therefore, there is no varicocele. Dull testicular pain can also be idiopathic, especially if there is no inflammation or obvious cause. This pain management can be done in hospital settings if pain medications will not work.

You can take tablet Amitriptyline 10 mg at night. I hope you will be well.

Thank you doctor,

So what do you think is the cause of the pain?



Welcome back to

As there is no infection and ultrasound is normal, there is no obvious cause. The only I thing can see from your presentation is pain increase when you exercise which indicate increased blood flow increases the pain and this usually present in varicocele and for diagnosing varicocele ultrasound is accurate which showed normal so the cause can be idiopathic (unknown) as with many people pain is idiopathic.

Management of this pain is by antibiotics that you already took, like Ciprofloxacin. The second line of treatment is Amitriptyline. The third line is injectable pain killers in the spermatic cord, and the fourth line will be denervation surgery.

Please take the medication and update me if no improvement.

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