Dr. Sandip Pramanik
Urology
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Patient's Query
Hello doctor,
I have testicular pain in the right testis. I consulted with a primary care doctor. They gave me an ultrasound which came out negative. But revealed tiny right tunica albuginea cyst. I am covered under VA health care and the urologist consultation has taken months with no follow-up. Meanwhile, I have a dull aching pain there and poor sexual performance from time to time. When I had a climax or orgasm it is very weak, uncomfortable, low volume, and unsatisfying. When at the peak I feel the dull aching and pressure in the right testis (then feel the above results). Can you help me figure out what is going on and how to fix it? I am embarrassed to talk with VA doctors of fear they would know what to do. I also have Kaiser but the doctor is new.
Hello,
Welcome to icliniq.com.
I have gone through your queries. You are having two issues. One is testicular pain. Another is PME (premature ejaculation), and ED (erectile dysfunction). Firstly, I come to testicular pain. It may be due to mild epididymo-orchitis. Or it may be due to the cyst. Do not worry. Please use tight underwear or scrotal suspensory bandage. It will help you to alleviate testicular dull aching pain. Now for the problem of ED/PME. Do you have normal morning erection? Do you have diabetes? Or any other comorbidities? Please undergo one USG (ultrasound) Doppler study of penis. It will tell you about the vascularity of penis. We can manage this problem according to the report of Doppler study. Do not worry. Both problems can be solved or rather treated successfully. Meanwhile, you can use Tadalafil 10 mg plus Dapoxetine 30 mg (30 minutes before sex). This drug will act only after you get to involve in foreplay.
Patient's Query
Thank you doctor,
Yes, I have a normal morning erections. No diabetes, I was borderline pre-diabetic about a year ago but implemented a dietary change and fixed it. Also, I had high cholesterol over a year ago and took medication for it. However, after a dietary change, I successfully eliminated the need for it. I will check into the USG Doppler and will report to you the findings.
Hi,
Welcome back to icliniq.com.
If you are having a sound morning erection, then you need not worry much about your ED, PME. The chance of getting a normal report in USG Doppler study of the penis is more. Good morning erection means good vascular flow to the penis. You do not have diabetes or any other comorbidities. That is also a good sign. You please use tight underwear to get testicular pain relieved and you may use Tadalafil plus Dapoxetine for PME issues. I think this will fix your problem. If not settled, then please contact your local urologist and get treated as you need clinical examination too and I am not able to examine you clinically.
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Urology
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