Creator: Dr. Saurabh S Pandya
Published: 2018-05-24T12:56:36-04:00

Patient's Query

Hi doctor,

I am 27 years old. I have mild pain in right testicle for a week. The nerves connecting to the right testicle are always in strain mainly in the area of epididymis and vas deference. It pains when I walk, jump, rub or masturbate. I get random swelling, irritation and pain in my right testicle.

Sometime, the pain also accompanied by fever. When there is pain, the scrotum becomes swollen and turn red. I also have pain with ejaculation.

My ultrasound was perfect, nothing came abnormal. I am having this problem since eight years.

I am taking Dolo 650, Levomac- 500 and EIDO multivitamin capsule.

Please suggest me some medication or tests to get them cured. Thank you.

Answer

Dr. Saurabh S Pandya

Urology

Hi,

Welcome to icliniq.com.

From your symptoms, I believe you are having one of the following:

Chronic inflammation of prostate (prostatitis) with pain being referred to testis.
Pelvic pain syndrome with primary involvement of testis.

Very rarely ureteric stones for repeated testicular torsion can cause testicular pain. A per-rectal examination, ultrasound of KUB (kidneys, ureters and bladders) and prostate, urine routine tests and urine culture (after per-rectal prostatic massage) will help.

Ask your family doctor to get these done or refer you to a urologist for further physical evaluation and you can get back with the reports. If you have redness, swelling of scrotum along with pain attacks and especially if there is vomiting, better get ultrasound scrotum with Doppler study to rule out recurrent torsion.

From the above details:

If it is prostatitis then treatment with antibiotics for two months will help.
In the presence of ureteric stones, get treatment of the stones as per location and size.
If it is found to be torsion then single stitch to fix the testis will be needed.
If all the above ruled out, pelvic pain then this needs long-term pain management and SOS (as and when required) physiotherapy.

Revert back with the investigations to a urologist online --> https://www.icliniq.com/ask-a-doctor-online/urologist

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Patient's Query

Hello doctor,

Ultrasound of scrotum was done. Reports are uploaded for your reference. Upper part of my right testicle is paining and it looks red when there is pain.

After masturbation my right testicle starts with pain like burning sensation. I am fearing about testicular torsion. Is it my problem? I have only pain no vomiting.

Please clarify few of my questions. My penis bend to left when erection. Is it fine for sexual intercourse? (Photos are uploaded, please see.)

Next year, I am planning to get married. But, this pain is depressing me. Can I have sex with this pain? I have a doubt on testicle epididymitis.

Which tests I have to go for to confirm this? Kindly suggest.

Answer

Dr. Saurabh S Pandya

Urology

Hello,

Welcome back to icliniq.com.

I went through your reports and photographs (attachments removed to protect patient identity).

Apparently minor bending of erected penis is normal and seen in many people. There will not be any problem in intercourse due to minor bending.

Your pain is due to chronic prostatitis. For pain you have to ask your doctor to prescribe tablet Ofloxacin 400 mg once daily for two months and tablet Tamsulosin (Flomax) 0.4 mg once daily for two months after physical evaluation.

Initially, you may have to take anti-inflammatory medicines for a week or so. Yoga and relaxation exercises will help. Finally, you need to divert your attention from the pain.

For further information consult a urologist online --> https://www.icliniq.com/ask-a-doctor-online/urologist

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