Persistent Testicular Discomfort: Seeking Answers for Ongoing Pain

Q: Persistent Testicular Discomfort: Seeking Answers for Ongoing Pain

Hello： There are two possibilities： 1) The treatment at the clinic is nearly complete, so the hospital believes there is no significant issue, or 2) it could be discomfort related to the muscles or the spermatic cord. <br>There are two approaches： 1) Visit a medical center for an

Testicular discomfort?

Last year, I had acute epididymitis, which resolved after a few months.
However, it has recurred this year.
I have been taking medication from a clinic for almost three months now, but there has been no improvement.
The clinic doctor said it is mild, but why has it lasted so long? A month ago, I went to a large hospital for an examination.
The doctor examined my testicles and said everything was fine, attributing it to mild varicocele, and prescribed me pain relief and muscle relaxants.
After taking those, I felt no effect at all, so I returned to the clinic's medication (which is antibiotics).
While the antibiotics do not make my testicles feel worse, there has still been no improvement until now.
If I get an ultrasound, will it reveal what is happening with my testicles? What should I do? I really can't stand this every day.

Bang, 10~19 year old female. Ask Date: 2019/10/28

Dr. Du Shixi reply Urology

Hello: There are two possibilities: 1) The treatment at the clinic is nearly complete, so the hospital believes there is no significant issue, or 2) it could be discomfort related to the muscles or the spermatic cord.
There are two approaches: 1) Visit a medical center for an examination to determine the most likely issue, and 2) pay attention to lifestyle habits, such as avoiding prolonged standing or sitting, minimizing activities that exert pressure on the scrotum and perineum, maintaining a light diet, wearing loose-fitting underwear, and engaging in gentle exercise for 20-30 minutes daily.
P.S.
You can search online for the symptoms of acute epididymitis.
Wishing you good health.

Reply Date: 2019/10/28

More Info

Persistent testicular discomfort can be a challenging issue, especially after experiencing acute epididymitis, which is an inflammation of the epididymis often caused by infection. It’s understandable that you are seeking answers, especially since your symptoms have persisted despite treatment.
Firstly, it's important to recognize that the testicular area is complex, and various conditions can lead to discomfort. After an episode of acute epididymitis, some individuals may experience lingering pain or discomfort due to several reasons, including residual inflammation, scarring, or even chronic epididymitis. The fact that you have been treated with antibiotics suggests that your healthcare providers are considering an infectious cause, but if the symptoms persist, it may indicate that the initial infection has resolved but left behind some lingering issues.

You mentioned that a doctor diagnosed you with mild varicocele (enlargement of veins within the scrotum) during your visit to a larger hospital. Varicoceles can cause discomfort and are known to affect fertility, but they are often asymptomatic. If the discomfort you are experiencing is indeed related to a varicocele, it may not necessarily respond to antibiotics, as it is not an infectious condition.
Regarding your question about ultrasound, yes, an ultrasound can be very helpful in evaluating the testicular area. It can provide detailed images of the testicles, epididymis, and surrounding structures. An ultrasound can help identify any abnormalities such as fluid collections, masses, or changes in blood flow that might explain your ongoing discomfort. It is a non-invasive procedure and is often the first step in evaluating testicular pain.

If you have not already done so, it may be beneficial to seek a second opinion from a urologist, especially one who specializes in male reproductive health. They can perform a thorough examination, review your medical history, and possibly recommend further imaging studies like an ultrasound or even a Doppler ultrasound to assess blood flow in the area.
In terms of management, if the ultrasound shows no significant abnormalities, treatment options may include pain management strategies. Nonsteroidal anti-inflammatory drugs (NSAIDs) can help alleviate discomfort. If a varicocele is confirmed and is deemed to be the source of your pain, surgical options may be considered, especially if it is causing significant discomfort or affecting fertility.

Lastly, it’s essential to communicate openly with your healthcare provider about your symptoms and the impact they have on your daily life. If the current treatment is not effective, do not hesitate to express your concerns and ask for alternative options or referrals to specialists who can provide a more comprehensive evaluation and management plan.

In summary, persistent testicular discomfort following an episode of acute epididymitis can be multifactorial. An ultrasound can help clarify the underlying cause, and seeking a urologist's opinion may provide you with the answers and relief you need. Remember, it’s important to advocate for your health and ensure that you receive the appropriate care for your symptoms.

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