Testicular Pain: Diagnosis and Treatment Options - Internal Medicine

Abdominal issues?

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On December 8, I visited a clinic in Tainan due to left testicular pain.
The doctor prescribed medication, but after three days of taking it, there was no improvement.
On December 12, during a follow-up visit, I asked the doctor if it could be a varicocele.
The doctor only performed a physical examination and concluded it was not, prescribing a stronger medication for five days (as the doctor described).
After finishing the five-day course, I still experienced pain and wanted to undergo an ultrasound examination, so on December 17, I went to another clinic where I was diagnosed with a varicocele.
I also recall the doctor mentioning inflammation of the spermatic cord.
The doctor prescribed anti-inflammatory and pain relief medication for five days.

On December 22, since I still felt discomfort in the testicle and had soreness in the inner thigh (though it had decreased significantly from a severity of 5 to about 2-3), I returned to the clinic.
The doctor again prescribed anti-inflammatory and pain relief medication for seven days and recommended that I go to a larger hospital for further examination.
Later, due to a long wait for an ultrasound at Cheng Kung University Hospital from December to February, I decided to visit Shuanghe Hospital in New Taipei City on January 5.
At that time, the left scrotum no longer had significant pain.
After the ultrasound, the doctor diagnosed me with mild varicocele and prescribed antibiotics and pain relief medication for seven days.

On January 12, since I still felt discomfort rated at 2-3, I returned for a follow-up, and the doctor continued the medication for another seven days, adding Clonidine.
On January 17, I experienced abdominal bloating and discomfort, with tenderness in a specific area of the lower left abdomen (I suspect it was the sigmoid colon, but this was not confirmed).
Sometimes, the discomfort felt nonspecific.
At that time, I no longer had soreness in the inner thigh or testicle.

On January 19, I reported my symptoms to the doctor at Shuanghe, who suggested that this referred pain required a CT scan (urography).
I scheduled the scan for January 26 and a follow-up on January 29.
However, on January 20, feeling extremely uncomfortable, I went to Yadong Hospital's emergency department, where blood tests, urinalysis, and abdominal ultrasound (to check the liver and kidneys) were performed, all of which came back normal.
The X-ray indicated that excessive stool was causing my symptoms, so I was given a glycerin suppository and prescribed a stool softener.

On January 21, there was no significant improvement in the bloating and pain, and I experienced slight burning discomfort in the stomach area.
Therefore, on January 22, I visited the gastroenterology department at Yadong Hospital.
The doctor did not recommend further tests but prescribed laxatives, stomach medication, and prokinetic agents.
From January 22 to January 27, I consumed a lot of vegetables, engaged in brisk walking and running, and as I passed stool, the bloating gradually improved, and I felt increasingly comfortable.
During this period, I had bowel movements about three times a day, sometimes yellow and sometimes dark brown and harder stools.
I believed these were the stools that needed to be expelled, as I no longer felt discomfort.
Consequently, I canceled the CT scan previously scheduled with the urology department and did not return for follow-up.

On January 28, the bloating returned, but it was not as severe as on January 17, when I also experienced abdominal pain and discomfort in the stomach area during prolonged walking.
On January 29, since most of the doctors I had seen previously spent only 4-7 minutes with me, I went to a pediatrician recommended by a friend to explain my entire medical history for an initial assessment.
The pediatrician (whose specialty seemed to be general internal medicine) concluded that I had taken too many medications, leading to gastrointestinal damage, and indicated that I had a gastrointestinal virus.
He advised me not to see other doctors or take random medications and prescribed Gasgel and Panadol.
He did not recommend further examinations for the gastrointestinal issues but suggested I visit the urology department at Fu Jen Catholic University.

On January 31, there was still no significant improvement in the bloating.
I would consistently feel the urge to have a bowel movement in the morning, and after doing so, the bloating would lessen.
However, after eating during the day, I would still gradually experience some bloating, while stomach pain had mostly subsided.
From January 31 to February 8, I did not experience much bloating, but I had two bowel movements daily—soft stools in the morning and diarrhea in the afternoon.
During this period, I still had slight soreness in the perineum, some tenderness in the epididymis, and occasional soreness in the inner left thigh.
I underwent an endoscopy and fecal occult blood test at Yadong Hospital, which only indicated gastroesophageal reflux, while the rest was normal.
When I visited the urology department at Yadong Hospital, the doctor merely advised me to relax (which is difficult when in pain).

Later, I consulted a traditional Chinese medicine practitioner, and after taking herbal medicine, I no longer experienced diarrhea and had regular bowel movements once a day.
However, I still felt a dull pain in the lower left abdomen, and some stools were thinner.
I suspect this discomfort may be due to a sensitive sigmoid colon or the varicocele affecting my abdominal discomfort.

I would like to ask the doctor what might be causing the dull pain in my lower left abdomen and whether I need to undergo surgery for the varicocele.
I am eager to proceed with the surgery, as I feel that the varicocele may be affecting lower limb circulation and causing chronic pelvic or prostate inflammation that is difficult to resolve.
However, most urologists I have encountered have been rather casual.
Currently, I am considering seeing Dr.
Yang Zhi-hsien at the Veterans General Hospital for an examination.
Should I wait and observe, or should I see a doctor? If I need to see a doctor, which specialty should I consult, and what examinations should I undergo?

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Xiao Wei, 20~29 year old female. Ask Date: 2021/02/12