Testicular and Prostate Inflammation: Causes and Concerns

Q: Testicular and Prostate Inflammation: Causes and Concerns

Excessive exercise leading to excessive sweating and reduced urine output should be avoided, especially in your case. <br>Additionally, prolonged activities such as cycling, DIY projects, or sexual intercourse, along with high stress levels, insufficient sleep, and poorly managed

Unexplained Orchitis and Prostatitis

Hello doctor, I would like to explain from the beginning.
Starting from July 12, when I went to work, I suddenly experienced discomfort and pain in my right testicle.
Later, I visited a urology clinic in San Chong, New Taipei City, where the doctor performed an ultrasound and diagnosed me with testicular inflammation (orchitis).
He prescribed antibiotics for me.
After taking them for a few days, I felt some improvement, but there was still a bit of discomfort.
I had several follow-up visits during which the doctor prescribed different antibiotics.
By August 28, I decided to see a urologist at Renai Hospital, where the doctor advised me to stop taking antibiotics.
Interestingly, around that time, the discomfort in my testicle decreased significantly.
During this period, I also visited Shudian Clinic, where I underwent ultrasound and urinalysis, but no bacteria were detected.
However, starting from late August, I began to experience frequent urination.
On September 11, I returned to the urology clinic in San Chong for another consultation, this time with a different doctor.
I informed him about my frequent urination and occasional sensation of urinary leakage (sometimes I feel a slight urge to leak urine suddenly while sitting).
I also mentioned that my previous issue was discomfort in the right testicle, but now it has changed to frequent urination and unexplained leakage.
The doctor diagnosed me with prostatitis and suggested that bacteria might be present in the prostate, making it difficult to detect through urinalysis.
He prescribed Ciflodal F.C.
Tablets, Harnalidge D Tablets, and Oxbu Extended-Release for me.
After taking the medication, I experienced less frequent urination, but sometimes I still feel the urge, especially after bowel movements, where I still feel like I need to urinate but cannot.
Occasionally, while sitting or stopping at a red light on my motorcycle, I feel a slight sensation of leakage, and sometimes while standing, but it hasn’t resulted in wetting my underwear.
The doctor advised me to finish the medication and return for a follow-up on September 25.
Throughout this period, I have not engaged in any sexual activity.
I have undergone multiple urinalyses at the urology clinic in San Chong, Shudian Clinic, and Renai Hospital, all of which showed no bacteria.
I would like to know why I suddenly developed orchitis and prostatitis.
Could it be related to prolonged periods of masturbation without ejaculation? My right testicle still occasionally feels uncomfortable, mostly after ejaculation, but it is much better compared to July and August, and most of the time, it feels normal.
Due to the occasional discomfort in my right testicle and the leakage, I am hesitant to ride a bicycle or engage in weight training.
I would like to hear the doctor’s opinion on these symptoms.
(The urology clinic in San Chong conducted blood tests, showing β-HCG <0.60, AFP 5.67, and LDH 304.
The doctor mentioned that there are many reasons for elevated LDH and advised me to follow up.)

De, 20~29 year old female. Ask Date: 2023/09/17

Dr. Li Xinyi reply Urology

Excessive exercise leading to excessive sweating and reduced urine output should be avoided, especially in your case.
Additionally, prolonged activities such as cycling, DIY projects, or sexual intercourse, along with high stress levels, insufficient sleep, and poorly managed chronic conditions, can contribute to persistent infections of the reproductive and urinary systems.

Reply Date: 2023/09/17

More Info

Understanding testicular and prostate inflammation can be complex, especially when symptoms overlap and diagnostic tests yield inconclusive results. Based on your detailed account, it appears you are experiencing a combination of testicular discomfort, urinary frequency, and potential prostate issues, which can be interconnected.

Testicular Inflammation (Orchitis)
Your initial diagnosis of testicular inflammation (orchitis) is often caused by infections, trauma, or autoimmune responses. In your case, the ultrasound indicated swelling, and the prescription of antibiotics suggests a bacterial infection was suspected. It's important to note that even after treatment, some individuals may continue to experience discomfort due to residual inflammation or other underlying issues.
The fact that your discomfort improved after stopping antibiotics could indicate that the inflammation was resolving on its own or that the antibiotics were not necessary for your condition. However, persistent discomfort, especially after ejaculation, can suggest that the inflammation may not be entirely resolved or that there could be another underlying issue, such as a chronic condition or nerve irritation.

Prostate Inflammation (Prostatitis)
Your symptoms of frequent urination and a sensation of incomplete bladder emptying are classic signs of prostatitis, which can be acute or chronic. Chronic prostatitis can be particularly challenging to diagnose and treat, as it may not always present with clear bacterial infections detectable in urine tests. The prostate can harbor bacteria that are difficult to culture, leading to a diagnosis of chronic pelvic pain syndrome (CPPS) when no infection is found.

The medications prescribed, such as Ciflodal (an antibiotic), Harnalidge (an alpha-blocker), and Oxbu (an anticholinergic), are aimed at alleviating symptoms associated with prostatitis and improving urinary flow. The fact that your urinary symptoms have improved with medication is a positive sign, but the lingering sensation of urgency and occasional leakage may require further evaluation.

Possible Connections
You raised an interesting point regarding the relationship between your symptoms and prolonged periods of sexual arousal without ejaculation. This can lead to a condition known as "blue balls," where the testicles become congested with blood and can cause discomfort. While this is typically a temporary condition, chronic congestion could potentially lead to inflammation or discomfort.

Moreover, psychological factors such as anxiety about your symptoms can exacerbate physical sensations, leading to a cycle of discomfort and concern. It’s crucial to address both the physical and psychological aspects of your health.

Recommendations
1. Follow-Up with a Specialist: Since your symptoms are persisting, consider seeking a second opinion from a urologist who specializes in chronic pelvic pain or prostatitis. They may recommend additional tests, such as a prostate massage to check for inflammation or further imaging studies.

2. Lifestyle Modifications: Avoid activities that exacerbate your symptoms, such as cycling or heavy lifting, until you have a clearer understanding of your condition. Regular, gentle exercise can help maintain overall health without straining your pelvic area.

3. Pelvic Floor Exercises: Engaging in pelvic floor exercises (Kegel exercises) can strengthen the muscles around the bladder and prostate, potentially alleviating some urinary symptoms.

4. Psychological Support: If anxiety about your symptoms is affecting your quality of life, consider speaking with a mental health professional. Cognitive-behavioral therapy (CBT) can be effective in managing health anxiety.

5. Monitor Symptoms: Keep a detailed log of your symptoms, including any triggers, frequency of discomfort, and urinary patterns. This information can be invaluable for your healthcare provider in tailoring your treatment plan.

In conclusion, while your symptoms may seem daunting, they are not uncommon, and with the right approach, many individuals find relief. It’s essential to remain proactive in your healthcare and advocate for further evaluations if your symptoms persist.

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