Question: Hi,
I am a 27 year old Male.
I am suffering from some pain in the testicular region (mostly when I sit down) and also discomfort while wearing undergarments.

Here is a little bit of background:
I suffered a lower back injury while working out, 2 years ago which was resolved with physiotherapy. I experienced severe testicular sensitivity for the first time while smoking marijuana and every time after that.
All the Ultrasound scans were normal, no torsion and nothing in the urine/blood examination. It went away after a couple of months.

Now, fast forward to about a couple of months ago, I injured my lower back again and had to get physiotherapy for the same. That cleared up.

But exactly a week after that, one day I felt severe discomfort in the testicular region which would only resolve if I removed my undergarments. Consulted a urologist and got scans done, but again there was no result. Have been put on a painkiller and antibiotics because the urologist observed some tenderness and a lot of pain on examination. Blood and urine cultures are all normal.

I am a non-smoker, non-drinker.
However, I do have a regular partner who had some form of an infection, around the same time that my problems began. A gynaecologist advised both of us to take Fas-3-kit.

Could someone please help me figure out what could be the cause of it? It's been a couple of weeks and I am unable to lead a normal life.

Hi,
I am a 27 year old Male.
I am suffering from some pain in the testicular region (mostly when I sit down) and also discomfort while wearing undergarments.

Here is a little bit of background:
I suffered a lower back injury while working out, 2 years ago which was resolved with physiotherapy. I experienced severe testicular sensitivity for the first time while smoking marijuana and every time after that.
All the Ultrasound scans were normal, no torsion and nothing in the urine/blood examination. It went away after a couple of months.

Now, fast forward to about a couple of months ago, I injured my lower back again and had to get physiotherapy for the same. That cleared up.

But exactly a week after that, one day I felt severe discomfort in the testicular region which would only resolve if I removed my undergarments. Consulted a urologist and got scans done, but again there was no result. Have been put on a painkiller and antibiotics because the urologist observed some tenderness and a lot of pain on examination. Blood and urine cultures are all normal.

I am a non-smoker, non-drinker.
However, I do have a regular partner who had some form of an infection, around the same time that my problems began. A gynaecologist advised both of us to take Fas-3-kit.

Could someone please help me figure out what could be the cause of it? It's been a couple of weeks and I am unable to lead a normal life.

Hi Dr. XXXXXXX

Thanks for writing in and clearing that up.
It's great to be able to find some sort of clarity regarding the issue.

The inflammation of the spermatic cord or funiculitis that you mentioned, doesn't show up in any of these tests is it? Even if there is no sign of infection or trauma, can this still occur? What could be the cause of the same?

I also have a strange pulling sensation in the left inguinal region whenever I am seated or I try to bend my legs. Do you think that these two are related?

Also, do you recommend I stop any and all sexual activity during the period?

I am also planning to start swimming as I feel I have gained weight in the past couple of months due to the lower back issue. Would you recommend that I do so?

Please let me know.
Thanks!

Hi Dr. XXXXXXX

Thanks for writing in and clearing that up.
It's great to be able to find some sort of clarity regarding the issue.

The inflammation of the spermatic cord or funiculitis that you mentioned, doesn't show up in any of these tests is it? Even if there is no sign of infection or trauma, can this still occur? What could be the cause of the same?

I also have a strange pulling sensation in the left inguinal region whenever I am seated or I try to bend my legs. Do you think that these two are related?

Also, do you recommend I stop any and all sexual activity during the period?

I am also planning to start swimming as I feel I have gained weight in the past couple of months due to the lower back issue. Would you recommend that I do so?

Please let me know.
Thanks!

Hi Doctor.

Thanks a lot for your answers. I have just a few more queries.

I'm on my 8th day of antibiotics (Levoday) and Naproxen (day 5) and the pain and discomfort seemed to have reduced yesterday but then today, it is back again.

I did not go for swimming today, but apart from that, there has been no difference in my routine.

Basically, I now only have pain mostly in the underside of the right testes when I sit down beyond a specified time period. I have also started using an icepack to help control the inflammation.

Does masturbation/ejaculation cause aggravation of the condition? Would you suggest that I refrain from the same during the treatment?

Thanks.

Hi Doctor.

Thanks a lot for your answers. I have just a few more queries.

I'm on my 8th day of antibiotics (Levoday) and Naproxen (day 5) and the pain and discomfort seemed to have reduced yesterday but then today, it is back again.

I did not go for swimming today, but apart from that, there has been no difference in my routine.

Basically, I now only have pain mostly in the underside of the right testes when I sit down beyond a specified time period. I have also started using an icepack to help control the inflammation.

Does masturbation/ejaculation cause aggravation of the condition? Would you suggest that I refrain from the same during the treatment?

Thanks.

Thank you for the answer, doctor. I will follow your advice.

So I am to continue with Naproxen (2x daily) and Levoday (1x daily) for one more week?
I am also taking Pregabalin (1x daily) for some hot and cold sensation along my left outer thigh which seems to have been aggravated by my lower back injury.

Thank you for the answer, doctor. I will follow your advice.

So I am to continue with Naproxen (2x daily) and Levoday (1x daily) for one more week?
I am also taking Pregabalin (1x daily) for some hot and cold sensation along my left outer thigh which seems to have been aggravated by my lower back injury.

Hi Doctor,

Had a follow-up consultation with another urologist and he performed a rectal examination, after a scrotal examination.

He advised me to go for another ultrasound scan, which I did.
Turns out that I have a left varicocele and some cysts in the epididymis.

He also mentioned that I seem to have epididymo-orchitis and tenderness in the prostate and testicular region possibly caused by a low-grade infection.

He has changed my medications and put me on Augmentin 625 (BD), Endemol and Chymerol Forte (3x daily) and advised 3-days of bed rest along with using some icepacks.

I'm a little confused now as to how this diagnosis is different and would like your opinion regarding the same. I am attaching the reports for the same.

Please take a look and let me know your thoughts. It is getting increasingly difficult to get a definitive diagnosis and course of treatment for the same.

Thanks.

Hi Doctor,

Had a follow-up consultation with another urologist and he performed a rectal examination, after a scrotal examination.

He advised me to go for another ultrasound scan, which I did.
Turns out that I have a left varicocele and some cysts in the epididymis.

He also mentioned that I seem to have epididymo-orchitis and tenderness in the prostate and testicular region possibly caused by a low-grade infection.

He has changed my medications and put me on Augmentin 625 (BD), Endemol and Chymerol Forte (3x daily) and advised 3-days of bed rest along with using some icepacks.

I'm a little confused now as to how this diagnosis is different and would like your opinion regarding the same. I am attaching the reports for the same.

Please take a look and let me know your thoughts. It is getting increasingly difficult to get a definitive diagnosis and course of treatment for the same.

Thanks.